Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
J Craniofac Surg. 2024;35(2):473-477. doi: 10.1097/SCS.0000000000009873. Epub 2023 Nov 20.
Cleft patients often need orthognathic surgery to correct maxillary hypoplasia and rhinoplasty to correct nasal deformity. Rhinoplasty can be performed as a staged procedure after orthognathic surgery or simultaneously with maxillary osteotomy.
The authors evaluated need for and complications of staged and simultaneous rhinoplasties in patients with different cleft types undergoing maxillary osteotomy.
This retrospective study examined 99 (54 females) consecutive nonsyndromic patients with cleft lip/palate [23 bilateral cleft lip and palate (BCLP), 51 unilateral cleft lip and palate (UCLP), and 25 cleft palate (CP)] with a mean age of 17.8 (range: 11.5-45.3) years who had undergone Le Fort I maxillary advancement or bimaxillary osteotomy at the Cleft Palate and Craniofacial Center, Helsinki University Hospital, Finland, between 2002 and 2016. Medical charts were accessed through the hospital's archives and database.
Of patients who underwent maxillary osteotomy, 45% (45/99) needed rhinoplasty (14 BCLP, 27 UCLP, and 4 CP). A significant difference ( P <0.01) existed in the need for rhinoplasty between different cleft types, those with BCLP and UCLP needing the most operations (60% and 53%). In 20 patients (20%), rhinoplasty was performed simultaneously with maxillary osteotomy, and in 25 patients (25%) in a second operation after osteotomy. The overall complication rate was 14%. No difference existed in complication rate in patients with or without simultaneous rhinoplasty.
Of cleft patients who underwent maxillary osteotomy, 45% needed rhinoplasty. Patients with BCLP and UCLP needed rhinoplasty most often. Staged and simultaneous procedures were almost equally common with similar complication rates.
唇腭裂患者常需要正颌手术来矫正上颌骨发育不良，并进行鼻整形术来矫正鼻畸形。鼻整形术可以在正颌手术后分期进行，也可以与上颌骨切开术同时进行。
作者评估了不同唇腭裂类型的患者在接受上颌骨切开术后行分期和同期鼻整形术的需求和并发症。
这项回顾性研究共纳入了 99 例（54 名女性）连续的非综合征性唇腭裂患者[23 例双侧唇腭裂（BCLP），51 例单侧唇腭裂（UCLP）和 25 例腭裂（CP）]，这些患者的平均年龄为 17.8 岁（范围：11.5-45.3 岁），他们在芬兰赫尔辛基大学医院的腭裂和颅面中心接受了 Le Fort I 上颌骨前徙或双颌骨切开术，时间为 2002 年至 2016 年。通过医院的档案和数据库获取病历。
在接受上颌骨切开术的患者中，有 45%（45/99）需要行鼻整形术（14 例 BCLP，27 例 UCLP 和 4 例 CP）。不同唇腭裂类型之间行鼻整形术的需求存在显著差异（P<0.01），BCLP 和 UCLP 患者需要手术的比例最高（分别为 60%和 53%）。在 20 例（20%）患者中，同期进行了鼻整形术和上颌骨切开术，在 25 例（25%）患者中，在骨切开术后的第二次手术中进行了鼻整形术。总的并发症发生率为 14%。同期行鼻整形术和未同期行鼻整形术的患者的并发症发生率无差异。
在接受上颌骨切开术的唇腭裂患者中，有 45%需要行鼻整形术。BCLP 和 UCLP 患者最常需要行鼻整形术。分期和同期手术的应用率几乎相同，并发症发生率也相似。
