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

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.

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

2019 ◽  
Author(s):  
Lingling Pu ◽  
Renkai Liu ◽  
Bing Shi ◽  
David W Low ◽  
Chenghao Li
Keyword(s):  
Cleft Lip ◽  
Skeletal Maturity ◽  
Nasal Bone ◽  
Morphological Characteristics ◽  
Saddle Nose ◽  
Nasal Dorsum ◽  
Radiologic Evaluation ◽  
Saddle Nose Deformity ◽  
Significant Difference ◽  
Nose Deformity

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).

scholarly journals An assessment of nasal and orbital parameters in human fetuses

2017 ◽  
Vol 5 (4) ◽  
pp. 1445
Author(s):  
Musa Acar ◽  
Ahmet Salbacak ◽  
Aynur E. Çiçekcibaşı ◽  
Mustafa Büyükmumcu ◽  
Tahir K. Şahin
Keyword(s):  
Nasal Bone ◽  
Reference Ranges ◽  
Third Trimester ◽  
Orbital Parameters ◽  
Biparietal Diameter ◽  
Significant Difference ◽  
Nasal Bone Length ◽  
The Difference ◽  
The Right ◽  
Turkish Community

Background: Nasal bone aplasia and hypoplasia have been reported on fetuses with aneuploidy. Trisomy 21 is one of the most common chromosomal abnormality detected in new-borns. The purpose of our study is to obtain data of some face parameters in Turkish fetal population and to contribute creation of reference ranges that may be used for prenatal diagnosis.Methods: This study was performed in 66 spontaneously aborted fetuses (47 second trimester and 19 third trimester) (28 male and 38 female) with no detectable external pathology or anomalies. Measurements were designed as nasal bone length (NBL), nose length (NL), nose width (NW), nostril width (NsW),                intraocular distance (IOD), innercanthal distance (ICD), outercanthal distance (OCD), orbital diameter (OD), biparietal diameter (BPD).Results: In comparison between genders, ICD and BPD averages were found significantly higher in male fetuses than female fetuses (P<0.05). There was not any statistically significant difference between averages of the values on the right and left. The difference between second and the third trimester was significant in terms of all parameters (P<0.05). A strong correlation was detected between gestational age and our parameters.Conclusions: Present study has contributed to create reference ranges of Turkish community. When importance of early diagnosis is considered, we believe that this data will be useful for clinicians.

Cross-Sectional Study of the Length of the Nasal Bone in Cleft Lip and Palate Subjects

2005 ◽  
Vol 42 (4) ◽  
pp. 417-422 ◽  
Author(s):  
Bo Werner Nielsen ◽  
Kirsten Mølsted ◽  
Lene Theil Skovgaard ◽  
Inger KjæR
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nasal Bone ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Male Adult ◽  
Female Ratio ◽  
Bone Length ◽  
Significant Difference ◽  
Nasal Bone Length

Objective The purpose of this study was to analyze the human nasal bone length in newborns and male adults with cleft lip (CL), cleft palate (CP), and unilateral cleft lip and palate (UCLP) and to compare the results to previous findings in prenatal material. Design This study was a radiographic profile cephalometric cross-sectional analysis. Subjects and Methods Profile radiographs from 60 newborns with a male-to-female ratio of 1:1 in each group (20 CL, 20 CP, and 20 UCLP) and 60 male adults (20 CL, 20 CP, and 20 UCLP) were randomly selected among radiographs, taken for optimizing the treatment planning. The nasal bone lengths (n-na) were measured with a digital caliper on the profile radiographs. To compare the nasal bone lengths in the different cleft groups, Student's t tests at a significant level at 5% were performed. Results Nasal bone length was significantly shorter in male adult patients with CL compared with patients with CP. Furthermore, the nasal bone length was significantly shorter in newborns with CL (2 months) compared to newborns with UCLP (2 months). A borderline significance was seen in the comparison of patients with CL and UCLP in male adults. There was no significant difference in the nasal bone length between the patients with CP and UCLP, in either the newborns or the male adults. Conclusions Nasal bone length was significantly shorter in subjects with CL compared with subjects in whom the palate was clefted. The results show that the clefted lip in CL is associated with a subjacent skeletal deviation in the upper midface.

Human Prenatal Nasal Bone Lengths: Normal Standards and Length Values in Fetuses with Cleft Lip and Cleft Palate

2005 ◽  
Vol 42 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Lene Hansen ◽  
Lene Theil Skovgaard ◽  
Dorrit Nolting ◽  
Birgit Fischer Hansen ◽  
Inger Kjær
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nasal Bone ◽  
Crown Rump Length ◽  
Bone Length ◽  
Foot Length ◽  
Nasal Bone Length ◽  
Isolated Cleft Palate ◽  
Normal Standards

Objective The aim of this study was to present prenatal autopsy standards for nasal bone length in normal fetuses, as well as to compare nasal bone lengths in human fetuses with cleft lip and palate with those standards. Material and Methods The material consisted of human fetuses investigated in connection with diagnosed and legally approved abortions and spontaneous abortions; 40 were normal and 26 had cleft lip and palate (7 isolated cleft lip, 12 isolated cleft palate, and 7 combined cleft lip and palate). Menstrual ages (MA) ranged from 12 to 25 weeks, crown-rump length (CRL) from 55 to 210 mm and foot length (FL) from 7 to 44 mm. All fetuses were radiographed in lateral projection, and, using these images, the nasal bone lengths were measured with a digital caliper. Regression analyses were performed. Results Standards for normal nasal bone length at different ages are expressed as menstrual age, crown-rump length, or foot length. Comparisons with normal standards showed that the isolated cleft lip group had a significantly smaller nasal bone length than the normal fetuses had. Fetuses with isolated cleft palate and fetuses with combined cleft lip and palate showed no significant deviation from normal standards. Conclusion Normal nasal bone standards can contribute to information on deviations in nasal bone length for aborted fetuses with known and unknown genotypes. The differences in nasal bone lengths in fetuses with different lip and palate clefting can contribute to understanding the pathogenesis of cleft lip and palate.

scholarly journals Immediate rehabilitation with feeding appliance of a three day old neonate with cleft lip and palate- a case report

2017 ◽  
Vol 13 (2) ◽  
pp. 293-295
Author(s):  
Deepika Kapoor ◽  
Deepanshu Garg
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Multidisciplinary Approach ◽  
Cleft Lip And Palate ◽  
Facial Growth ◽  
Orofacial Clefts ◽  
High Incidence ◽  
Negative Effect ◽  
Growth Development ◽  
Very High

Orofacial clefts (OFC) are one of the most common congenital problems seen with a very high incidence. It imparts a negative effect on the overall health of the child by hindering in his feeding practices, normal facial growth, development of dentition and hence speech. Infants born with orofacial clefts have oronasal communication which creates a problem with the creation of negative pressure inside the oral cavity required for suckling.The treatment for such patients is with the multidisciplinary approach but the preliminary  concern for the neonate is to help with the feeding for which a feeding appliance is given. This case report presents a case of a 3-day old infant to whom a feeding appliance was given to aid in suckling. 

Indications for Preservation Rhinoplasty: Avoiding Complications

2021 ◽  
Vol 37 (01) ◽  
pp. 045-052
Author(s):  
Mario Bazanelli Junqueira Ferraz ◽  
Guilherme Constante Preis Sella
Keyword(s):  
Nasal Bone ◽  
Nasal Dorsum ◽  
Ideal Candidate ◽  
Deviated Nose ◽  
Lateral Osteotomy ◽  
Upper Lateral Cartilage ◽  
High Radix ◽  
The One ◽  
Different Levels ◽  
The Ideal

AbstractNasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.

scholarly journals The nasal cantilever technique in children undergoing primary cleft lip surgery: novel concepts and review

2020 ◽  
Vol 5 (1-2) ◽  
pp. 53-62
Author(s):  
Badr M. I. Abdulrauf
Keyword(s):  
Learning Curve ◽  
Cleft Lip ◽  
Nasal Bone ◽  
Case Series ◽  
Nasal Deformity ◽  
Challenging Issue ◽  
Primary Surgery ◽  
Novel Concept ◽  
Cleft Nasal Deformity

AbstractBackgroundNasal deformity associated with cleft lip deformity is a challenging issue, encompassing controversies, theories, and a diversity of techniques. Historically, esthetic outcomes have ranged from being below expectations to barely acceptable.MethodBased on the concept that the nasal cartilaginous framework in clefts is similar to that of a collapsing pyramid, a novel suspension technique has been described. The entire cartilaginous structure is lifted from the infratip segment with a loop suture and is secured in a cantilever fashion onto the periosteum overlying the nasal bone. This part of the operation is performed in a semiclosed manner. The technique is applied during primary surgery in bilateral and unilateral nasal cleft lip deformities, with changes in the orientation of the cantilever loop suture. Studies conducted by Masters S. Tajima, H. McComb, H. Thomson, D. Fisher, and J. Mulliken, which are most relevant to this article, have been reviewed and discussed throughout.ResultsThe technique was first applied over 10 years ago. A case series of nine children whose parents consented to the developing technique is presented with follow-up ranging from months to years, along with technical descriptions and illustrative drawings. None of these cases had preoperative orthopedic correction, molding, or postoperative nostril splints. The esthetic outcome was optimal enough; none of the cases requested a secondary correction.ConclusionThe nasal cantilever technique is a novel concept in cleft nasal deformity, which can be used in conjunction with an appropriate lip technique, per the surgeon’s discretion. Other than a learning curve, we believe that it provides a solid correction by securing the cartilaginous structures after they have been mobilized to a stable base, the nasion.

scholarly journals Genome-wide meta-analyses of nonsyndromic orofacial clefts identify novel associations between FOXE1 and all orofacial clefts, and TP63 and cleft lip with or without cleft palate

2017 ◽  
Vol 136 (3) ◽  
pp. 275-286 ◽  
Author(s):  
Elizabeth J. Leslie ◽  
Jenna C. Carlson ◽  
John R. Shaffer ◽  
Azeez Butali ◽  
Carmen J. Buxó ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Orofacial Clefts ◽  
Genome Wide ◽  
Meta Analyses ◽  
Novel Associations

Variation of Fetal Nasal Bone Length in Second-Trimester Fetuses According to Race and Ethnicity

2005 ◽  
Vol 24 (11) ◽  
pp. 1487-1489 ◽  
Author(s):  
Carolyn M. Zelop ◽  
Elizabeth Milewski ◽  
Kimberly Brault ◽  
Peter Benn ◽  
Adam F. Borgida ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Nasal Bone ◽  
Second Trimester ◽  
Bone Length ◽  
Fetal Nasal Bone ◽  
Nasal Bone Length

Morphological Presentation of Orofacial Clefts: An Epidemiological Study of 5004 Patients in a Tertiary Care Hospital of Central India

2021 ◽  
pp. 105566562110577
Author(s):  
Jaideep Singh Chauhan ◽  
Sarwpriya Sharma
Keyword(s):  
Cleft Palate ◽  
Epidemiological Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Orofacial Clefts ◽  
Chi Square ◽  
The Right

Objective: To analyse the morphological presentation of orofacial clefts, gender, syndromes and systemic anomalies associated with them. Design: This was an epidemiological study performed in the patients who were registered for cleft lip and palate surgeries in our centre. The data was evaluated both retrospectively as well as prospectively. Patients/ Participants: The patients registered from November 2006 to April 2021 were studied. Out of 5276 patients, data of 5004 cases were analysed, rest 272 patients were excluded due to lack of information. Statistical analysis and Chi square test were applied. Results: Cleft deformities were more common in males than females. Cleft lip with palate was the commonest phenotype (52.2%). It was followed by isolated cleft lip (22.9%), isolated cleft palate (22.1%), rare clefts (1.62%) and syndromic clefts (1.18%). Unilateral variants were more frequent than bilateral. In unilateral, left side was more common than the right side. Among bilateral, most of the cases had premaxillary protrusion. In the present study, 3.46% of all the patients had associated anomalies affecting their other organs. Less common cleft phenotypes like microform cleft lip and submucous cleft palate ± bifid uvula showed frequency of 0.62% and 0.64% respectively. Conclusion: Thorough examination of cleft deformity should be done as it may appear as an isolated deformity or part of a syndrome and have associated systemic anomalies. This may help us to deliver comprehensive care to the patients and can prevent potential operative complications.

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