Does the Nostril Shape Change After Le Fort I Advancement in Patients With Unilateral Complete Cleft Lip?
| Autor: | Olivia C. Langa, Ingrid M. Ganske, Robin A. Tan, Bonnie L. Padwa, Carly E. Calabrese |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Maxillary hypoplasia Adolescent Cephalometry medicine.medical_treatment Nostril Cleft Lip Osteotomy 03 medical and health sciences 0302 clinical medicine Suture (anatomy) otorhinolaryngologic diseases medicine Maxilla Humans Osteotomy Le Fort In patient Retrospective Studies Orthodontics business.industry 030206 dentistry respiratory system Craniometry medicine.disease Sagittal plane Cleft Palate medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Case-Control Studies Surgery Oral Surgery business |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 78(6) |
| ISSN: | 1531-5053 |
| Popis: | Purpose Patients with unilateral cleft lip and palate (UCLP) may require Le Fort I advancement to correct maxillary hypoplasia after reaching skeletal maturity. The underlying cleft anatomy, previous operations, and scarring can affect nostril changes after maxillary advancement. The purpose of the present study was to determine whether Le Fort I advancement affects the nostril configuration (ie, width, axis, shape) in patients with UCLP. The specific aims were to (1) compare cleft and noncleft nostrils in patients with UCLP after maxillary advancement and (2) compare the changes in nostril configuration in patients with UCLP with those in noncleft controls after Le Fort advancement. Patients and Methods A retrospective case-control study of nonsyndromic, skeletally mature patients with UCLP and a case-matched control group without UCLP who had undergone single-piece Le Fort I advancement with alar cinch suture from 2010 to 2014. Patients were included if they had undergone pre- and postoperative 3-dimensional photogrammetry without intervening nasal revision. Three-dimensional anthropometry was used to evaluate changes in nostril axis and width, soft triangle angle, columellar show, and nasal width after orthognathic correction. Results The present study included 19 patients with UCLP (11 males; mean age, 18.0 years) and 19 noncleft controls (11 males; mean age, 18.7 years; P = .276). The mean sagittal advancement in the patients with UCLP and noncleft controls was 7.5 mm and 6.3 mm, respectively (P = .143). On average, the nostrils widened, the soft triangles flattened, and the columellar show increased. No significant difference was found in the changes to the nostril configuration between the cleft and noncleft sides in the patients with UCLP. No significant differences were found in the nostril changes between patients with UCLP and noncleft controls. Conclusions Baseline nostril asymmetry is not altered by Le Fort osteotomy in patients with UCLP because both nostrils respond similarly to the deforming forces of maxillary advancement. Similarly, no differences were found in the nostril changes between the cleft and noncleft controls. These findings can aid proper surgical planning for cleft nasal revisions. |
| Databáze: | OpenAIRE |
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