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Surgical technique for secondary correction of unilateral cleft lip-nose deformity: clinical and 3-dimensional observations of preoperative and postoperative nasal forms.
J Oral Maxillofac Surg. 2010 Sep; 68(9):2248-57.JO

Abstract

PURPOSE

Despite recent developments in cleft surgery, a surgical method for secondary correction of unilateral cleft lip-nose deformity has not yet been established. The purpose of this study was to describe the surgical techniques for secondary correction of unilateral cleft lip-nose deformity with 3-dimensional (3D) observations of preoperative and postoperative nasal forms.

PATIENTS AND METHODS

Secondary corrections of unilateral cleft lip-nose deformity were performed on 13 patients with a complete unilateral cleft lip and palate, and these patients were followed up for 1 year to more than 3 years. All patients were treated by open rhinoplasty through a bilateral reverse-U incision and transcolumellar incision, correction of the columella base with/without septoplasty, nasal tip cartilage graft, and medial-upward advancement of nasolabial components with vestibular expansion by free mucosal graft. Preoperative and postoperative nasal forms were observed by use of photos and 3D data obtained serially.

RESULTS

The postoperative nasal forms were improved in all patients. The preoperative 3D color images indicated asymmetry of the alar groove and nasal tip visually. The top of the alar groove on the cleft side was dislocated distally and downwardly, resulting in a small snub ala. The postoperative 3D color images showed symmetric nasal forms with the adequately recovered nasal tip projection and the appropriate circle of the nasal ala groove on the cleft side. There were no serious postoperative complications.

CONCLUSIONS

Repositioning of the nasalis muscle and sufficient expansion of the nasal vestibule as well as reconstruction of nasal cartilages are important for correction of unilateral cleft lip-nose deformity.

Authors+Show Affiliations

Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. nakamura@denta.hal.kagoshima-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19913968

Citation

Nakamura, Norifumi, et al. "Surgical Technique for Secondary Correction of Unilateral Cleft Lip-nose Deformity: Clinical and 3-dimensional Observations of Preoperative and Postoperative Nasal Forms." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 68, no. 9, 2010, pp. 2248-57.
Nakamura N, Okawachi T, Nishihara K, et al. Surgical technique for secondary correction of unilateral cleft lip-nose deformity: clinical and 3-dimensional observations of preoperative and postoperative nasal forms. J Oral Maxillofac Surg. 2010;68(9):2248-57.
Nakamura, N., Okawachi, T., Nishihara, K., Hirahara, N., & Nozoe, E. (2010). Surgical technique for secondary correction of unilateral cleft lip-nose deformity: clinical and 3-dimensional observations of preoperative and postoperative nasal forms. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 68(9), 2248-57. https://doi.org/10.1016/j.joms.2009.06.012
Nakamura N, et al. Surgical Technique for Secondary Correction of Unilateral Cleft Lip-nose Deformity: Clinical and 3-dimensional Observations of Preoperative and Postoperative Nasal Forms. J Oral Maxillofac Surg. 2010;68(9):2248-57. PubMed PMID: 19913968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical technique for secondary correction of unilateral cleft lip-nose deformity: clinical and 3-dimensional observations of preoperative and postoperative nasal forms. AU - Nakamura,Norifumi, AU - Okawachi,Takako, AU - Nishihara,Kazuhide, AU - Hirahara,Narihiro, AU - Nozoe,Etsuro, Y1 - 2009/11/13/ PY - 2009/03/12/received PY - 2009/06/25/accepted PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/9/17/medline SP - 2248 EP - 57 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J. Oral Maxillofac. Surg. VL - 68 IS - 9 N2 - PURPOSE: Despite recent developments in cleft surgery, a surgical method for secondary correction of unilateral cleft lip-nose deformity has not yet been established. The purpose of this study was to describe the surgical techniques for secondary correction of unilateral cleft lip-nose deformity with 3-dimensional (3D) observations of preoperative and postoperative nasal forms. PATIENTS AND METHODS: Secondary corrections of unilateral cleft lip-nose deformity were performed on 13 patients with a complete unilateral cleft lip and palate, and these patients were followed up for 1 year to more than 3 years. All patients were treated by open rhinoplasty through a bilateral reverse-U incision and transcolumellar incision, correction of the columella base with/without septoplasty, nasal tip cartilage graft, and medial-upward advancement of nasolabial components with vestibular expansion by free mucosal graft. Preoperative and postoperative nasal forms were observed by use of photos and 3D data obtained serially. RESULTS: The postoperative nasal forms were improved in all patients. The preoperative 3D color images indicated asymmetry of the alar groove and nasal tip visually. The top of the alar groove on the cleft side was dislocated distally and downwardly, resulting in a small snub ala. The postoperative 3D color images showed symmetric nasal forms with the adequately recovered nasal tip projection and the appropriate circle of the nasal ala groove on the cleft side. There were no serious postoperative complications. CONCLUSIONS: Repositioning of the nasalis muscle and sufficient expansion of the nasal vestibule as well as reconstruction of nasal cartilages are important for correction of unilateral cleft lip-nose deformity. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/19913968/Surgical_technique_for_secondary_correction_of_unilateral_cleft_lip_nose_deformity:_clinical_and_3_dimensional_observations_of_preoperative_and_postoperative_nasal_forms_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(09)01333-0 DB - PRIME DP - Unbound Medicine ER -