Photometric Evaluation of Adult Patients With Bilateral Cleft Lip and Palate Treated With Nasoalveolar Molding and Primary Columella Lengthening

2021 ◽  
pp. 105566562110240
Author(s):  
Maria Costanza Meazzini ◽  
Francesca Parravicini ◽  
Vera Donati ◽  
Roberto Brusati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adulthood ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Nasal Tip ◽  
Nasolabial Angle ◽  
Primary Rhinoplasty ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding

A short columella and a flattened nasal tip are the characteristic stigmata of patients with complete bilateral cleft lip and palate (BCLP). Objective: The aim of this study was to assess the nasal shape of young adults with BCLP treated with primary surgical columella lengthening and nasoalveolar molding (NAM). Setting and Patients: A group of 28 young adult patients with BCLP (mean age: 19.1±1.4 years) was compared through normalized photogrammetry to a control of 28 age- and sex-matched noncleft young adults. Results: Nasal protrusion and length of the columella were not different from noncleft young adults. On the other hand, nasolabial angle, columellar width, interalar, and nasal tip width were significantly wider than the noncleft controls. Thus, 27% of the patients have requested at this time secondary correction of the excessive nasal width. Conclusions: Both NAM and primary rhinoplasty in patients with BCLP resulted in a near normal length of the columella and nasal projection until young adulthood. Nevertheless, width of all nasal features was significantly wider than the noncleft population and required secondary nasal correction in one-third of the sample.

Photometric Evaluation in Adolescence of Patients With Bilateral Cleft Lip and Palate Treated With Nasoalveolar Molding and Primary Columella Lengthening

2017 ◽  
Vol 55 (4) ◽  
pp. 568-573 ◽  
Author(s):  
Maria Costanza Meazzini ◽  
Carlo Chiavenna ◽  
Luca Autelitano ◽  
Giovanna Garattini ◽  
Roberto Brusati
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Matched Control ◽  
The Other ◽  
Nasal Tip ◽  
Other Hand ◽  
Nasolabial Angle ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding ◽  
Photographic Records

Objective: Nasal stigma in patients with bilateral cleft lip and palate (BCLP) are a short columella and a flattened nasal tip. Design: The aim of this study was to evaluate the aesthetics of adolescents with BCLP, operated with a modified Cutting primary columella lengthening technique, associated to a modified Grayson orthopedic nasoalveolar molding (NAM). Setting and Patients: 72 BCLP patients were operated with this approach. Standardized photographic records were taken every 2 years. A group of 23 patients between 12 and 13 years of age was compared through normalized photogrammetry to a matched control of 23 noncleft adolescents. Results: Nasal protrusion and length of the columella were very close to normal. On the other hand, nasolabial angle and interalar width were still excessively wide compared to the noncleft sample. Conclusions: NAM and primary columella lengthening in BCLP has allowed to avoid traditional secondary columella lengthening at 5 to 6 years of age and given the patients a more pleasing, near-normal nasolabial appearance until adolescence. Some of the patients will require correction of the nasal width at a later stage.

scholarly journals Long-Term Nasal Growth after Primary Rhinoplasty for Bilateral Cleft Lip Nose Deformity: A Three-Dimensional Photogrammetric Study with Comparative Analysis

2019 ◽  
Vol 8 (5) ◽  
pp. 602 ◽  
Author(s):  
Hyung Joon Seo ◽  
Rafael Denadai ◽  
Lun-Jou Lo
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Normal Subjects ◽  
Width Ratio ◽  
Nasal Dorsum ◽  
Nasal Tip ◽  
Primary Rhinoplasty ◽  
Bilateral Cleft Lip

Nasal deformity is associated with congenital cleft lip and palate. Primary rhinoplasty for reconstruction of the nasal deformity at the time of bilateral cleft lip repair is a controversial issue in cleft care due to traditional teaching concerning the potential impairment of nasal growth. This study assessed long-term nasal growth in patients with bilateral cleft lip and palate who underwent primary rhinoplasty by a single surgeon between 1995 and 2002 and reached skeletal maturity (n = 39; mean: 19 ± 2 years). Normal age-, gender-, and ethnicity-matched subjects (n = 52) were enrolled for comparative analyses. Three-dimensional nasal photogrammetric measurements (10 linear, 4 angular, 6 proportional, 1 surface area, and 1 volume parameter) were collected from patients with bilateral cleft lip and palate and normal subjects. Patients who underwent rhinoplasty presented with significantly (all p < 0.05) smaller nasal tip projection and nasal tip angles, but greater values for nasal dorsum length, nasal protrusion, alar width, columellar height, dome height, columellar angle, labiocolumellar angle, nasal tip height ratio, nasal index, alar width/intercanthal distance ratio, and alar width/mouth width ratio compared to normal subjects. There were no differences (all p > 0.05) in nasal height, tip/midline deviation, nasal dorsum angle, dome-to-columella ratio, columella height/alar width ratio, area surface, and volume parameters between the two groups. This study shows that primary rhinoplasty performed in patients with bilateral cleft lip and palate during infancy does not result in deficiency of the nasal dimensions relative to controls.

Facial Growth in Patients with Bilateral Cleft Lip and Palate: A Cephalometric Study

1994 ◽  
Vol 31 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Kiki L.W.M. Heidbüchel ◽  
Anne Marie Kuijpers-Jagtman ◽  
Hans Peter M. Freihofer
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Long Term Results ◽  
Facial Growth ◽  
Nasolabial Angle ◽  
Comparison Results ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Bilateral Cleft Lip

In this study, sagittal facial growth of bilateral cleft lip and palate (BCLP) patients between 6 and 20 years of age is analyzed. The data of Nljmegen were derived from 131 lateral cephalograms taken in 21 BCLP patients who were treated In the Cleft Lip and Palate Center of the University Hospital of Nljmegen. Reported data of 90 BCLP patients treated at the Center of Oslo were used as a reference for comparison. Results of this Investigation showed mandibular growth to be similar in both centers. In the premaxillary region some differences were found: The Nljmegen patients presented a more protrusive premaxilla than those at Oslo. The upper front teeth and hence, the premaxilla, were more retroclined In the Nljmegen sample. There were also statistically significant differences in the soft tissue profile. The mean z-score was positive for the nasolabial angle and negative for the angle N'-Sn-Pg'. At 18 years of age, these differences are still apparent. In comparison with Broadbent's values of normal individuals, the SNPg-angle was smaller and the mandibular angle greater in Nljmegen and Oslo. The profiles of the BCLP patients are more convex in Nljmegen and more concave in Oslo than In the noncleft group. Finally, the different treatment strategies of the Cleft Lip and Palate Centers of Nljmegen and Oslo are compared and discussed In terms of their long-term results.

scholarly journals A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate

2016 ◽  
Vol 10 (03) ◽  
pp. 435-438 ◽  
Author(s):  
Chitravelu Siva Subramanian ◽  
N. K. K. Koteswara Prasad ◽  
Arun B. Chitharanjan ◽  
Eric Jein Wein Liou
Keyword(s):  
Functional Outcome ◽  
Surgical Procedures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Technique ◽  
Patient Needs ◽  
Nasal Cartilage ◽  
Primary Rhinoplasty ◽  
Cleft Lip Repair ◽  
Nasoalveolar Molding

ABSTRACTNasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application.

Effects of Nasoalveolar Molding Therapy on Alveolar and Palatal Cleft Deformities in Unilateral and Bilateral Cleft Lip and Palate

2018 ◽  
Vol 29 (2) ◽  
pp. e179-e184 ◽  
Author(s):  
Belma Isik Aslan ◽  
Ayşe Gülşen ◽  
Kemal Findikçioğlu ◽  
Deniz Uzuner ◽  
Neslihan Üçüncü
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding

Craniofacial Morphology in Adult Patients with Unoperated Complete Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Omar Gabriel da Silva Filho ◽  
Rita de Cássia Moura Carvalho Lauris ◽  
Leopoldino Capelozza Filho ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Craniofacial Morphology ◽  
Bilateral Cleft Lip

Presurgical Nasoalveolar Molding Therapy for the Treatment of Bilateral Cleft Lip and Palate: A Preliminary Study

2006 ◽  
Vol 43 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Adam L. Spengler ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jaime Gateno ◽  
James J. Xia
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
University Of Texas ◽  
Bilateral Cleft Lip ◽  
Before And After ◽  
Nasal Tip Projection ◽  
A Prospective Study ◽  
The University ◽  
Nasoalveolar Molding

Objective To evaluate the outcome of presurgical nasoalveolar molding therapy in the treatment of patients with bilateral cleft lip and palate. Design A prospective study with blinded measurements. Setting The Cleft and Craniofacial Clinic at the University of Texas at Houston Medical School, Houston, Texas. Patients Eight patients with bilateral cleft lip and palate, treated between 2002 and 2004. Interventions The starting age for presurgical nasoalveolar molding therapy was 34.9 days and the average length of the therapy was 212.5 days. Main Outcome Measures Measurements of intraoral and extraoral casts were performed, and statistical analyses were used to compare the differences between measurements before and after therapy. Results Intraoral measurements demonstrated that there was a statistically significant reduction of the premaxillary protrusion and deviation. There was also a significant reduction in the width of the larger cleft. Extraoral measurements revealed that there was a significant increase in the bi-alar width and in the columellar length and width. Moreover, there was a significant improvement in columellar deviation. Finally, the nostril heights of both sides were increased. Conclusion The authors have quantitatively shown that presurgical nasoalveolar molding therapy has significant advantages in the treatment of bilateral cleft lip and palate patients. It improves the nasal asymmetry and deficient nasal tip projection associated with bilateral cleft lip and palate. It also forces the protruded premaxillary segment into alignment with the dental alveolar segments, improving the shape of the maxillary arch. As a result, the changes associated with presurgical nasoalveolar molding therapy help decrease the complexity of subsequent surgeries.

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