Department of Plastic, Burns, and Maxillofacial Surgery, Ain-Shams University, Cairo, 11591, Egypt.
Department of Plastic, Burns, and Maxillofacial Surgery, Ain-Shams University, Cairo, 11591, Egypt.
Oral Maxillofac Surg Clin North Am. 2023 Feb;35(1):127-137. doi: 10.1016/j.coms.2022.06.011. Epub 2022 Nov 3.
While primary cleft lip nasal deformity has been well described, secondary cleft lip nasal deformity reflects the combination of residual deformity that follows primary operative maneuvers and growth-related nasal distortions. Secondary cleft lip nasal deformities are further associated with underlying skeletal and dentofacial abnormalities along with soft tissue constriction adding to the complexity of the deformity and posing major aesthetic and functional challenges to the multidisciplinary care team. Definitive rhinoplasties are performed to address these deformities and improve the quality of life in cleft patients following skeletal maturity and ideally after all underlying skeletal discrepancies have been corrected by orthognathic surgery. Maxillary advancement with or without mandibular setback is often required after careful planning and orthodontic preparation. Patients with cleft lip benefit tremendously from definitive rhinoplasty irrespective of inevitable residual discrepancies that remain and adjuvant therapies could enhance the overall outcome.
尽管原发性唇裂鼻畸形已有很好的描述，但继发性唇裂鼻畸形反映了原发性手术操作后残留畸形和与生长相关的鼻畸形的组合。继发性唇裂鼻畸形还与潜在的骨骼和牙颌面异常以及软组织收缩有关，这增加了畸形的复杂性，并对多学科护理团队构成了重大的美学和功能挑战。进行确定性鼻整形术是为了解决这些畸形问题，并在骨骼成熟后，理想情况下在所有潜在的骨骼差异都通过正颌手术纠正后，改善唇裂患者的生活质量。在仔细规划和正畸准备后，通常需要上颌骨前徙术加或不加下颌骨后退术。唇裂患者从确定性鼻整形术中获益匪浅，无论不可避免的残留差异如何，辅助治疗都可以增强整体效果。
