Meazzini Maria Costanza, Chiavenna Carlo, Autelitano Luca, Garattini Giovanna, Brusati Roberto
1 Smile House, Regional Center for CLP, San Paolo Hospital, Department of Maxillo-Facial Surgery, University of Milan, Milan, Italy.
2 Department of Orthodontics, University of Milan, San Paolo Hospital, Milan, Italy.
Cleft Palate Craniofac J. 2018 Apr;55(4):568-573. doi: 10.1177/1055665617732785. Epub 2017 Dec 14.
Nasal stigma in patients with bilateral cleft lip and palate (BCLP) are a short columella and a flattened nasal tip.
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).
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.
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.
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.
双侧唇腭裂（BCLP）患者的鼻畸形表现为鼻小柱短小和鼻尖扁平。
本研究的目的是评估采用改良的Cutting原发性鼻小柱延长技术联合改良的Grayson正畸鼻牙槽塑形（NAM）手术的BCLP青少年患者的美学效果。
72例BCLP患者采用该方法进行手术。每2年进行标准化摄影记录。通过归一化摄影测量法，将一组23例12至13岁的患者与23例非唇腭裂青少年的匹配对照进行比较。
鼻突出度和鼻小柱长度非常接近正常。另一方面，与非唇腭裂样本相比，鼻唇角和鼻翼间宽度仍然过宽。
BCLP患者采用NAM和原发性鼻小柱延长术可避免传统的5至6岁继发性鼻小柱延长术，并使患者在青春期前拥有更美观、接近正常的鼻唇外观。部分患者后期需要矫正鼻宽度。
