Influence of the Number of Revision Surgeries and Nasal Symmetry After Final Rhinoplasty for Patients With Cleft Lip.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
01 Oct 2023
01 Oct 2023
Historique:
received:
30
10
2022
accepted:
24
05
2023
pubmed:
15
8
2023
medline:
15
8
2023
entrez:
15
8
2023
Statut:
ppublish
Résumé
The effects of operative intervention on vertical nasal growth in patients with unilateral cleft lips (CLs) are well described. However, the factors influencing nasal symmetry have not been sufficiently evaluated. Therefore, this study aimed to study the factors that cause difficulties in obtaining nasal symmetry postoperatively in patients with CLs. We conducted a retrospective analysis using data from patients with CLs who underwent a series of treatments at Keio University Hospital from 1990 to 2000. We collected data on the patients' sex, cleft type, number and time of revision surgery, palatal fistula incidence, and history of the pharyngeal flap and orthognathic surgery. Nasal symmetry was analyzed as the symmetrical ratio after the final touch-up surgery, and multivariate analysis was conducted using binary logistic regression to determine the factors affecting nasal symmetry. This study included 89 patients with unilateral CL. Multivariate analysis revealed that complete cleft lip and palate ( P < 0.05, odds ratio = 4.37) and repeated revision surgery ( P < 0.05, odds ratio = 9.28) were significant predictors of the final nasal symmetry. Our study showed that cleft type and the number of revision surgeries were identified as important factors for obtaining nasal symmetry after final touch-up rhinoplasty. Revision surgery may be necessary to relieve patients' psychological stress due to nasal deformity, suggesting that this dilemma needs to be overcome.
Identifiants
pubmed: 37582287
doi: 10.1097/SCS.0000000000009577
pii: 00001665-990000000-00950
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2129-2132Informations de copyright
Copyright © 2023 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Salyer KE. Primary correction of the unilateral cleft lip nose: a 15-year experience. Plast Reconstr Surg 1986;77:558–568
Kane AA, Pilgram TK, Moshiri M, et al. Long-term outcome of cleft lip nasal reconstruction in childhood. Plast Reconstr Surg 2000;105:1600–1608
Byrd HS, Salomon J. Primary correction of the unilateral cleft nasal deformity. Plast Reconstr Surg 2000;106:1276–1286
Schnitt DE, Agir H, David DJ. From birth to maturity: a group of patients who have completed their protocol management. Part I. Unilateral cleft lip and palate. Plast Reconstr Surg 2004;113:805–817
Kim SK, Cha BH, Lee KC, et al. Primary correction of unilateral cleft lip nasal deformity in Asian patients: anthropometric evaluation. Plast Reconstr Surg 2004;114:1373–1381
Seo HJ, Denadai R, Vamvanij N, et al. Primary rhinoplasty does not interfere with nasal growth: a long-term three-dimensional morphometric outcome study in patients with unilateral cleft. Plast Reconstr Surg 2020;145:1223–1236
Anderl H, Hussl H, Ninkovic M. Primary simultaneous lip and nose repair in the unilateral cleft lip and palate. Plast Reconstr Surg 2008;121:959–970
Yoshimura Y, Okumoto T, Iijima Y, et al. Reduced nasal growth after primary nasal repair combined with cleft lip surgery. J Plast Reconstr Aesthet Surg 2015;68:e159–66
Fujimoto T, Imai K, Hatano T, et al. Follow-up of unilateral cleft-lip nose deformity after secondary repair with a modified reverse-U method. J Plast Reconstr Aesthet Surg 2011;64:747–953
Reddy SG, Devarakonda V, Reddy RR. Assessment of nostril symmetry after primary cleft rhinoplasty in patients with complete unilateral cleft lip and palate. J Craniomaxillofac Surg 2013;41:147–152
Liu CS, Hsiao YC, Huang JJ, et al. Secondary unilateral cleft rhinoplasty using natural curvature of rib cartilage as alar rim graft: a three-dimensional evaluation of long-term results. Plast Reconstr Surg 2020;145:775–779
Zhang Z, Huang TC, He Y, et al. Modified use of costal cartilage in Asians for the correction of nostril asymmetry in unilateral secondary cleft lip nasal deformity. Ann Plast Surg 2021;86:175–181
Nakajima T, Tamada I, Miyamoto J, et al. Straight line repair of unilateral cleft lip: a new operative method based on 25 years experience. J Plast Reconstr Aesthet Surg 2008;61:870–878
Bardach J. Two-flap palatoplasty: Bardach’s technique. Operative Tech Plast Reconstr Surg 1995;2:211–214
Boyne PJ, Sands NR. Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg 1972;30:87–92
Tajima S, Maruyama M. Reverse U incision for secondary repair of cleft lip nose. Plast Reconstr Surg 1977;60:256–261
Chouairi F, Torabi SJ, Gabrick KS, et al. Secondary cleft rhinoplasty in 1720 patients: are national practices consistent with guidelines. Cleft Palate Craniofac J 2020;57:438–443
Tse RW, Mercan E, Fisher DM, et al. Unilateral cleft lip nasal deformity: foundation-based approach to primary rhinoplasty. Plast Reconstr Surg 2019;144:1138–1149