Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Effect of Preoperative Nasal Retainer on Nasal Growth in Patients with Bilateral Incomplete Cleft Lip: A 3-Year Follow-Up Study

  • Kim, Young Chul (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeong, Woo Shik (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Tae Suk (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Jong Woo (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koh, Kyung S. (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2017.03.06
  • Accepted : 2017.07.04
  • Published : 2017.09.15
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Abstract

Background The purpose of this study was to evaluate changes in nasal growth after the implementation of a preoperative nasal retainer in patients with bilateral incomplete cleft lip. Methods Twenty-six infants with bilateral incomplete cleft lip and cleft palate were included in the study. A preoperative nasal retainer was applied in 5 patients from the time of birth to 2.6-3.5 months before primary cheiloplasty. Twenty-one patients who were treated without a preoperative nasal retainer were placed in the control group. Standard frontal, basal, and lateral view photographs were taken 3 weeks before cheiloplasty, immediately after cheiloplasty, and at the 1- and 3-year postoperative follow-up visits. The columella and nasal growth ratio and nasolabial angle were indirectly measured using photographic anthropometry. Results The ratio of columella length to nasal tip protrusion significantly increased after the implementation of a preoperative nasal retainer compared to the control group for up to 3 years postoperatively (P<0.01 for all time points). The ratios of nasal width to facial width, nasal width to intercanthal distance, columellar width to nasal width, and the nasolabial angle, for the two groups were not significantly different at any time point. Conclusions Implementation of a preoperative nasal retainer provided significant advantages for achieving columellar elongation for up to 3 years postoperatively. It is a simple, reasonable option for correcting nostril shape, preventing deformities, and guiding development of facial structures.

Keywords

References

  1. Tan SP, Greene AK, Mulliken JB. Current surgical management of bilateral cleft lip in North America. Plast Reconstr Surg 2012;129:1347-55. https://doi.org/10.1097/PRS.0b013e31824ecbd3
  2. Matsuo K, Hirose T, Tomono T, et al. Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Plast Reconstr Surg 1984;73:38-51. https://doi.org/10.1097/00006534-198401000-00009
  3. Cutting C, Grayson B, Brecht L, et al. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg 1998;101:630-9. https://doi.org/10.1097/00006534-199803000-00009
  4. Lee CT, Garfinkle JS, Warren SM, et al. Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate. Plast Reconstr Surg 2008;122:1131-7. https://doi.org/10.1097/PRS.0b013e318184590c
  5. Spengler AL, Chavarria C, Teichgraeber JF, et al. Presurgical nasoalveolar molding therapy for the treatment of bilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J 2006;43:321-8. https://doi.org/10.1597/05-093.1
  6. Garfinkle JS, King TW, Grayson BH, et al. A 12-year anthropometric evaluation of the nose in bilateral cleft lip-cleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction. Plast Reconstr Surg 2011;127:1659-67. https://doi.org/10.1097/PRS.0b013e31820a64d7
  7. Liou EJ, Subramanian M, Chen PK. Progressive changes of columella length and nasal growth after nasoalveolar molding in bilateral cleft patients: a 3-year follow-up study. Plast Reconstr Surg 2007;119:642-8. https://doi.org/10.1097/01.prs.0000239600.79638.6f
  8. Koh KS, Choi JW, Kim H. Minimal paring of skin flaps for primary repair of incomplete unilateral cleft lip. Plast Reconstr Surg 2008;121:1382-5. https://doi.org/10.1097/01.prs.0000305519.02853.ca
  9. Farakas LG. Anthropometry of the head and face. 2nd ed. New York: Raven Press; 1994.
  10. Mulliken JB, Kim DC. Repair of bilateral incomplete cleft lip: techniques and outcomes. Plast Reconstr Surg 2013; 132:923-32. https://doi.org/10.1097/PRS.0b013e31829f4b81
  11. Vyas HJ, Sharma SM, Shetty V. Levy-Bercowski D, Abreu A, DeLeon E, Looney S, Stockstill J, Weiler M, Santiago PE. Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J. 2009;46:521-8. https://doi.org/10.1597/07-236.1
  12. Vyas HJ, Sharma SM, Shetty V. Levy-Bercowski D, Abreu A, DeLeon E, Looney S, Stockstill J, Weiler M, Santiago PE. Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J 2012;49:766. https://doi.org/10.1597/11-122
  13. Kim SH, Whang E, Choi HG, et al. Analysis of the midface, focusing on the nose: an anthropometric study in young Koreans. J Craniofac Surg 2010;21:1941-4. https://doi.org/10.1097/SCS.0b013e3181f4ed67
  14. Chang CS, Liao YF, Wallace CG, et al. Long-term comparison of the results of four techniques used for bilateral cleft nose repair: a single surgeon's experience. Plast Reconstr Surg 2014;134:926e-936e. https://doi.org/10.1097/PRS.0000000000000715

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