1
|
Saito T, Tu JCY, Chou PY, Lo LJ. Primary rhinoplasty in patients with bilateral cleft lip: Longitudinal results and comparison between closed and semi-open approaches. J Plast Reconstr Aesthet Surg 2024; 89:117-124. [PMID: 38176136 DOI: 10.1016/j.bjps.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/27/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION 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.
Collapse
Affiliation(s)
- Takafumi Saito
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Junior Chun-Yu Tu
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Pang-Yun Chou
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
2
|
Long Y, Yao M, Fu Y, Gao J, Zang J, Song W, Li C, Shi B, Low DW, Li C. Aesthetic evaluation of nasolabial reconstruction using abbe flap in bilateral cleft lip patients with secondary deformities. J Plast Reconstr Aesthet Surg 2023; 84:496-504. [PMID: 37418848 DOI: 10.1016/j.bjps.2023.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND The Abbe flap is a common technique frequently utilized in secondary surgery for bilateral cleft lip deformities, but objective indications for the Abbe flap remain unclear, and postoperative aesthetic evaluations are limited. METHODS The study group consisted of 92 bilateral cleft lip patients with secondary deformities aged 7-39 years, and the control group consisted of 33 people aged 19-35 years. Thirteen objective nasolabial aesthetic parameters were selected to evaluate patients' nasolabial aesthetics. RESULTS Minor secondary deformities were characterized by a smaller lip height index than severe deformities, as well as a smaller columellar angle compared with moderate and severe deformities (P < 0.05). For all patients, significant differences were found between preoperative and postoperative values of intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, lip vermilion height index, lip protrusion angle, columellar-labial angle, and nasal tip angle (P < 0.05). For patients with minor deformity, intercanthal distance/philtrum width ratio and intercanthal distance/medial cutaneous upper lip height ratio showed no significant change postoperatively (P > 0.05), and labial protrusion angle was smaller than the control group (P < 0.05). CONCLUSIONS Patients undergoing secondary surgery using an Abbe flap achieved good nasolabial aesthetics. Intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, columellar-labial angle, nasolabial angle, nasal tip angle, and columellar angle are the objective aesthetic indicators for Abbe flap selection. Intercanthal distance/philtrum width ratio, intercanthal distance/medial cutaneous upper lip height ratio, and labial protrusion angle are reference parameters for choosing an Abbe flap for secondary bilateral cleft lip revision.
Collapse
Affiliation(s)
- Yifei Long
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Meilin Yao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yihang Fu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Junjie Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Jiaxing Zang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Wenyan Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Chen Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China
| | - David W Low
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Chenghao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, People's Republic of China.
| |
Collapse
|
3
|
Aljancic L, Rougier G, Neiva-Vaz C, Vazquez MP, Picard A, Kadlub N. Millard's modified technique in the reconstruction of bilateral cleft lip: Objective and subjective assessment. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:532-537. [PMID: 34752974 DOI: 10.1016/j.jormas.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/22/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Laurine Aljancic
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France.
| | - Guillaume Rougier
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France
| | - Cécilia Neiva-Vaz
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France
| | - Marie-Paule Vazquez
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France
| | - Arnaud Picard
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France
| | - Natacha Kadlub
- Université de Paris, 85 Boulevard Saint Germain 75006 Paris, France; Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75015 Paris, France
| |
Collapse
|
4
|
Kim RS, Seo HJ, Park MS, Bae YC. Long-Term Evaluation of the Lip and Nose in Bilateral Complete Cleft Lip Patients following Lip Adhesion and Secondary Nose Correction. Arch Plast Surg 2022; 49:510-516. [PMID: 35919547 PMCID: PMC9340188 DOI: 10.1055/s-0042-1751106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background
Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip.
Methods
A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained.
Results
All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter (
p
< 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater (
p
< 0.05) than in the control group.
Conclusion
Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.
Collapse
Affiliation(s)
- Ryuck Seong Kim
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
| | - Hyung Joon Seo
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Min Suk Park
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
| | - Yong Chan Bae
- Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
5
|
Manlove AE, Linnebur AM. Primary Bilateral Cleft Lip Repair Using the Modified Millard Technique. Atlas Oral Maxillofac Surg Clin North Am 2022; 30:19-25. [PMID: 35256106 DOI: 10.1016/j.cxom.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Ashley E Manlove
- Department of Oral and Maxillofacial Surgery, Carle Foundation Hospital, 611 West Park Street, Urbana, IL 61801, USA.
| | - Alexis M Linnebur
- Department of Oral and Maxillofacial Surgery, Carle Foundation Hospital, 611 West Park Street, Urbana, IL 61801, USA
| |
Collapse
|
6
|
Zhao X, Wu Y, Wang G, Yang Y, Cai M. Repair of Asymmetric Bilateral Cleft lip: 1 Stage or 2 Stage. Cleft Palate Craniofac J 2021; 59:436-441. [PMID: 34018417 DOI: 10.1177/10556656211013978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To verify the advantages and indications of 1-stage and 2-stage repair for asymmetric bilateral cleft lip (BCL). DESIGN Retrospective study. SETTING From January 2004 to December 2016 in our department. PATIENTS Patients with BCL. MAIN OUTCOME MEASURE(S) Over 6 months after the operation, the surgery outcomes were evaluated and graded by 2 experienced surgeons. RESULTS The result of surgery was evaluated using the scoring method of Mortier et al and Anastassov and Chipkov. Among 133 patients with asymmetric BCL, 61 (45.9%) had 1-stage repair and 72 (54.1%) had 2-stage repair. Sixty-eight (51.1%) patients had complete-incomplete cleft lip (CL), and those who underwent 1-stage repair showed a trend of better outcome (P = .028). Fifty (37.6%) patients with incomplete-microform CL showed no significant difference between the outcomes of 2 surgery plans (P = .253). In 15 (11.3%) patients with complete-microform CL, only one had 1-stage repair with a score of 8.5. The other 14 patients with 2-stage repair were scored 3.68 ± 1.28. Two-stage repair was preferable when the deformity degree was very different on 2 sides, as it could reduce unnecessary scar tissue and extend the nasal columella. One-stage repair could help to achieve the anatomical reduction of the orbicularis oris and a better contour of the vermilion tubercle. CONCLUSION One-stage repair is recommended for patients with complete-incomplete CL and incomplete-microform CL. Two-stage repair for patients with complete-microform CL is preferred in our center, but more studies are required to support this conclusion.
Collapse
Affiliation(s)
- Xinran Zhao
- Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Oral Diseases Clinical Research Center, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, China
| | - Yilai Wu
- Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Oral Diseases Clinical Research Center, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, China
| | - Guomin Wang
- Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Oral Diseases Clinical Research Center, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, China
| | - Yusheng Yang
- Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Oral Diseases Clinical Research Center, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, China
| | - Ming Cai
- Department of Oral & Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Oral Diseases Clinical Research Center, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, China
| |
Collapse
|
7
|
Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
Collapse
Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| |
Collapse
|
8
|
Chung KH, Sato N, Chou PY, Lo LJ. An Intraoperative Rescue Procedure for the Protruding Premaxilla in the Repair of Complete Bilateral Cleft Lip: Rapid Premaxillary Molding. Cleft Palate Craniofac J 2020; 58:251-256. [PMID: 32648486 DOI: 10.1177/1055665620938480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Primary reconstruction of complete bilateral cleft lip and palate (BCLP) with protruding premaxilla in one-stage surgery is challenging because of the tension on muscle repair. Such patients are also common in the developing countries. For this condition, we have applied intraoperative "rapid premaxillary molding (RPM)" technique and obtained satisfactory results. METHODS We reviewed the data of patients with complete BCLP with protruding premaxilla applying intraoperative RPM including both our institution and cleft missions to developing countries in the past 20 years. Selection criteria were patients receiving either no or insufficient preoperative molding presenting with significant protruding premaxilla, had consecutive follow-ups after surgery. To perform this technique, the surgeon holds the patient's face with both hands and compresses the protruding premaxilla with both thumbs. An intermittent but stable backward pressure is applied to the premaxilla until the segment is gradually flexible. Repeated compression is performed prior to tying the muscle sutures, at which time the premaxilla is retro-positioned and aligned with the lateral maxillary segments. Pre- and postoperative data were evaluated. RESULTS We have treated a total of 60 patients with complete BCLP with protruding premaxilla applying intraoperative RPM. All patients tolerated the operations and there were no major intra- and postoperative complications including lip dehiscence and vomer fracture. All of them had satisfactory results such as adequate muscle repair and symmetry of the lip and nostrils. CONCLUSION The RPM is a reliable and valuable intraoperative adjunct procedure for patients with complete BCLP presenting the protrusive premaxilla.
Collapse
Affiliation(s)
- Kyung Hoon Chung
- Plastic & Reconstructive Surgery, and Craniofacial Research Center, 22386Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Nobuhiro Sato
- Plastic & Reconstructive Surgery, and Craniofacial Research Center, 22386Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Pang-Yun Chou
- Plastic & Reconstructive Surgery, and Craniofacial Research Center, 22386Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Lun-Jou Lo
- Plastic & Reconstructive Surgery, and Craniofacial Research Center, 22386Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| |
Collapse
|
9
|
Oliveira NVD, Tou GAA, Silva RS, Rezende SE, Pretti H, Macari S. The First-Year Follow-Up of a Cleft Lip and Palate Patient Treated With Nasoalveolar Molding (NAM). Braz Dent J 2020; 31:190-196. [PMID: 32556020 DOI: 10.1590/0103-6440202003040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/27/2019] [Indexed: 11/21/2022] Open
Abstract
The objectives of pre-surgical orthopedics are to allow surgical repair with minimal tension of the involved tissues and less restriction to the craniofacial growth. The aim of this study was to evaluate the benefits of nasoalveolar model (NAM) as a pre-operative therapy in a patient with bilateral cleft lip and palate followed by labioplasty and palatoplasty. A 15-day-old patient underwent orthopedic treatment with NAM. After pre-operative treatment, retraction of the pre-maxilla was observed with reduction of the fissure. Due to the successful effects of NAM treatment the patient had a one-step surgery for lip correction. Six months later, due to lip pressure the fissure was further decreased. After six months, the patient underwent palatoplasty. Both surgeries contributed to the remaining closure of the fissure, which were reduced by half compared to the end of pre-operative treatment. The uses of NAM as a pre-operative treatment approached the alveolar segments, centralized the pre-maxilla, decreased the cleft palate resulting in a marked improvement of the arch and provide superior surgical results. In addition, it allows the primary repair of the patient's lip with asymmetric bilateral fissure in only one-step surgery; in consequence, it will reduce treatment morbidity and decrease cost of treatment.
Collapse
Affiliation(s)
- Nathália Viegas de Oliveira
- Department of Pediatric Dentistry and Orthodontics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Gabriel Antônio Anjos Tou
- Department of Restorative Dentistry, Faculty of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Raquel Souto Silva
- Department of Pediatric Dentistry and Orthodontics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sérgio Edriane Rezende
- Department of Head and Neck Surgeon and Skull-Maxillofacial Surgeon, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Serviço de Cirurgia Plástica - CENTRARE - Hospital da BALEIA, Belo Horizonte, MG, Brasil
| | - Henrique Pretti
- Department of Restorative Dentistry, Faculty of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Soraia Macari
- Department of Restorative Dentistry, Faculty of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
10
|
Hsu PJ, Denadai R, Pai BCJ, Lin HH, Lo LJ. Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery. Sci Rep 2020; 10:2346. [PMID: 32047228 PMCID: PMC7012815 DOI: 10.1038/s41598-020-58682-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/15/2020] [Indexed: 02/08/2023] Open
Abstract
Computer-assisted 3D planning has overcome the limitations of conventional 2D planning-guided orthognathic surgery (OGS), but difference for facial contour asymmetry outcome has not been verified to date. This comparative study assessed the facial contour asymmetry outcome of consecutive patients with unilateral cleft lip and palate who underwent 2D planning (n = 37)- or 3D simulation (n = 38)-guided OGS treatment for correction of maxillary hypoplasia and skeletal Class III malocclusion between 2010 and 2018. Normal age-, gender-, and ethnicity-matched individuals (n = 60) were enrolled for comparative analyses. 2D (n = 60, with 30 images for each group) and 3D (n = 43, with 18 and 25 images for 2D planning and 3D simulation groups, respectively) photogrammetric-based facial contour asymmetry-related measurements were collected from patients and normal individuals. The facial asymmetry was further verified by using subjective perception of a panel composed of 6 blinded raters. On average, the facial contour asymmetry was significantly (all p < 0.05) reduced after 3D virtual surgery planning for all tested parameters, with no significant differences between post-OGS 3D simulation-related values and normal individuals. No significant differences were observed for pre- and post-OGS values in conventional 2D planning-based treatment, with significant (all p < 0.05) differences for all normal individuals-related comparisons. This study suggests that 3D planning presents superior facial contour asymmetry outcome than 2D planning.
Collapse
Affiliation(s)
- Po-Jung Hsu
- Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Rafael Denadai
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Betty C J Pai
- Department of Craniofacial Orthodontics and Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiu-Hsia Lin
- Image Lab and Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
11
|
Upper Lip Fat Grafting Using the Anatomical Subunit and Fat Compartment Principles Improves Lip Cant and Symmetry in Patients With Unilateral Upper Lip Asymmetries. Ann Plast Surg 2019; 84:163-172. [PMID: 31688118 DOI: 10.1097/sap.0000000000002027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
12
|
|
13
|
Wei Y, Zhong T, Yin X, Shi B, Zheng Q, Li J. Dynamic Nasolabial Growth After Primary Surgery for Patients With Bilateral Cleft Lip: A Five-Year Follow-Up Study. J Oral Maxillofac Surg 2019; 77:2125.e1-2125.e10. [PMID: 31238020 DOI: 10.1016/j.joms.2019.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Bilateral complete cleft lip (BCCL) causes severe tissue deficit and usually requires multiple revisions after primary repair. In the present study, we aimed to illustrate the nasolabial changes after primary BCCL correction. PATIENTS AND METHODS The present retrospective cohort study compared patients who had undergone BCCL and palate (BCCLP) and cleft palate only (CPO). All included patients had undergone surgery at the same treatment center (West China Hospital of Stomatology) from 2007 to 2012. The patients returned for follow-up surgery at 6 months and 5 years after their primary repair surgery. We retrieved the facial plaster casts of the enrolled patients and recorded the key nasolabial measurements. The outcome variables included the prolabial length (PL), peak distance, nasal width, and columellar length (CL). The data were analyzed using a general linear model for repeated measures, and the linear association was tested using SPSS. The level of testing efficiency (P value) was set at .05. RESULTS A total of 160 patients, 80 who had undergone BCCLP and 80 CPO controls, were included. All nasolabial measurements in the BCCLP group had increased during the 5-year follow-up period. The PL of the BCCLP group had increased more quickly than the PL of the CPO group (P = .000 < .05), but the CL had increased nearly as much (P = .270). CONCLUSIONS For the primary correction of bilateral cleft lip nose deformity, dissection and repositioning of the cleft lip and nose did not significantly inhibit the growth of the nasolabial region in the first 5 years after surgery. Nose deformities should not remain uncorrected after primary surgical repair. In contrast, cleft surgeons should focus on the finer adjustment of columella with less doubt regarding adverse effects.
Collapse
Affiliation(s)
- Yuhao Wei
- Resident, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tianhang Zhong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xing Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China; and Research Fellow, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China; and Professor and Department Head, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qian Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China; and Professor, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingtao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China; and Associate Professor, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|