Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan.
Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan.
J Plast Reconstr Aesthet Surg. 2019 Aug;72(8):1411-1417. doi: 10.1016/j.bjps.2019.04.009. Epub 2019 Apr 20.
It is debatable whether rhinoplasty is necessary during a primary operation for cleft lip. However, many surgeons believe that rhinoplasty should be performed simultaneously for severe deformities. We investigated whether alveolar cleft severity is involved in nasal deformity.
Forty-three patients were assessed for alveolar cleft severity using maxillary plaster models prepared during primary cheiloplasty. We conducted morphological assessments of nasal deformities using three-dimensional photogrammetry. Patients were divided into two groups according to alveolar cleft severity: group A, overlap of the alveolar segments; group B, nonoverlap of the alveolar segments. Nasal asymmetry was assessed by measuring distances between landmarks around the nostrils and the columellar angle. These measurements were compared between the groups. The correlations between the columellar angle and the ratios of the five cleft side/non-cleft side distances and the correlation of each ratio were analyzed.
Groups A and B included 21 and 22 patients, respectively. Group A demonstrated superior deviation of the alar base on the non-cleft side than that of the alar base on the cleft side (p < 0.05). No other statistically significant differences were observed. Group A had more severe nasal deformity. Columellar angle and nostril base width demonstrated correlation.
In an uncorrected, unoperated unilateral cleft lip nasal deformity, alar base deformity is affected by deformity of the alveolar segments.
在唇裂初次手术中是否需要进行鼻整形术存在争议。然而,许多外科医生认为对于严重畸形应同时进行鼻整形术。我们研究了牙槽裂严重程度是否与鼻畸形有关。
在初次唇裂修复术期间使用上颌石膏模型评估 43 例患者的牙槽裂严重程度。我们使用三维摄影术对鼻畸形进行形态学评估。根据牙槽裂严重程度将患者分为两组:A 组,牙槽段重叠;B 组,牙槽段不重叠。通过测量鼻孔周围和鼻中隔角之间的标志点之间的距离来评估鼻翼不对称。比较两组之间的差异。分析鼻中隔角与五个裂侧/非裂侧距离比值的关系以及每个比值的相关性。
A 组和 B 组分别包括 21 例和 22 例患者。A 组非裂侧鼻翼基底的外偏程度大于裂侧鼻翼基底(p<0.05)。未观察到其他统计学上的显著差异。A 组的鼻畸形更严重。鼻中隔角和鼻孔基底宽度存在相关性。
在未经矫正和未手术的单侧唇裂鼻畸形中,鼻翼基底的畸形受牙槽段畸形的影响。