An Anatomical Study of the Three-Dimensional Structure of the Nasal Septum in Patients with Alveolar Clefts and Alveolar-Palatal Clefts

Nagasao, Tomohisa; Miyamoto, Junpei; Yasuda, Shohei; Ogata, Hisao; Imanishi, Yorihisa; Zhu, Xiaodong; Jiang, Hua; Ogawa, Kaoru; Nakajima, Tatsuo

doi:10.1097/prs.0b013e3181706f87

Cited by 28 publications

(29 citation statements)

References 14 publications

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“…Examinations with computer tomography (CT) have also revealed reduced nasal airway size in CLP patients [4]. An association between the severity of the cleft and the degree of the nasal septum deviation has been found in patients with UCLP examined by CT [5]. However, Reiser et al [6] found no correlation between initial cleft size and nasal airway size and airflow in patients treated for UCLP.…”

Section: Introductionmentioning

confidence: 99%

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate

Morén¹,

Mani

Lundberg³

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

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Section: Introductionmentioning

confidence: 99%

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate

Morén¹,

Mani

Lundberg³

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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“…CT and CBCT are mainly used for planning orthognathic surgery before and after treatment and for assessing anatomical differences in the nose [47], [56], [79], [81], [85]. These techniques are also used for treatment planning and measuring the results of bone grafting [30], [33]–[35], [46], [64], [73], [75], [77], [78], [89].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

et al. 2014

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BackgroundCurrent guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising.ObjectiveTo identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate.Data sourcesLiterature was searched using PubMed (1948–2012), EMBASE (1980–2012), Scopus (2004–2012), Web of Science (1945–2012), and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction.Study selectionWe included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included.Data extractionIndependent extraction of data and quality assessments were performed by two observers.ResultsFive hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time.ConclusionAvailable evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods. Further research is warranted to elucidate it.Systematic review registrationInternational Prospective Register of Systematic Reviews, PROSPERO CRD42012002041

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“…Because of its clinical importance, a wide range of studies concerning its treatment [1][2][3][4][5], morphological analysis [6], diagnosis [7], and aetiology [8], has been reported. Despite extensive research, few studies exist about the risk of facial fracture in patients with unilateral complete cleft palate.…”

Section: Introductionmentioning

confidence: 99%

Experimental evaluation of susceptibility to fractures of the orbital floor in patients with unilateral complete cleft palate

Nagasao

Miyamoto

Jiang

et al. 2010

Journal of Plastic Surgery and Hand Surgery

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We set out this study to verify a hypothesis that orbital floor fractures tend to affect wider areas in patients with unilateral complete cleft palate. Using a striking machine, the inferior orbital rims of eight normal skulls (intact skull group) and eight skulls with parts of the maxillas removed to simulate alveolar and palatal clefts (cleft skull group) were impacted. The fractured areas were compared. Models designed using a computer were produced to simulate the skulls of 12 normal people and 12 patients with left unilateral complete cleft palate, and were classified as the intact model group and the cleft model group, respectively. Computer simulation of applying external forces to the inferior orbital rim of each model was performed. Areas where stresses exceeded the bone-yielding threshold were compared. Actual fractured areas were significantly larger in the cleft skull group than in the intact skull group. Theoretical fracture areas were also significantly greater in the cleft model group than in the intact model group. We conclude that orbital floor fractures develop in wider areas in patients with unilateral complete cleft palates, because of the instability of the maxilla on the cleft side.

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An Anatomical Study of the Three-Dimensional Structure of the Nasal Septum in Patients with Alveolar Clefts and Alveolar-Palatal Clefts

Abstract: The nasal septa present different three-dimensional morphologic patterns between the patients with alveolar clefts only and those with alveolopalatal clefts. This difference should be considered when performing surgical treatments for these patients.

Cited by 28 publications

References 14 publications

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate

Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

Experimental evaluation of susceptibility to fractures of the orbital floor in patients with unilateral complete cleft palate

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