scholarly journals Prosedur penatalaksanaan celah bibir inkomplit bilateral dan rinoplasti primer dengan modifikasi mulliken

2019 ◽  
Vol 49 (1) ◽  
pp. 93
Author(s):  
Al Hafiz ◽  
Debby Apri Grecwin
Keyword(s):  
Cleft Lip ◽  
Cochrane Library ◽  
Upper Lip ◽  
Literature Study ◽  
Nasal Tip ◽  
Tip Projection ◽  
Primary Rhinoplasty ◽  
Bilateral Cleft Lip ◽  
Modification Technique ◽  
Nasal Tip Projection

Latar belakang: Celah bibir dengan atau tanpa celah lelangit merupakan abnormalitas perkembangan kraniofasial yang paling sering terjadi. Kelainan ini bisa unilateral atau bilateral, dan mungkin disertai dengan anomali kongenital lain. Celah bibir bilateral berpotensi mengubah struktur dan bentuk wajah serta menyebabkan gangguan dalam perkembangan makan, bicara, gigi geligi, dan kosmetik. Celah bibir selalu disertai dengan deformitas hidung, termasuk pada kasus celah bibir inkomplit. Mulliken adalah pionir yang melakukan perbaikan celah bibir bilateral dan rinoplasti primer dalam satu tahap operasi. Tujuan: Mengetahui keberhasilan operasi celah bibir inkomplit bilateral dan rinoplasti primer dengan teknik modifikasi Mulliken. Laporan kasus: Dilaporkan satu kasus celah bibir inkomplit bilateral pada anak laki-laki usia 7 bulan yang ditatalaksana dengan teknik modifikasi Mulliken. Metode: Telaah literatur berbasis bukti mengenai perbaikan celah bibir inkomplit bilateral dan rinoplasti primer dengan teknik modifikasi Mulliken melalui database Cochrane library, Pubmed Medline, dan hand searching. Hasil: Pertumbuhan nasal tip projection, nasal width, columellar length, upper lip height, cutaneous lip height, dan vermilion-mucosal height mendekati nilai normal. Kesimpulan: Prosedur celah bibir inkomplit bilateral disertai rinoplasti primer dengan teknik modifikasi Mulliken memberikan hasil yang baik. Introduction: Cleft lip with or without cleft palate is the most common disorder of craniofacial development. This disorder could be occurred unilaterally or bilaterally, and sometimes were also accompanied by other type of congenital disorders. Bilateral cleft lip potentially could change the face structure and shape, causing interference in eating, speech, dental development, and aesthetics. Cleft lip always occurred with nasal deformity, even in incomplete cleft lip. Mulliken is a pioneer in performing a repair in bilateral cleft lip and primary rhinoplasty altogether at the same time. Purpose: To find out the result of surgery procedure in bilateral incomplete cleft lip and primary rhinoplasty using Mulliken modification technique. Case report: A bilateral incomplete cleft lip case in a 7 months old boy and managed by Mulliken modification technique. Method: Evidence based literature study of bilateral incomplete cleft lip and primary rhinoplasty with Mulliken modification technique through Cochrane library, Pubmed Medline, and hand searching. Result: The growth of nasal tip projection, nasal width, collumellar length, upper lip height, cutaneus lip height, and vermilion mucous height were close to normal size. Conclusion: Procedure of bilateral incomplete cleft lip and primary rhinoplasty repair using Mulliken modification technique delivered a good outcome.

Premaxillary Injection for Perioral Rejuvenation and Lip Enhancement

2019 ◽  
Vol 40 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Thuy-Van T Ho ◽  
Eric W Cerrati ◽  
Nimit D Gandhi ◽  
Arjun Kalbag ◽  
Steven H Dayan
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Significance ◽  
Primary Objective ◽  
Upper Lip ◽  
Height Ratio ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Nasal Tip ◽  
Tip Projection ◽  
Nasal Tip Projection

Abstract Background This is the first study to evaluate the effect of premaxillary filler injection on nasal tip projection, upper lip projection, and upper lip vermilion height. Objectives The primary objective of this study was to analyze the change in nasal tip projection (measured by the Goode ratio) and the change in upper lip projection (measured by the Z angle) following premaxillary hyaluronic acid injection. A secondary objective was to measure the change in upper lip vermilion height. We hypothesized that treated subjects will show an increase in nasal tip projection, upper lip projection, and upper lip vermilion height. Methods Twenty volunteer patients with signs of perioral aging or poor upper lip projection were enrolled in this prospective cohort study and underwent premaxillary hyaluronic acid filler injection between November 2017 and June 2018. Nasal tip projection, upper lip projection, and upper lip vermilion height were assessed from baseline and posttreatment photographs based on the Goode ratio, Z angle, and lip vermilion height ratio, respectively. Results No significant change was noted between pre- and posttreatment Goode ratio measurements (P = 0.841). There was a significant decrease in Z angle and therefore significant increase in upper lip projection with treatment (P < 0.001). The lip vermilion height ratio demonstrated a trend of increased upper lip vermilion height but this did not achieve statistical significance (P = 0.561). Conclusions Premaxillary filler treatment resulted in a significant increase in upper lip projection. Premaxillary filler injection when performed in a safe manner is a valuable treatment option for perioral rejuvenation. Level of Evidence: 4

Dynamic Presurgical Nasal Remodeling in Patients with Unilateral and Bilateral Cleft Lip and Palate: Modification to the Original Technique

2006 ◽  
Vol 43 (6) ◽  
pp. 639-648 ◽  
Author(s):  
Ricardo D. Bennun ◽  
Alvaro A. Figueroa
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nasal Deformity ◽  
Nasal Tip ◽  
Palatal Plate ◽  
Bilateral Cleft Lip ◽  
Technical Modifications ◽  
Cleft Lip Repair ◽  
Nasal Tip Projection ◽  
Cleft Nasal Deformity

Objective: To present technical modifications to the original presurgical nasal remodeling appliance introduced in 1991. The purpose of the modifications is to improve the cleft nasal deformity before unilateral and bilateral cleft lip repair. Method: The principle behind this technique, known as dynamic presurgical nasal remodeling (DPNR), is the use of the force generated during suction and swallowing. A conventional intraoral plate is built with a nasal extension added to the labial vestibular flange. The nasal extension was modified and consists of three components. The palatal plate is left loose in the mouth to generate a discontinuous but controlled impact directed to the affected nasal structures during suction and swallowing. The principle aim of the DPNR technique in unilateral cases is to improve the deformation of nasal structures by straightening the columella, elevating the nasal tip, and remodeling the depressed cleft side alar cartilages. In bilateral cases, the aims are to elongate the columella and to obtain nasal tip projection. Conclusions: The modifications introduced in the appliance enhance the original DPNR technique and are effective in ameliorating the initial cleft nasal deformity. This facilitates primary surgical cleft lip and nose correction and improves surgical outcomes in patients with complete unilateral and bilateral cleft lip and palate.

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.

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

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.

scholarly journals Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Adham Farouk ◽  
Saad Ibrahiem
Keyword(s):  
Cleft Lip ◽  
Negative Impact ◽  
Common Condition ◽  
Upper Lip ◽  
Cartilage Grafts ◽  
Rib Cartilage ◽  
Tip Projection ◽  
Aesthetic Appearance ◽  
Cartilage Grafting ◽  
Nasal Tip Projection

Recession of the midface is a relatively common condition that can have a negative impact on facial and nasal aesthetic appearance, and it poses a challenge to plastic surgeons. In cases with generalized maxillary retrusion and/or malocclusion, bone advancement surgery is required, but in localized cases, mostly seen in cleft lip patients, the quest is for an ideal material and a proper technique that would be used to augment the receding area. Throughout a period of seven years, thirty-two patients with nose and midface retrusion were managed by a construct of rib cartilage grafts designed to compensate the deficiency at the maxillary, piriform, and premaxillary areas. Results were satisfactory for most patients in terms of improved fullness of malar area, improved nasal tip projection and rotation, and improvement of upper lip. The presented technique of rib cartilage grafting is a safe and effective method for nose and midface augmentation.

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.

Sign in / Sign up

Export Citation Format

Share Document