Rossell-Perry Percy, Gavino-Gutierrez Arquimedes
From the Health of Science Faculty School of Human Medicine,Peruvian University Union (UpeU), Lima, Peru.
South American Medical Advisory Council, Smile Train Foundation USA, New York, N.Y.
Plast Reconstr Surg Glob Open. 2023 Oct 16;11(10):e5313. doi: 10.1097/GOX.0000000000005313. eCollection 2023 Oct.
Recently, there has been an increased acceptance of the primary cleft rhinoplasty providing acceptable outcomes. Nose reconstruction, and specifically cleft nose deformity, should be addressed based on this philosophy. The purpose of this study was to evaluate surgical outcomes during the mixed dentition period after primary surgery to address unilateral cleft lip nose deformity based on the proposed technique.
This is a retrospective cohort study. Thirty-two primary complete unilateral cleft lip patients were operated on by a single surgeon using the V-Y-Z cleft rhinoplasty. This method combines a composite V-Y advancement flap with lateral Z-plasty. Data collection was accomplished by evaluation of nasal symmetry through anthropometric measurements performed under general anesthesia during primary cleft palatoplasty and alveolar bone graft. The outcomes were evaluated through anthropometric measurements of the repaired nose during the mixed dentition period of follow-up, and no type of presurgical management was performed for any of the patients.
Total nasal symmetry has been observed in 34.37% of patients at 7 years or more and 40.62% at 1-year follow-up. Nonstatistically significant differences were observed during follow-up, and major revision requirement (>3 mm of asymmetry in any of the nose measurements) was observed in 9.37% of patients.
The proposed primary cleft rhinoplasty is a good approach to improve nasal appearance in patients with complete unilateral cleft lip and palate.
最近，一期唇裂鼻整形术获得可接受的效果越来越被认可。鼻再造，尤其是唇裂鼻畸形，应基于这一理念进行处理。本研究的目的是根据所提出的技术，评估一期手术治疗单侧唇裂鼻畸形后混合牙列期的手术效果。
这是一项回顾性队列研究。32例一期完全性单侧唇裂患者由同一位外科医生采用V-Y-Z唇裂鼻整形术进行手术。该方法将复合V-Y推进皮瓣与外侧Z成形术相结合。数据收集通过在一期腭裂修复术和牙槽骨植骨术期间全身麻醉下进行人体测量来评估鼻对称性来完成。通过在随访的混合牙列期对修复后的鼻子进行人体测量来评估结果，并且没有对任何患者进行任何类型的术前处理。
在7岁及以上的患者中，34.37%观察到完全鼻对称，在1年随访时为40.62%。随访期间观察到无统计学意义的差异，9.37%的患者需要进行大的修复（任何鼻测量中不对称超过3毫米）。
所提出的一期唇裂鼻整形术是改善完全性单侧唇腭裂患者鼻外观的一种好方法。
