Reduced nasal growth after primary nasal repair combined with cleft lip surgery

Yoshimura, Yoko; Okumoto, Takayuki; Iijima, Y.; Inoue, Yoshikazu

doi:10.1016/j.bjps.2015.06.014

Cited by 20 publications

(21 citation statements)

References 8 publications

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“…The easiest evidence to evaluate is when PR recipients were compared with patients who only had a lip repair, leaving the nose untouched. 16,24,25,27,29 The aforementioned studies had follow-up periods ranging from 5 to 10 years. Morselli et al 25 showed a significantly improved nostril thickness and decrease in septal deviation in those undergoing primary repair.…”

Section: Discussionmentioning

confidence: 99%

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Primary cleft rhinoplasty: A systematic review of results, growth restriction, and avoiding secondary rhinoplasty

Zelko

Zielinski

Santiago

et al. 2022

Plastic &Amp; Reconstructive Surgery

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ince the first reports of cleft lip repair, surgeons have continued to innovate to maximize functional and aesthetic results. During a large portion of this time, there was a fear that correcting the cleft nasal deformity would disturb nasal or maxillary development. In the 1950s, Gelbke 1 challenged this idea by performing a primary rhinoplasty during cleft repair. His invasive approach ultimately led to poor results, which propagated concerns about early nasal interventions. Embryologic research by Latham 2 in 1970 led to further apprehension regarding primary rhinoplasty through the "septal concept of facial growth." His experiments demonstrated that the nasal septum, by means of the septopremaxillary ligament, transmits a force that induces growth of the maxilla.In the 1970s, physicians began to revisit primary rhinoplasty (PR) during cleft lip repair.McComb postulated that the procedure could Background: Primary rhinoplasty during correction of unilateral cleft lip continues to be a topic of debate because of concerns that early nasal intervention may affect nasal and maxillary development over the long term. This study aims to determine the volume and quality of evidence for and against primary unilateral cleft rhinoplasty. Methods: A systematic review was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were pulled from PubMed and EMBASE and screened by title and abstract. Studies with human participants undergoing rhinoplasty at the time of unilateral cleft lip repair and some evaluation of the nasal outcome were included. Studies with a large proportion of syndromic patients, case reports, editorials, letters, reviews, studies exclusive to bilateral clefts, and studies not available in English were excluded. Those that met criteria were then systematically reviewed. Results: Twenty-five articles were included. Ten articles that assessed the results of primary rhinoplasty subjectively all supported cleft lip repair with primary rhinoplasty. Sixteen articles assessed the results of primary rhinoplasty objectively, with 15 supporting primary rhinoplasty during cleft lip repair. Eight of nine studies that evaluated nasal growth and development over time found no restriction in nasal development. Five studies with a follow-up period of at least 6 years found that the percentage of patients who avoided revision rhinoplasty ranged from 43% to 100%. There were significant risks of bias in the majority of studies. Conclusion:The majority of studies reviewed support that primary rhinoplasty during unilateral cleft lip repair results in good outcomes with limited or no effect on nasal growth.

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Section: Discussionmentioning

confidence: 99%

“…However, the majority of the included studies used conventional 2D photography. 11,17,18,23,24,[26][27][28][29]32 2D photography requires rigorous standardization and can suffer from differences in lighting, camera distance, and focal length. This makes 2D photography a more challenging medium to use for objective measurements.…”

Section: Nasal Anthropometricsmentioning

confidence: 99%

Primary cleft rhinoplasty: A systematic review of results, growth restriction, and avoiding secondary rhinoplasty

Zelko

Zielinski

Santiago

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…A recent study of Yoshimura et al . [ 23 ] suggests that performing nasal repair at the time of primary cleft lip surgery adversely affects nose growth. By contrast, many studies have reported normal nose growth after primary rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…[ 24 25 ] Yoshimura et al . [ 23 ] performed an observational study with a small sample size. This issue remains controversial and requires better scientific evidence in future.…”

Section: Discussionmentioning

confidence: 99%

Primary unilateral cleft lip nasal deformity repair using V-Y-Z plasty: An anthropometric study

Rossell-Perry

2017

Indian J Plast Surg

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Background:Secondary nose deformity after unilateral cleft lip repair is a common problem. Loss of tip projection on the cleft side of unilateral cleft lip nasal deformity can be difficult to correct due to lack of adequate support. The purpose of this study is to evaluate the surgical outcome after using V-Y-Z plasty to address unilateral cleft lip nasal deformities.Methods:A cross-sectional study of one surgeon's outcome of 58 performed primary complete unilateral cleft lip nasal deformity repairs. All these patients met the study criterion of having anthropometric measurements at the cleft and non-cleft side of the nose performed at least 1 year postoperatively.Results:Since 2012, 32 consecutive patients have undergone primary anatomical repair of the cleft nasal deformity in patients with a complete unilateral cleft. We have not found statistically significant differences between the cleft and non-cleft nostril dome height and columella length measured at least 1 year postoperatively.Conclusions:The findings suggest that the V-Y-Z plasty is a good alternative to create a more symmetric nasal tip in patients with primary unilateral cleft lip nasal deformity. Additional studies are required to evaluate functional and long-term outcomes after primary rhinoplasty in patients with unilateral cleft lip.

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“…A review on primary cleft rhinoplasty (Gudis and Patel, 2014) has concluded that this procedure reduces the frequency and magnitude of intermediate and definitive operations. A recent study from Japan (Yoshimura et al, 2015) where nasal growth evaluation using lateral cephalograms has been done to assess cases with and without primary rhinoplasty, growth of the nose was found to be adversely affected in the primary rhinoplasty cases. Although this study had a follow-up duration of 5 and 10 years, the sample size was very small—only 14 patients with and 12 without primary rhinoplasty.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Closed Versus Open Technique of Rhinoplasty During Primary Repair of Unilateral Cleft Lip: A Systematic Review

Jayarajan

Natarajan²,

Nagamuttu³

2018

The Cleft Palate Craniofacial Journal

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Reduced nasal growth after primary nasal repair combined with cleft lip surgery

Cited by 20 publications

References 8 publications

Primary cleft rhinoplasty: A systematic review of results, growth restriction, and avoiding secondary rhinoplasty

Primary cleft rhinoplasty: A systematic review of results, growth restriction, and avoiding secondary rhinoplasty

Primary unilateral cleft lip nasal deformity repair using V-Y-Z plasty: An anthropometric study

Outcomes of Closed Versus Open Technique of Rhinoplasty During Primary Repair of Unilateral Cleft Lip: A Systematic Review

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