Component Restoration in the Unilateral Intermediate Cleft Tip Rhinoplasty: Technique and Long-Term Outcomes

被引:15
作者
Ayeroff, Julia R.
Volpicelli, Elizabeth J.
Mandelbaum, Rachel S.
Pfaff, Miles J.
Asanad, Samuel
Bradley, James P.
Lee, Justine C. [1 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Div Plast & Reconstruct Surg, 200 Med Plaza,Suite 460, Los Angeles, CA 90095 USA
关键词
SECONDARY REPAIR; NASAL DEFORMITY; LIP; PALATE; NOSE; CHILDREN; REGION; GRAFT;
D O I
10.1097/PRS.0000000000005367
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The intermediate cleft tip rhinoplasty is performed in childhood to address residual tip asymmetries during the most critical period of psychosocial development. The authors describe and evaluate long-term outcomes of that approach for the unilateral cleft lip and palate patient based on the concept of individual restoration of each abnormal anatomical component. Methods: Photomorphometric analyses of unilateral cleft lip and palate patients (n = 50) who underwent intermediate cleft tip rhinoplasty using the component restoration technique were evaluated preoperatively (time 0) and postoperatively at less than 1 year (time 1), 1 to 3 years (time 2), and more than 3 years (time 3) and compared to age-matched unilateral cleft lip and palate control patients. Nasal relationships (alar symmetry, nasal tip protrusion-to-alar base width ratio, and height-to-width dimensions for the cleft and noncleft nostrils) were compared over time using a linear mixed-effect model. Results: At time 0, both groups demonstrated similar nasal relationships, with the exception of a wider cleft-side nostril in relationship to height in the rhinoplasty group. The component restoration technique improved all four nasal relationships at all postoperative time points compared with time 0 in a statistically significant manner, whereas control patients did not demonstrate significant changes at the corresponding ages. Long-term differences at time 3 revealed a trend toward improved alar symmetry and cleft-side and non-cleft-side nostril dimensions, and a significant improvement in the nasal tip protrusion-to-alar base width ratio in intermediate cleft tip rhinoplasty-treated versus control patients (p = 0.002). Conclusion: The component restoration technique for the unilateral intermediate cleft tip rhinoplasty improves nasal relationships toward normal immediately and in a sustained manner for at least 3 year
引用
收藏
页码:572E / 580E
页数:9
相关论文
共 32 条
[1]  
BERKELEY W T, 1959, Plast Reconstr Surg Transplant Bull, V23, P567, DOI 10.1097/00006534-195906000-00001
[2]  
BERNSTEIN NR, 1981, PSYCHOSOMATICS, V22, P697
[3]   ONLAY CARTILAGE GRAFT OF THE ALAR LATERAL CRUS FOR CLEFT-LIP NASAL DEFORMITIES [J].
BLACKWELL, SJ ;
PARRY, SW ;
ROBERG, BC ;
HUANG, TT .
PLASTIC AND RECONSTRUCTIVE SURGERY, 1985, 76 (03) :395-401
[4]  
BRODER H, 1989, CLEFT PALATE J, V26, P114
[5]  
Burget GC, 2012, Aesthetic reconstruction of the child's nose
[6]  
Byrd HS, 2007, DALLAS RHINOPLASTY S, V2, P1261
[7]   GEOGRAPHY OF THE NOSE - A MORPHOMETRIC STUDY [J].
FARKAS, LG ;
KOLAR, JC ;
MUNRO, IR .
AESTHETIC PLASTIC SURGERY, 1986, 10 (04) :191-223
[8]  
FARKAS LG, 1993, CLEFT PALATE-CRAN J, V30, P1, DOI 10.1597/1545-1569(1993)030<0001:AAAFOT>2.3.CO
[9]  
2
[10]   Comparison of the morphology of the "cleft face" and the normal face: Defining the anthropometric differences [J].
Farkas, LG ;
Forrest, CR ;
Phillips, JH .
JOURNAL OF CRANIOFACIAL SURGERY, 2000, 11 (02) :76-82