Morphological analysis of the lip and nose following cleft lip repair with simultaneous partial primary rhinoplasty: A prospective study over 4 years

2015 ◽  
Vol 43 (5) ◽  
pp. 599-605 ◽  
Author(s):  
Susanne Kluba ◽  
Christoph Bopp ◽  
Margit Bacher ◽  
Siegmar Reinert ◽  
Michael Krimmel
Keyword(s):  
Prospective Study ◽  
Morphological Analysis ◽  
Cleft Lip ◽  
Primary Rhinoplasty ◽  
Cleft Lip Repair ◽  
A Prospective Study

scholarly journals Comparison of professional and laypeople evaluation of nasolabial esthetics following unilateral cleft lip repair

2018 ◽  
Vol 12 (04) ◽  
pp. 516-522 ◽  
Author(s):  
Adekunle Moses Adetayo ◽  
Modupe Olusola Adetayo ◽  
Oguntade Funmi A ◽  
Mayowa Solomon Somoye ◽  
Michael O Adeyemi ◽  
...  
Keyword(s):  
Prospective Study ◽  
Cleft Lip ◽  
Surgical Repair ◽  
University Teaching ◽  
Facial Esthetics ◽  
Surgical Evaluation ◽  
Significant Disagreement ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
A Prospective Study

ABSTRACT Objectives: The objective is to know the extent of agreement of clinicians' perception of nasolabial esthetic compared to that of laypeople (parents). Materials and Methods: This was a prospective study of comparison of clinician's perception of nasolabial esthetics with that of laypeople following surgical repair of UCL. Participants were recruited from the Cleft Clinic of the Lagos University Teaching Hospital, and surgical repair of the cleft was performed under general anesthesia. Surgical evaluation was done through direct clinical evaluation using the modified form of the Christofides' criteria by laypeople and professionals. Results: A total of 48 cleft participants were enrolled in the study. The evaluation of the lip by both the laypeople and professionals was similar, and there was no difference (0.588) in their rating. However, there was a significant disagreement (P = 0.001) between them in the nose assessment. Conclusion: Neither the solitary opinion of the professionals nor that of the laypeople is satisfactory in the evaluation of facial esthetics; both are equally important, especially in the assessment of nasal esthetics. However, opinion of either the laypeople or the professional might be enough in the evaluation of the lip esthetics.

scholarly journals Presurgical nasoalveolar moulding in unilateral cleft lip and palate

2016 ◽  
Vol 49 (01) ◽  
pp. 42-52 ◽  
Author(s):  
Mohammed Zuhaib ◽  
Krishnamurthy Bonanthaya ◽  
Renu Parmar ◽  
Pritham N. Shetty ◽  
Pradeep Sharma
Keyword(s):  
Prospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Valuable Adjunct ◽  
Alar Base ◽  
Student’S T ◽  
A Prospective Study ◽  
Post Therapy ◽  
Student’S T Test

ABSTRACT Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.

scholarly journals A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate

2016 ◽  
Vol 10 (03) ◽  
pp. 435-438 ◽  
Author(s):  
Chitravelu Siva Subramanian ◽  
N. K. K. Koteswara Prasad ◽  
Arun B. Chitharanjan ◽  
Eric Jein Wein Liou
Keyword(s):  
Functional Outcome ◽  
Surgical Procedures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Technique ◽  
Patient Needs ◽  
Nasal Cartilage ◽  
Primary Rhinoplasty ◽  
Cleft Lip Repair ◽  
Nasoalveolar Molding

ABSTRACTNasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application.

Day Case Cleft Lip Surgery in Lagos, Nigeria

2009 ◽  
Vol 46 (6) ◽  
pp. 636-641 ◽  
Author(s):  
A. O. Ugburo ◽  
I. Desalu ◽  
A. F. Adekola ◽  
I. O. Fadeyibi
Keyword(s):  
Cleft Lip ◽  
Febrile Illness ◽  
Nasal Deformity ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Excessive Crying ◽  
Cleft Lip Repair ◽  
A Prospective Study ◽  
Frequent Reason

Background: The correction of cleft lip deformity has included overnight admission and postoperative ward admission from 5 to 7 days. In developing countries, increasing cost of treatment and medical insurance and shortage of bed space have led to a reduction in the length of hospitalization or its elimination for some cases of surgery. Objective: To assess the feasibility and complications associated with day case cleft lip surgery in our center. Methods: A prospective study of patients undergoing day case cleft lip repair at three hospitals from 1995 to 2005. Results: A total of 43 patients were seen. Twenty seven (63.8%) were treated as day case, and 16 (37.2%) were operated as inpatients. The mean age for patients treated as day case was 1.32 ± 1.45 years. Fifteen (55.6%) of these patients had severe associated nasal deformities, six (22.2%) had moderate nasal deformity, and four (14.83%) had mild nasal deformity. The only complication was a nasovestibular fistula that occurred in one of the day case patients. From 27 patients operated on as day cases, eight calls were received. Two (7.4%) mothers called to report febrile illness in their children on the first postoperative day. Two mothers (7.4%) reported excessive crying. The most frequent reason for postoperative consultation was obstruction of the modified nasal retainer, which occurred in four patients (14.8%). Conclusion: Day case surgery for cleft lip can be said to be safe, with a 2.3% rate of complications in selected patients. Day case surgery was a cheaper alternative to admission.

Assessment of Scar Quality after Cleft Lip Closure

2012 ◽  
Vol 49 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Franceline A. Frans ◽  
Paul P.M. van Zuijlen ◽  
J.P.W. Don Griot ◽  
Chantai M.A.M. van Der Horst
Keyword(s):  
Linear Regression ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Scar Assessment ◽  
Scar Quality ◽  
Cleft Lip Repair ◽  
A Prospective Study

Objective To assess scar quality after cleft lip repair. Design The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar characteristics were important according to patients and observer. Setting Regular outpatient follow-up visit with the cleft palate teams of two tertiary centers. Patients All consecutive patients were asked to participate in this study after informed consent, minimally 1 year postsurgery. Main Outcome Measure Scar characteristics influencing patient and observer opinion after cleft lip repair. Results A total of 86 patients with cleft lip with or without cleft palate were included, resulting in evaluation of 99 scars. Two scar characteristics, itching and pain, were seldom a concern for the patients. Linear regression showed that scars assessed longer after surgery had a better outcome. Conclusion Scar itching and pain did not seem to have an effect on patient opinion of the quality of the scar, and the majority of the patients were more satisfied with the outcome of their scar than the observer was.

Primary Rhinoplasty in Unilateral Cleft Patients: The “Limited Open” Approach and Other Technical Considerations

2006 ◽  
Vol 43 (4) ◽  
pp. 492-498 ◽  
Author(s):  
Rajeev B. Ahuja
Keyword(s):  
Cleft Lip ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
Mattress Suture ◽  
Absolute Increase ◽  
Primary Rhinoplasty ◽  
Transcolumellar Incision ◽  
Cleft Lip Repair ◽  
Presurgical Orthopedics

Objective To validate a method of primary anatomic alar repositioning using a “limited open rhinoplasty” approach, along with cleft lip repair, without presurgical orthopedics. Methods The cleft lip deformities were repaired using a modified Tennison technique, and primary muscle union and gingivoperiosteoplasty were achieved in all cases. The alar cartilages were visualized using an inverted “U” incision on the cleft side and a rim incision on the noncleft side, without joining the two with a transcolumellar incision. The domes of the cartilages were approximated by a single horizontal mattress suture. Patients Thirty-five patients were operated on by this technique between March 1999 and February 2004. The patients ranged in age from 4 to 36 months (mean, 6 months). The follow-up ranged from 4 months to 4.5 years (mean, 18 months). Results Overall, the results for nasal shape and symmetry have been extremely good. Conclusions The technique used here provides an exposure just short of an “open” rhinoplasty without scarring the columella or nasal tip. Arch alignment and a symmetric and stable bony platform are generally achieved by 2 to 3 months after the surgery. In severe cases of complete clefts, we have observed an absolute increase in alar arch length as a result of tissue stretch.

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