Change in upper lip height and nostril sill after alveolar bone grafting in unilateral cleft lip alveolus patients

Introduction: Alveolar bone grafting is known to reduce nasal asymmetry by supporting a defective alar base and a sunken nostril. However, there are no studies which include details of changes to the upper lip with appropriate measurements. The purpose of this study was to measure the change in the upper lip height and nostril sill after alveolar bone grafting, using photogrammetry. Materials and methods: The study included 18 unilateral cleft lip alveolus (UCLA) patients who were diagnosed with unilateral cleft lip and palate (mean age, 9.87 years). The patients underwent alveolar bone grafting with iliac bone between June 2007 and June 2008. The average follow-up period was 16.6 months. The average bone graft volume was 2.39 cm(3). We obtained photographs of the frontal, lateral and basal views using standardised photographic techniques. We defined 14 landmarks and measured the distance of 11 points (distance items) for the determination of upper lip height, upper lip projection and nostril sill elevation. We defined the proportion index as the ratio of the cleft side to non-cleft side or reference line (R). We compared the preoperative proportion index with the postoperative proportion index for each distance items. Results: The height of the upper lip increased significantly in four of five distance items. The projection of the upper lip was more prominent, but it was not statistically significant. The nostril sill was significantly elevated in all four distance items. Conclusion: The height of the upper lip was elongated and the nostril sill was elevated after alveolar bone grafting in UCLA patients. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.