Balaji S M
Director and Consultant, Oral and Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India.
Indian J Dent Res. 2018 Jan-Feb;29(1):26-33. doi: 10.4103/ijdr.IJDR_694_17.
Nasal deformity in bilateral cleft lip and palate (BCLP) correction is highly challenging. Several solution has been proposed. The aim of the present study is to assess qualitatively and quantitatively the results of Cronin's flap, Fork flap, and Abbe's flap for BCLP rhinoplasty at a follow-up period.
: Records of all BCLP rhinoplasty performed between 2010 and 2016, fulfilling inclusion and exclusion criteria were collected. From records, qualitative improvement and previously described methods of quantification of columella length were performed. These collected data were analyzed with descriptive statistics, Chi-square tests, and one-way analysis of variance tests. P ≤ 0.05 was taken as statistically significant.
Forty-eight cases fulfilled the criteria of which 31 patients had Abbe's flap, 9 Cronin, and 8 forked flaps. The mean age of the study population was 20.33 ± 4.94 years in 21 females and 27 males with a mean follow-up of 15.3 ± 2.3 months. The success of the lengthening of columella at immediate postoperative period as compared to the preoperative columella length was not statistically different (P = 0.176) between the three flaps, while the same was statistically different at 1-year period (P = 0.031). The extent of change was very minimal for the Abbe flap with a high degree of statistical significance (P = 0.000). At 1-year postoperative period, 83.9% (n = 26) of Abbe flap patients felt their nose to be good after surgery while the same was 55.6% (n = 5) in Cronin flap design and 37.5% (n = 3) in forked flap design (P = 0.007).
Abbe flap gave the best results under most of the common BCLP rhinoplasty, and a flap choice algorithm for choice of flap was arrived based on this experience.
双侧唇腭裂（BCLP）矫正中的鼻畸形矫正极具挑战性。已经提出了几种解决方案。本研究的目的是在随访期定性和定量评估用于BCLP鼻整形术的克罗宁皮瓣、叉状皮瓣和阿贝皮瓣的效果。
收集2010年至2016年间所有符合纳入和排除标准的BCLP鼻整形术记录。从记录中，进行定性改善和先前描述的鼻小柱长度量化方法。这些收集的数据用描述性统计、卡方检验和单因素方差分析进行分析。P≤0.05被视为具有统计学意义。
48例符合标准，其中31例患者采用阿贝皮瓣，9例采用克罗宁皮瓣，8例采用叉状皮瓣。研究人群的平均年龄为20.33±4.94岁，其中女性21例，男性27例，平均随访15.3±2.3个月。与术前鼻小柱长度相比，三种皮瓣术后即刻鼻小柱延长的成功率无统计学差异（P = 0.176），而在1年时差异有统计学意义（P = 0.031）。阿贝皮瓣的变化程度非常小，具有高度统计学意义（P = 0.000）。术后1年，83.9%（n = 26）的阿贝皮瓣患者术后感觉鼻子良好，而克罗宁皮瓣设计的患者为55.6%（n = 5），叉状皮瓣设计的患者为37.5%（n = 3）（P = 0.007）。
在大多数常见的BCLP鼻整形术中，阿贝皮瓣效果最佳，并基于此经验得出了皮瓣选择算法。
