Radiologic Evaluation of the Influence of Cleft Type on Nasal Dorsum Growth

AbstractPurposeThe study was designed to evaluate whether intrinsic morphological characteristics of the nasal dorsum are affected by cleft type, specifically cleft lip only (CL) and cleft lip with cleft palate(CL/P).Methods576 cleft patients (278 CL only, 298 CL/P), and 333 individuals without orofacial clefts were retrospectively enrolled. Lateral cephalometric radiographs of all individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn’s test was used to analyze the difference (p < 0.001).ResultsIn CL and control, the angulation of the nasal bone and nasal dorsum increase by age similarly (5y-18y, p>0.05). In CL, the total dorsal length is significantly shorter (5y-18y, p<0.001). Although the upper nasal dorsum is similar (except in 5y-6y), the lower nasal dorsum is shorter (5y-18y, p<0.001).In CLP, there is no significant difference in the nasal bone angle compared with controls between 5y-7y. However, it develops insufficiently as children grow (8y-18y, p<0.001). The nasal dorsum angle is notably smaller (5y-18y, p<0.001). Nasal bone length is not significantly different from control at all stages except during ages 11y-13y (p<0.05). Total nasal dorsal length is similar to the control at skeletal maturity (17y-18y, p>0.05), although it is shorter during 8y to 16y (p<0.05). The upper nasal dorsum is overdeveloped (14y-18y, p<0.05), whereas the lower nasal dorsum is underdeveloped (5y-18y, p<0.001).ConclusionCL inhibits the growth of nasal dorsum length, leading to short nose deformity. CL/P patients are prone to saddle-nose deformity because of the diminished nasal height (decreased nasal angle).

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Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620962693 ◽

2020 ◽

pp. 105566562096269

Author(s):

Lingling Pu ◽

Renkai Liu ◽

Bing Shi ◽

David W. Low ◽

Chenghao Li

Keyword(s):

Cleft Lip ◽

Skeletal Maturity ◽

Nasal Bone ◽

Nasal Dorsum ◽

Orofacial Clefts ◽

Repair Technique ◽

Radiologic Evaluation ◽

Nasal Bone Length ◽

The Difference ◽

Nasal Length

Objective: The study addresses whether the growth of the nasal dorsum is disturbed by cleft treatments, for cleft lip only (CL) and cleft lip with cleft palate (CLP). Design: A total of 576 patients with cleft (278 CL, 298 CLP) and 333 individuals without orofacial clefts were retrospectively enrolled. Cleft lip only group was treated with a modified Millard technique combined with Tajima incision for rhinoplasty at 3 to 6 months. The CLP group underwent the same lip repair technique and then underwent a Sommerlad palatoplasty at 9 to 12 months. Lateral cephalometric radiographs of all individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn test was used to analyze the difference ( P < .001). Results: Compared with control, in CL, nasal bone angle and nasal dorsum angle increase by age similarly (5-18 years, P > .05); the total dorsum is significantly shorter (5-18 years, P < .001), while the upper nasal dorsum length is similar (except in 5-6 years), and the lower nasal dorsum is shorter (5-18 years, P < .001). In CLP, nasal bone angle develops insufficiently as children grow (8-18 years, P < .001); the nasal dorsum angle is notably smaller (5-18 years, P < .001); nasal bone length is not significantly different except 11 to 13 years ( P < .05); nasal dorsal length is similar at skeletal maturity (17-18 years, P > .05), although it is shorter during 8 to 16 years ( P < .05); the upper nasal dorsum is overdeveloped (14-18 years, P < .05), whereas the lower nasal dorsum is underdeveloped (5-18 years, P < .001). Conclusion: Treatments in both CL and CLP could be the important factors in disturbing the growth of cartilaginous portion of the nasal dorsum (including nasal tip) and the nasal dorsum height.

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Nasal Dorsum Skin Expansion for Reconstruction of Saddle Nose Due to Gunshot Injury: A Case Report

Canadian Journal of Plastic Surgery ◽

10.1177/229255030501300304 ◽

2005 ◽

Vol 13 (3) ◽

pp. 148-150 ◽

Cited By ~ 1

Author(s):

Serdar Ozturk ◽

Fatih Zor ◽

Mustafa Sengezer

Keyword(s):

Case Report ◽

Gunshot Injury ◽

Saddle Nose ◽

Nasal Dorsum ◽

Skin Expansion ◽

Saddle Nose Deformity ◽

Nose Deformity ◽

Nasal Implant ◽

Skin Healing

Saddle nose deformity due to gunshot injury is a challenging problem for the maxillofacial surgeon. Because of the severe damage to the soft and bony tissues, the reconstructive options are very limited. In the present case report, a saddle nose deformity sustained from gunshot injury was reconstructed with a porous polyethylene nasal implant after a successful expansion of the nasal dorsum skin. Healing was uneventful at two-year follow-up, with superior patient satisfaction. Nasal dorsum skin expansion should be considered as an option in the reconstruction of moderately sized soft tissue deficits of the nose.

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