Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
J Plast Reconstr Aesthet Surg. 2024 Feb;89:117-124. doi: 10.1016/j.bjps.2023.12.017. Epub 2023 Dec 19.
Although several studies have shown that primary rhinoplasty in patients with cleft lip provides good outcomes with limited effect on nasal growth, the surgical procedure remains to be standardized. The purpose of this study was to evaluate the long-term outcome of primary semi-open rhinoplasty with Tajima reverse-U incision, compared with that of closed rhinoplasty.
Consecutive nonsyndromic patients with complete bilateral cleft lip and palate (n = 52) who underwent primary semi-open rhinoplasty between 2001 and 2016 were reviewed. Patients who underwent primary closed rhinoplasty (n = 61) and control group individuals were recruited for comparison. Computer-based standardized measurements of 2D photographs and panel assessments by laypersons were collected and statistically analyzed.
In the comparative analysis at preschool age, semi-open rhinoplasty significantly improved the typical nasal deformities, including transversely oriented wide nostrils, short columella, and de-projected nasal tip, more effectively than closed rhinoplasty. Without major drawbacks, these parameters in the semi-open group were well maintained closer to those in the control group till skeletal maturity. After primary rhinoplasty, 54% of patients in the closed group and 4% in the semi-open group underwent intermediate rhinoplasty at preschool age.
This study showed that the patients who underwent primary semi-open rhinoplasty achieved long-term and persistent outcomes that were closer to the normal nasal morphology compared with the patients treated with closed rhinoplasty, while avoiding intermediate rhinoplasty during the preschool to adolescent periods.
尽管已有多项研究表明，唇裂患者的初次鼻整形术效果良好，对鼻生长的影响有限，但手术方法仍有待标准化。本研究旨在评估 Tajima 反 U 切口的初次半开放式鼻整形术与闭合式鼻整形术的长期效果。
回顾性分析 2001 年至 2016 年间接受初次半开放式鼻整形术的连续非综合征性完全双侧唇裂腭裂患者（n=52）。同时纳入接受初次闭合式鼻整形术的患者（n=61）和对照组个体进行比较。收集基于计算机的 2D 照片的标准化测量值和外行小组评估，并进行统计学分析。
在学龄前的对比分析中，半开放式鼻整形术比闭合式鼻整形术更有效地改善了典型的鼻部畸形，包括横向宽鼻孔、短鼻中隔和突出度不足的鼻尖。半开放式组的这些参数没有明显的缺点，并且在接近骨骼成熟时，与对照组更接近。初次鼻整形术后，闭合组 54%的患者和半开放式组 4%的患者在学龄前接受了中期鼻整形术。
本研究表明，与接受闭合式鼻整形术的患者相比，接受初次半开放式鼻整形术的患者获得了更长期和持久的效果，更接近正常的鼻部形态，同时避免了学龄前至青春期的中期鼻整形术。
