Rhinoplasty and Le Fort I Maxillary Osteotomy in Cleft Patients.
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:
20 Nov 2023
20 Nov 2023
Historique:
received:
04
01
2023
accepted:
09
10
2023
medline:
20
11
2023
pubmed:
20
11
2023
entrez:
20
11
2023
Statut:
aheadofprint
Résumé
Cleft patients often need orthognathic surgery to correct maxillary hypoplasia and rhinoplasty to correct nasal deformity. Rhinoplasty can be performed as a staged procedure after orthognathic surgery or simultaneously with maxillary osteotomy. The authors evaluated need for and complications of staged and simultaneous rhinoplasties in patients with different cleft types undergoing maxillary osteotomy. This retrospective study examined 99 (54 females) consecutive nonsyndromic patients with cleft lip/palate [23 bilateral cleft lip and palate (BCLP), 51 unilateral cleft lip and palate (UCLP), and 25 cleft palate (CP)] with a mean age of 17.8 (range: 11.5-45.3) years who had undergone Le Fort I maxillary advancement or bimaxillary osteotomy at the Cleft Palate and Craniofacial Center, Helsinki University Hospital, Finland, between 2002 and 2016. Medical charts were accessed through the hospital's archives and database. Of patients who underwent maxillary osteotomy, 45% (45/99) needed rhinoplasty (14 BCLP, 27 UCLP, and 4 CP). A significant difference (P<0.01) existed in the need for rhinoplasty between different cleft types, those with BCLP and UCLP needing the most operations (60% and 53%). In 20 patients (20%), rhinoplasty was performed simultaneously with maxillary osteotomy, and in 25 patients (25%) in a second operation after osteotomy. The overall complication rate was 14%. No difference existed in complication rate in patients with or without simultaneous rhinoplasty. Of cleft patients who underwent maxillary osteotomy, 45% needed rhinoplasty. Patients with BCLP and UCLP needed rhinoplasty most often. Staged and simultaneous procedures were almost equally common with similar complication rates.
Identifiants
pubmed: 37983115
doi: 10.1097/SCS.0000000000009873
pii: 00001665-990000000-01234
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2023 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Vasudavan S, Jayaratne YSN, Padwa BL. Nasolabial soft tissue changes after Le Fort I advancement. J Oral Maxillofac Surg 2012;70:e270–e277
Gil APS, Machado-Fernández A, Guijarro-Martínez R, et al. Le Fort I osteotomy and soft tissue response: a retrospective cohort study comparing three different techniques. J Craniomaxillofac Surg 2022;50:107–113
Wolfe SA, Nathan NR, MacArthur IR. The cleft lip nose: primary and secondary treatment. Clin Plast Surg 2016;43:213–221
Guyuron B. MOC-PS (SM) CME Article: Late cleft lip nasal deformity. Plast Reconstr Surg 2008;121(suppl):1–11
Allori AC, Mulliken JB. Evidence-based medicine: secondary correction of cleft lip nasal deformity. Plast Reconstr Surg 2017;140:166e
Sun AH, Steinbacher DM. Orthognathic surgery and rhinoplasty: simultaneous or staged? Plast Reconstr Surg 2018;141:322–329
Cottrell DA, Wolford LM. Factors influencing combined orthognathic and rhinoplastic surgery. Int J Adult Orthodon Orthognath Surg 1993;8:265–276
Seah TE, Bellis H, Ilankovan V. Orthognathic patients with nasal deformities: case for simultaneous orthognathic surgery and rhinoplasty. Br J Oral Maxillofac Surg 2012;50:55–59
Waite PD, Matukas VJ, Sarver DM. Simultaneous rhinoplasty procedures in orthognathic surgery. Int J Oral Maxillofac Surg 1988;17:298–302
Raffaini M, Cocconi R, Spinelli G, et al. Simultaneous rhinoseptoplasty and orthognathic surgery: outcome analysis of 250 consecutive patients using a modified Le Fort I osteotomy. Aesth Plast Surg 2018;42:1090–1100
McComb H. Treatment of the unilateral cleft lip nose. Plast Reconstr Surg 1975;55:596–601
Roy AA, Rtshiladze M, Stevens K, et al. Orthognathic surgery for patients with cleft lip and palate. Clin Plast Surg 2019;46:157–171
Good P, Mulliken J, Padwa B. Frequency of Le Fort I osteotomy after repaired cleft lip and palate or cleft palate. Cleft Palate Craniofac J 2007;44:396–401
Daskalogiannakis J, Mehta M. The need for orthognathic surgery in patients with repaired complete unilateral and complete bilateral cleft lip and palate. Cleft Palate Craniofac J 2009;46:498–502
Voshol IE, van der Wal KGH, van Adrichem LNA, et al. The frequency of Le Fort I osteotomy in cleft patients. Cleft Palate Craniofac J 2012;49:160–166
Heliövaara A, Leikola J, Hukki J. Craniofacial cephalometric morphology and later need for orthognathic surgery in 6-year-old children with bilateral cleft lip and palate. Cleft Palate Craniofac J 2013;50:35–40
Dalle Ore C, Schoenbrunner A, Brandel M, et al. Incidence of Le Fort surgery in a mature cohort of patients with cleft lip and palate. Ann Plast Surg 2017;78:199–203
Jacob L, Fahradyan A, Paulson P, et al. Orthognathic surgery rate in cleft care. J Craniofac Surg 2022;33:87–92
Heliövaara A, Rautio J. A comparison of craniofacial cephalometric morphology and the later need for orthognathic surgery in 6-year-old cleft children. J Craniomaxillofac Surg 2011;39:173–176
Antonarakis G, Watts G, Daskalogiannakis J. The need for orthognathic surgery in nonsyndromic patients with repaired isolated cleft palate. Cleft Palate Craniofac J 2015;52:8–13
Sykes JM, Tasman AJ, Suárez GA. Cleft lip nose. Clin Plast Surg 2016;43:223–235
Davidson E, Kumar AR. A preliminary three-dimensional analysis of nasal aesthetics following Le Fort I advancement in patients with cleft lip and palate. J Craniofac Surg 2015;26:e629–e633
Mustafa K, Shehzana F, Bhat HHK. Assessment of Alar flare and efficacy of Alar Cinch suture in the management of Alar flare following Le Fort 1 superior repositioning: a comparative study. J Maxillofac Oral Surg 2016;15:528–534
Marji FP, Bruce MK, Anstadt EE, et al. Changes to the cleft nose esthetic after Le Fort I advancement: a 3-dimensional analysis. FACE 2021;2:377–385
Lee CC, Peacock ZS. Is cleft lip or palate a risk factor for perioperative complications in orthognathic surgery? J Oral Maxillofac Surg 2022;80:276–284
Hwang DS, Choi HS, Kim UK, et al. Complications following orthognathic surgery for patients with cleft lip/palate. J Craniofac Surg 2019;30:1815–1819
Yamaguchi K, Lonic D, Lo LJ. Complications following orthognathic surgery for patients with cleft lip/palate: a systematic review. J Formos Med Assoc 2016;115:269–277
Panula K, Finne K, Oikarinen K. Incidence of complications and problems related to orthognathic surgery: a review of 655 patients. J Oral Maxillofac Surg 2001;59:1128–1136
Alaluusua S, Harjunpää R, Turunen L, et al. The effect of maxillary advancement on articulation of alveolar consonants in cleft patients. J Craniomaxillofac Surg 2020;48:472–476
Harjunpää R, Alaluusua S, Leikola J, et al. Le Fort I osteotomy in cleft patients: maxillary advancement and velopharyngeal function. J Craniomaxillofac Surg 2019;47:1868–1874
Kotaniemi KVM, Suojanen J, Palotie T. Peri- and postoperative complications in Le Fort I osteotomies. J Craniomaxillofac Surg 2021;49:789–798
Wang Z, Wang P, Zhang Y, et al. Nasal airway evaluation after Le Fort I osteotomy combined with septoplasty in patients with cleft lip and palate. J Craniofac Surg 2017;28:207–211
Kosyk MS, Zapatero ZD, Kalmar CL, et al. Nasal obstruction evaluation after Le Fort I osteotomy: a pilot study. J Craniofac Surg 2022;33:101
Semb G, Brattström V, Mølsted K, et al. The Eurocleft Study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 4: relationship among treatment outcome, patient/parent satisfaction, and the burden of care. Cleft Palate Craniofac J 2005;42:83–92
Roosenboom J, Hellings PW, Picavet VA, et al. Secondary cleft rhinoplasty: impact on self-esteem and quality of life. Plast Reconstr Surg 2014;134:1285–1292
Hens G, Picavet VA, Poorten VV, et al. High patient satisfaction after secondary rhinoplasty in cleft lip patients. Int Forum Allerg Rhinol 2011;1:167–172