Effectiveness of the Nasal Creator Device after Cheiloplasty in Patients with Cleft Lip and Palate as Measured by 3D Stereophotogrammetry

Objective: To evaluate nostril morphology post-cheiloplasty after patients with unilateral cleft lip and palate (UCLP) use of the nasal creator device. Study Design: This is a prospective study. Sixteen patients with nonsyndromic UCLP treated at Khon Kaen University underwent cheiloplasty and then wear the nasal creator device for 6 months. Three-dimensional images were taken, from which 5 lines and 8 landmark points were evaluated prior to (T0) and 1 day (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after cheiloplasty. A Repeated Measure ANOVA was used to evaluate nostril changes between time periods and a paired t-test was used to compare values between the affected and non-affected side at T4 (P < .05). Results: On the affected side, the nostril height significantly increased from T0 (2.46±0.89 mm) to T4 (4.22±1.03 mm), and the nostril width significantly decreased from T0 (9.46±2.57 mm) to T4 (7.34±1.41 mm). On the non-affected side, the nostril height significantly increased from T0 (3.39±0.78 mm) to T4 (4.65±1.07 mm), and the nostril width was not significantly different from T0 (6.00±1.25 mm) to T4 (6.59±0.95 mm). The alar base width was not significantly different between T0 (30.18±2.72 mm) and T4 (29.82±1.69 mm). Nostril height and width were not significantly different by T4 when comparing the affected and non-affected sides. Conclusion: Using nasal creator device for 6 months significantly increased the nostril height and decreased nostril width and alar base width after cheiloplasty.

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Facial Symmetry in Unilateral Cleft Lip and Palate following Alar Base Augmentation with Bone Graft: A Three-Dimensional Assessment

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-179.1 ◽

2007 ◽

Vol 44 (4) ◽

pp. 391-395 ◽

Cited By ~ 34

Author(s):

Mark F. Devlin ◽

Arup Ray ◽

Peter Raine ◽

Adrian Bowman ◽

Ashraf F. Ayoub

Keyword(s):

Bone Graft ◽

Bone Grafting ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Facial Symmetry ◽

Alar Base ◽

Student’S T ◽

A Prospective Study ◽

Dimensional Assessment

Objective: The aim of this study was to assess the outcome of bone grafting using a corticocancellous block of iliac crest to reconstruct the support for the deformed, volume-deficient alar base in treated patients with unilateral cleft lip and palate (UCLP). The main outcome being measured was nasal symmetry. Design: This was a prospective study using a noninvasive three-dimensional stereophotogrammetry system (C3D) to assess the position of the alar base. Images were captured immediately preoperatively and at 6 months following the augmentation of the alar base with a block of bone graft. These images were used to calculate facial symmetry scores and were compared using a two sample Student's t test to assess the efficacy of the surgical method in reducing facial/nasal asymmetry. Patients: This investigation was conducted on 18 patients with one patient failing to attend for follow-up. The results for 17 patients are presented. Results: Facial symmetry scores improved significantly following the insertion of the bone graft at the deficient alar base (p = 0.005). Conclusions: 3D stereophotogrammetry is a noninvasive, accurate, and archiveable method of assessing facial form and surgical change. Nasal symmetry can be quantified and measured reliably with this tool. Bone grafting to the alar base region of treated UCLP patients with volume deficiency produces improvement in nasal symmetry.

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Digital Surface Photogrammetry for Anthropometric Analysis of the Cleft Infant Face

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-077.1 ◽

2006 ◽

Vol 43 (3) ◽

pp. 350-355 ◽

Cited By ~ 45

Author(s):

Michael Krimmel ◽

Susanne Kluba ◽

Margit Bacher ◽

Klaus Dietz ◽

Siegmar Reinert

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Upper Lip ◽

Facial Deformity ◽

Alar Base ◽

Healthy Infants ◽

Standard Values ◽

Base Width ◽

Plaster Casts

Objective To analyze the three-dimensional morphology of the cleft infant face with digital surface photogrammetry. Design Fifty plaster casts of unoperated infants with cleft lip and palate were imaged three-dimensionally with digital surface photogrammetry. Twenty-one standard craniofacial measurements were taken. The plaster casts were divided into 4 groups with unilateral, bilateral, complete, and incomplete clefts of the lip and palate. The measurements were compared with standard values for healthy infants. Results Significant differences (p < .0025) were found for the alar base width (33% to 55%), the alar base root width (59% to 103%), the width of the nose (7% to 25%), the length of the alar wing (18% to 25%), and the intercanthal (6% to 17%) and biocular (4% to 12%) width, depending on the cleft type. The vertical dimensions of the nose and the upper lip did not differ significantly from the controls. Conclusion This study describes preliminary data on the cleft infant facial deformity. The obtained results were mainly in agreement with data in the limited literature. Three-dimensional photogrammetry has proven to be reliable and can be applied more readily to potentially uncooperative patients.

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Three-Dimensional Analysis of Bilateral Cleft Lip and Palate Nasal Deformity

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620940190 ◽

2020 ◽

Vol 58 (1) ◽

pp. 105-113

Author(s):

Lucas M. Harrison ◽

Rami R. Hallac ◽

Christopher A. Derderian

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Cross Sectional Study ◽

Cross Sectional ◽

Time Points ◽

Alar Base ◽

Nasolabial Angle ◽

Base Width ◽

Nasal Length

Objective: This cross-sectional study utilizes 3-dimensional analysis to assess nasal morphology in patients with bilateral cleft lip and palate (BCLP) compared to controls across the timeline of cleft care. Design: Retrospective comparative cross-sectional study. Setting: Tertiary pediatric academic institution. Patients and Participants: One hundred and twelve patients with BCLP and an equal number of age and sex-matched control participants. Main Outcome Measure(s): Nasolabial angle, nasal length, nasal protrusion, columella length, columella width, nasal tip width, alar width, and alar base width were collected at each time point. The measurements were collected pre-nasoalveolar molding (NAM) therapy, post-NAM therapy, post-primary cleft rhinoplasty, 1 year, 5 years, 10 years, and 15 years of age. Results: Nasolabial angle and nasal tip width were significantly different from controls from pre-NAM through 15 years of age time points. Nasal length was not significantly different at any time point. Alar width and alar base width were significantly different from pre-NAM through 10 years of age time points. Nasal protrusion, columella length, and columella width were significantly different from pre-NAM through 5 years of age time points. Conclusions: This study demonstrates that three-dimensional photogrammetry is effective in assessing the changes in nasal morphology that occur throughout the course of care in patients with BCLP from before cleft lip repair to the completion of nasal growth.

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Presurgical nasoalveolar moulding in unilateral cleft lip and palate

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.182235 ◽

2016 ◽

Vol 49 (01) ◽

pp. 42-52 ◽

Cited By ~ 3

Author(s):

Mohammed Zuhaib ◽

Krishnamurthy Bonanthaya ◽

Renu Parmar ◽

Pritham N. Shetty ◽

Pradeep Sharma

Keyword(s):

Prospective Study ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Valuable Adjunct ◽

Alar Base ◽

Student’S T ◽

A Prospective Study ◽

Post Therapy ◽

Student’S T Test

ABSTRACT Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.

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A Longitudinal Study on Influence of Primary Facial Deformities on Maxillofacial Growth in Patients with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-151.1 ◽

2005 ◽

Vol 42 (6) ◽

pp. 633-640 ◽

Cited By ~ 31

Author(s):

Norifumi Nakamura ◽

Akira Suzuki ◽

Hideki Takahashi ◽

Yasuo Honda ◽

Masaaki Sasaguri ◽

...

Keyword(s):

Surface Area ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Total Surface Area ◽

3D Analysis ◽

Alar Base ◽

Angular Measurements ◽

Ocular Hypertelorism

Objective The goal of this study was to use three-dimensional (3D) analysis to characterize the primary facial deformities in children with unilateral cleft lip and palate (UCLP) and then serially analyze the relationships between facial deformities and maxillofacial growth from infancy to adolescence. Participants Twenty-one Japanese subjects with unilateral cleft lip and alveolus (UCLA) and 20 with UCLP who had been operated on and then followed up for more than 15 years were enrolled in this study. Main Outcome Measures Facial cast models taken at cheiloplasty were scanned with a 3D laser scanner. Lateral cephalographs taken when subjects were 15 years of age or older were traced, and linear and angular measurements were calculated. The correlation between primary facial forms and maxillofacial morphology in adolescence was analyzed. Results Three-dimensional analysis showed larger ocular hypertelorism, wider cleft, greater deviation of the columella base, and more severe retruded position of the affected nasal alar base in subjects with UCLP than those with UCLA. Total surface area of the upper lips in subjects with UCLP was significantly smaller than those with UCLA. Correlation analyses revealed that the width of cleft lip, deviation of the columella base, difference of the nose base width, and surface area of the upper lip were statistically correlated with the maxillary length, the anterior position of the maxillary alveolar base, the posterior facial height, and the high angle of the mandible. Conclusion The subjects who had less severe facial deformities and more tissue volume of the upper lips at cheiloplasty showed better maxillofacial growth.

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Three-Dimensional Analysis of Definitive Secondary Unilateral Cleft Rhinoplasty Using Cartilage Graft

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211034099 ◽

2021 ◽

pp. 105566562110340

Author(s):

Thinnapat Hantawornchaikit ◽

Raweewan Arayasantiparb ◽

Kumar KC ◽

Kiatanant Boonsiriseth

Keyword(s):

Cleft Lip ◽

Three Dimensional ◽

Nasal Tip ◽

Tip Projection ◽

Alar Base ◽

Cleft Rhinoplasty ◽

Nasal Tip Projection ◽

Base Width ◽

Cleft Lip Nose

Objective Three-dimensional assessment of nasal morphology in patients with unilateral cleft lip nose treated by cartilage graft augmentation. Design Retrospective study. Patients and Intervention Thirteen patients with unilateral cleft lip nose underwent definitive secondary rhinoplasty and postsurgical changes were examined using a three-dimensional (3D) laser scan. Main Outcome Measure Nasal dorsum length, nasal tip, alar width, and alar base width in frontal view; nasion depth, nasal tip projection, nasal dorsal angle, and nasal tip angle in lateral view; nostril width, nostril height, and nasal tip height in basal view were measured at preoperative (T1: within 6 months), short follow-up (T2: 2-10 weeks), and long follow-up (T3: 9-14 months). Results A significant change in alar width, alar base width, nostril width, and nostril height at the cleft side, nasal dorsum length, nasion depth, nasal tip projection, and nasal tip height was observed from T1 to T3 follow-up after rhinoplasty ( P < .05), whereas the nostril height at the noncleft side was also significantly increased at T2 follow-up but the mean change in height relapsed at T3 follow-up. Alar width, alar base width, and nostril width at the noncleft side, and nasal tip angle did not change significantly after surgery at any follow-up period. Conclusions 3D imaging evaluation after secondary cleft rhinoplasty demonstrated improved functional and aesthetic outcomes using a septal or conchal graft.

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Facial Characterization of Infants with Cleft Lip and Palate Using a Three-Dimensional Capture Technique

The Cleft Palate-Craniofacial Journal ◽

10.1597/02-143 ◽

2004 ◽

Vol 41 (1) ◽

pp. 27-35 ◽

Cited By ~ 48

Author(s):

C. A. Hood ◽

M. T. Hosey ◽

M. Bock ◽

J. White ◽

A. Ray ◽

...

Keyword(s):

Soft Tissue ◽

Cleft Lip ◽

Soft Tissues ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Horizontal Displacement ◽

Soft Tissue Defect ◽

Facial Morphology ◽

Primary Surgery ◽

Alar Base

Objective To characterize the soft tissue features of infants with unilateral cleft lip (UCL) and unilateral complete cleft lip and palate (UCLP) prior to primary surgery and compare with noncleft controls. Design Prospective controlled capture of the facial morphology of infants using a noninvasive three-dimensional stereophotogrammetry method. Participants 23 children with presurgical cleft: 11 UCL (M = 6, F = 5); 12 UCLP (M = 9, F = 3), and 21 noncleft controls (M = 7, F = 14) were imaged at approximately 3 months of age (range 10 to 16 weeks). Main Outcome Measure Accurate, repeatable quantification of facial soft tissues in infants with clefts prior to surgery. Results Significant differences (p < .05) were found between the UCLP group and UCL and control groups in anatomical and soft nose width, cleft-side alar wing length, and nasal tip horizontal displacement. Both cleft groups were significantly different from controls and from each other in cleft-side nostril dimensions, alar wing angulation, columella angle, and alar base to corner of mouth dimension; alar base width; and soft tissue defect in nose and the lip and philtrum length bordering the cleft. Significant differences between clefts and controls were identified in the nostril and philtrum on the noncleft side. Conclusions The use of children with UCL as controls for UCLP studies is inappropriate. This technique overcame the limitations of direct measurement of infant faces to aid the surgeon in the planning and subsequent re-evaluation of surgical rationale.

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