Long-Term Comparison of Four Techniques for Obtaining Nasal Symmetry in Unilateral Complete Cleft Lip Patients: A Single Surgeonʼs Experience

Chang, Ching-Ter; Por, Yong Chen; Liou, Eric Jein-Wein; Chang, Chee Jen; Kuo, John S.; Noordhoff, M. Samuel

doi:10.1097/prs.0b013e3181ec21e4

Cited by 130 publications

(126 citation statements)

References 14 publications

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“…For nose width, the result was 1.21, which is statistically in distinguishable from the results of group I from Chang et al 13 . Individually, with regard to nose width, the patients with incomplete cleft had an index of 1.07.…”

Section: Discussionsupporting

confidence: 55%

“…Data obtained in this study were compared to those obtai ned by Chang et al 13 , who divided their cleft patients into four groups, each of which was submitted to a different therapeutic approach. Group I patients were treated by rhino plasty without nasoalveolar molding (NAM); group II, NAM without intervention to the nose; group III, NAM with primary rhinoplasty; and group IV, NAM with extended primary rhinoplasty 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Group I patients were treated by rhino plasty without nasoalveolar molding (NAM); group II, NAM without intervention to the nose; group III, NAM with primary rhinoplasty; and group IV, NAM with extended primary rhinoplasty 13 . Regarding nose height, we observed that the general group formed by all our patients had a relationship of 0.83, resembling group II from Chang et al 13 Similar results were obtained even when we stratified the groups into complete and incomplete cleft.…”

Section: Discussionmentioning

confidence: 99%

“…Using the program Adobe Photoshop CS5 Extended ® , the nose area, nose height, nose width, height at ¼ of the medial width, and the height of the base of the nose 13 were calculated on the cleft and noncleft sides ( Figure 3).…”

Section: Methodsmentioning

confidence: 99%

“…A straight line was drawn between the most medial points of the lateral edges of the nostrils, on both the cleft and noncleft sides; in a similar manner, the highest nose height, the largest width, the height at ¼ of the medial width, and the height of the nose base 13 were measured. The measurements of the cleft side, in millimeters, were S1 (nose area), A1 (nose height), L1 (nose width), Alt 1 ¼ (height at ¼ of the medial width), and AB1 (height of the base of the nose).…”

Section: Methodsmentioning

confidence: 99%

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Avaliação de parâmetros antropométricos nasais após queiloplastia primária pela técnica de Mohler

Somensi¹,

Giancolli²,

Almeida³

et al. 2012

Rev. Bras. Cir. Plást.

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Background: Efforts to obtain the best possible results in the nasal region of cleft patients are an ongoing process; it is therefore essential to correctly diagnose any changes in the nasal anatomy of cleft palate patients that occur over time and after surgical intervention. The aims of the present study were: (1) to evaluate the percentage of nose asymmetry in patients with either complete or incomplete unilateral cleft lip and palate who underwent primary cleft lip repair with the Mohler technique, both in the immediate postoperative period (T1) and after 1 year (T2); and (2) to compare the percentage of nasal asymmetry in both postoperative periods using the same indexes in children without cleft lip and palate. Methods: During the period from March 2007 to December 2010, 27 patients with unilateral cleft lip and palate were submitted to primary cleft lip repair. Measurements of area, height, height at ¼ of the medial width, and height of the base of the nose were obtained from two-dimensional photos by using Adobe Photoshop CS5 Extended ® . Statistical comparison of the values obtained for nasal asymmetry in the immediate postoperative period and 1 year after surgery was performed with ANOVA. Results: Percentile indexes of nasal asymmetry for cleft patients showed statistical differences in all variables when compared to controls, with the exception being the base of the nose. Conclusions: The results we obtained showed an improvement in nasal symmetry, although there was a tendency to relapse from the result obtained in T1. Patients with complete cleft were more susceptible to relapse with regard to the position of the nose.Keywords: Cleft palate. Cleft lip. Reconstructive surgical procedures. RESUMO Introdução:Os esforços para obtenção de melhores resultados da região nasal de pacientes fissurados são contínuos, portanto é necessário o correto diagnóstico das alterações da anatomia nasal sofrida com o decorrer do tempo após uma intervenção cirúrgica. Os objetivos do presente estudo foram: 1) avaliar o porcentual de assimetria do nariz de pacientes portadores de fissura labiopalatina unilateral completa e incompleta submetidos a queiloplastia primária com a técnica de Mohler, no pós-operatório imediato (T1) e após um ano da cirurgia (T2); e 2) comparar o porcentual de assimetria nasal em ambos os períodos pós-operatórios com os mesmos índices obtidos em crianças não-portadoras de fissura labiopalatina. 15Assessment of nasal anthropometric parameters after primary cleft lip repair using the Mohler technique área, altura, largura, altura em ¼ medial da largura e altura da base narinar identificados na fotografia em duas dimensões por meio do programa Adobe Photoshop CS5 Extended ® . Foi utilizado o teste de ANOVA para comparação estatística entre os valores da assimetria nasal no pós-operatório imediato e um ano após a cirurgia. Resultados: Foram obtidos índices porcentuais de assimetria nasal entre os pacientes fissurados e o grupo controle, demonstrando diferença estatística em todas as variáve...

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Avaliação de parâmetros antropométricos nasais após queiloplastia primária pela técnica de Mohler

Somensi¹,

Giancolli²,

Almeida³

et al. 2012

Rev. Bras. Cir. Plást.

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History and current presurgical infant orthopedic treatment

Avinoam¹,

Shetye²

2022

Cleft and Craniofacial Orthodontics

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Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding

Aihara

Yanagawa

Sasaki

et al. 2021

Clinical & Exp Dental Res

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Objectives: In recent years, many studies have reported that the presurgical nasoalveolar molding method improves the nose morphology; however, the reason for its effectiveness after surgery has never been understood. We evaluated the effect of nasoalveolar molding by comparing it with a passive orthopedic method without a nasal stent and focusing on the nostril morphology after primary cheiloplasty using various measurement methods. We then analyzed the essential factors. Materials and methods:The patients involved were 31 infants with unilateral complete cleft lip and palate treated with primary cheiloplasty at the University of Tsukuba Hospital from 2004 to 2011. Of the 31 infants, 16 received nasoalveolar molding treatment and 15 received passive orthopedic treatment as controls. Photographic facial measurements were performed for all patients immediately and 7 months after primary cheiloplasty. The esthetics of the nostrils were assessed according to the left-right nostril symmetry, as measured by the Hausdorff distance, area ratio, perimeter ratio, and aspect a/u (the aspect ratio of the affected side)/(the aspect ratio of the unaffected side) ratio. In addition, the inclination of the nasal ridge was assessed using anthropometric measurements (Grc-Grn∠midline and mid-line∠columellar axis).Results: The area ratio, perimeter ratio, and Grc-Grn∠midline were significantly greater in the nasoalveolar molding group immediately after surgery (p = 0.00062, 0.016, and 0.048, respectively) than in the control group. However, the Hausdorff distance and aspect a/u ratio were more favorable (p = 0.0018 and 0.0039, respectively) in the nasoalveolar molding group after 7 months. Conclusions:The results of our study suggested that using nasoalveolar molding as a presurgical orthopedic treatment could improve the shape of the nasal cartilage with surgeon's corrections.

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Long-Term Comparison of Four Techniques for Obtaining Nasal Symmetry in Unilateral Complete Cleft Lip Patients: A Single Surgeonʼs Experience

Abstract: The results revealed that group IV had the best overall result. Overcorrection of 20 percent was necessary to maintain the nostril height. Further technical modifications are necessary to minimize widening of the nostril width.

Cited by 130 publications

References 14 publications

Avaliação de parâmetros antropométricos nasais após queiloplastia primária pela técnica de Mohler

Avaliação de parâmetros antropométricos nasais após queiloplastia primária pela técnica de Mohler

History and current presurgical infant orthopedic treatment

Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding

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