Murali Srinisha P, Denadai Rafael, Sato Nobuhiro, Lin Hsiu-Hsia, Hsiao Jonathan, Pai Betty C J, Chou Pang-Yun, Lo Lun-Jou
From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center.
the Craniofacial Research Center, Craniofacial Center, Chang Gung Memorial Hospital.
Plast Reconstr Surg. 2023 Mar 1;151(3):441e-451e. doi: 10.1097/PRS.0000000000009923. Epub 2022 Nov 22.
No consensus exists regarding the timing or technique of rhinoplasty for correction of the unilateral cleft lip nose deformity, with few studies examining the long-term effects of a single technique. This study appraised the long-term outcomes of primary rhinoplasty using the Tajima technique for overcorrection in a cohort of patients with unilateral cleft lip nose deformity after attaining skeletal maturity.
Consecutive nonsyndromic patients with unilateral cleft lip nose deformity ( n = 103) who underwent primary rhinoplasty with overcorrection by a single surgeon between 2000 and 2005 were reviewed. Patients with unilateral cleft lip and nasal deformity who underwent primary rhinoplasty (but with no overcorrection) ( n = 30) and noncleft individuals ( n = 27) were recruited for comparison. Outcomes were assessed through FACE-Q scales evaluating satisfaction with appearance of nose and nostrils (two scales) and computer-based objective photogrammetric analysis of nasal symmetry (nostril height, nostril width, nostril area, alar height, and alar width parameters).
Significant differences (all P < 0.001) were observed between the Tajima and non-Tajima groups for all but one photogrammetric nasal parameter (nostril area), with the Tajima group demonstrating closer mean values to the noncleft group. The Tajima and noncleft groups demonstrated no significant difference (all P > 0.05) for scores of FACE-Q nose and nostrils scales.
This study indicated that the patients who underwent primary rhinoplasty with overcorrection had improved results with no necessity for intermediate rhinoplasty, emphasizing that the procedure is an effective approach to correct the unilateral cleft nose deformity.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
关于单侧唇裂鼻畸形矫正的鼻整形术时机或技术尚无共识，很少有研究探讨单一技术的长期效果。本研究评估了在骨骼成熟后，采用田岛技术进行过度矫正的原发性鼻整形术在单侧唇裂鼻畸形患者队列中的长期效果。
回顾了2000年至2005年间由单一外科医生进行原发性过度矫正鼻整形术的连续非综合征性单侧唇裂鼻畸形患者（n = 103）。招募了接受原发性鼻整形术（但未过度矫正）的单侧唇裂和鼻畸形患者（n = 30）以及非唇裂个体（n = 27）进行比较。通过FACE-Q量表评估结果，该量表评估对鼻子和鼻孔外观的满意度（两个量表），并通过基于计算机的鼻对称性客观摄影测量分析（鼻孔高度、鼻孔宽度、鼻孔面积、鼻翼高度和鼻翼宽度参数）。
除一个摄影测量鼻参数（鼻孔面积）外，田岛组和非田岛组之间在所有鼻参数上均观察到显著差异（所有P < 0.001），田岛组的平均值更接近非唇裂组。田岛组和非唇裂组在FACE-Q鼻子和鼻孔量表得分上无显著差异（所有P > 0.05）。
本研究表明，接受原发性过度矫正鼻整形术的患者效果有所改善，无需进行二期鼻整形术，强调该手术是矫正单侧唇裂鼻畸形的有效方法。
临床问题/证据水平：治疗性，III级。
