Department of Plastic and Reconstructive Surgery, Osaka City University, Graduate School of Medicine, Asahi 1-4-3, Abeno, Osaka 545-8585, Japan.
J Plast Reconstr Aesthet Surg. 2011 Feb;64(2):201-8. doi: 10.1016/j.bjps.2010.04.010. Epub 2010 May 31.
There is a difference between complete and incomplete cleft lip with regard to the nasal shape. Severe nasal deformity is found in almost all cases of complete cleft lip. This problem has been approached by preoperative nasoalveolar moulding, primary nasal correction and the use of a nostril retainer. We corrected the nasal deformity associated with complete cleft lip by using the combination of a nostril suspender and lip adhesion before cleft lip repair. The present article outlines this treatment strategy and assesses the effects of our treatment on nasal deformity.
Fourteen patients with complete cleft lip and palate were assigned to two groups for retrospective analysis: group A comprised seven patients, who underwent cleft lip repair after a combination of nostril suspension and lip adhesion, while group B had seven patients, who received cleft lip repair alone. In group A, a nostril suspender was fabricated and fitted to each patient at the initial visit, while lip adhesion was done at 1 month of life. At 1 year postoperatively, four parameters (nostril symmetry, alar cartilage slump, alar base level and columellar tilt) were scored on a scale of 1-4 to compare nasal shape between the two groups.
With respect to nostril symmetry, alar cartilage slump and columellar tilt, group A showed less deformity compared with group B and the difference between the two groups was statistically significant.
The use of a nostril suspender and lip adhesion can achieve dynamic correction of the nasal deformity associated with complete cleft lip.
完全性唇裂和不完全性唇裂的鼻型存在差异。几乎所有完全性唇裂病例都存在严重的鼻畸形。术前鼻牙槽塑形、初次鼻矫正和使用鼻孔保持器已被用于解决这一问题。我们通过在唇裂修复前使用鼻孔吊带和唇粘连来矫正完全性唇裂相关的鼻畸形。本文概述了这种治疗策略，并评估了我们的治疗方法对鼻畸形的效果。
14 例完全性唇裂腭裂患者被分为两组进行回顾性分析：A 组 7 例，采用鼻孔悬吊和唇粘连联合治疗后行唇裂修复，B 组 7 例，仅行唇裂修复。A 组患者在初诊时制作并佩戴鼻孔吊带，在 1 个月大时进行唇粘连。术后 1 年，对两组患者的 4 个参数（鼻孔对称性、鼻翼软骨塌陷、鼻翼基底水平和鼻中隔倾斜）进行 1-4 分评分，以比较两组患者的鼻型。
在鼻孔对称性、鼻翼软骨塌陷和鼻中隔倾斜方面，A 组的畸形程度低于 B 组，两组间差异具有统计学意义。
使用鼻孔吊带和唇粘连可以实现完全性唇裂相关鼻畸形的动态矫正。
