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appearance before and after columella elongation surgery in (a) frontal, (B) lateral, and (C) submental views.
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Background:. The evaluation of surgical outcomes is needed to achieve excellence in nasal reconstruction of patients with complete bilateral cleft lip and palate (BCLP). The study objective is to evaluate the quality of nasal aesthetics after the columella elongation surgery.
Methods:. The sample of this study consisted of 70 patients with complete...
Context in source publication
Context 1
... agreement was good to very good with kappa values ranging from 0.55 to 0.89. Interexaminer agreement was moderate with kappa values ranging from 0.36 to 0.54. After surgery, nasal width, nasal tip projection, and columella length had a significant change from bad to regular appearance (Table 3 and Fig. 4). Frequencies of each score before and after surgery are shown in Figure ...
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Cleft lip and palate (CLP) affects a person’s facial appearance and can cause appearance-related distress. Appearance-related distress and its manifestations are not fully understood. Women with CLP tend to experience a higher degree of distress as well as undergo more aesthetic revisions than men. The aim of this study was to investigate if self-r...
Introduction Children with oral clefts often present with dental anomalies which can impact function, aesthetics and complicate the patient's dental treatment and needs. An understanding of potential anomalies, along with early recognition and planning, is thus essential for effective care.
Aim This paper is the first in a two-part three-centre ser...
Cleft lip and palate (CLP) are conditions that require long-term management and review from infancy to adolescence. Surgical procedures become easier when nasoalveolar moulding (NAM) measures are applied during the neonatal period. Orthodontic treatment provided for these patients during the progressive dentition developmental periods can achieve p...
(WHO meetings on International Collaborative Research on Craniofacial Anomalies).
One of the most common congenital anomaly we come across is the Cleft Lip and palate where affected children suffer from range of functional as well as aesthetic problems. Cleft lip and palate is a multifunctional disease associated with environmental factors. Managem...
Unilateral cleft lip surgery is part and parcel of every trainee cleft surgeon's armamentarium. As their cleft expertise is founded on solid principles and anthropometric measurements, the chances of error and iatrogenic deformity are significantly lower than that of the untrained surgeon who attempts cleft surgery. In this communication we would l...
Citations
... 8 The Cronin technique utilizing V-Y advancement flaps from the nasal floor and alae was the next most popular. This technique involves using bipedicle flaps with external perialar incisions and an internal incision in the membranous septum ( Fig. 2A, B). 21,22 This was followed by the bilateral reverse technique using combined U-incisions and a V-Y plasty 23 and bilateral forked flaps (Fig. 2C, D). 22,24 Columella elongation has shown to significantly improve nasal width and projection as well as columella length and width in bilateral cleft lip and palate patients. 22,25 All elongation techniques have demonstrated limitations when compared with normal controls, but these limitations seem to decrease after alveolar bone grafting. ...
... 8 The Cronin technique utilizing V-Y advancement flaps from the nasal floor and alae was the next most popular. This technique involves using bipedicle flaps with external perialar incisions and an internal incision in the membranous septum ( Fig. 2A, B). 21,22 This was followed by the bilateral reverse technique using combined U-incisions and a V-Y plasty 23 and bilateral forked flaps (Fig. 2C, D). 22,24 Columella elongation has shown to significantly improve nasal width and projection as well as columella length and width in bilateral cleft lip and palate patients. 22,25 All elongation techniques have demonstrated limitations when compared with normal controls, but these limitations seem to decrease after alveolar bone grafting. ...
... This technique involves using bipedicle flaps with external perialar incisions and an internal incision in the membranous septum ( Fig. 2A, B). 21,22 This was followed by the bilateral reverse technique using combined U-incisions and a V-Y plasty 23 and bilateral forked flaps (Fig. 2C, D). 22,24 Columella elongation has shown to significantly improve nasal width and projection as well as columella length and width in bilateral cleft lip and palate patients. 22,25 All elongation techniques have demonstrated limitations when compared with normal controls, but these limitations seem to decrease after alveolar bone grafting. 22 The Cronin technique may provide better restoration of nasal width, while bilateral forked flaps have demonstrated better nasal tip projection. ...
Patients with cleft lip often undergo a primary rhinoplasty at the time of lip repair, and further surgical correction with secondary cleft rhinoplasty (SCR) is often warranted for improved form and function. The purpose of this study was to better elucidate current practice patterns and trends for how SCR is performed in the United States.
Methods:
We administered a survey to team surgeons affiliated with cleft lip and palate care teams approved by the American Cleft Palate Craniofacial Association (ACPA).
Results:
We received responses from 40 ACPA-approved teams for a response rate of 20.7%, with 59 total ACPA team surgeons completing the survey. 88.1% of surgeons perform intermediate cleft rhinoplasties. Among those who perform an intermediate cleft rhinoplasty, the mean age at which they would first consider the procedure is 5.83±2.66 years. The mean age for consideration of definitive cleft rhinoplasty was 15.86 ± 1.73 years. In both unilateral and bilateral cleft lips, a closed approach was more common in intermediate rhinoplasty, while an open approach was more common in definitive rhinoplasty (P < 0.001). The use of autologous grafts was more common in definitive rhinoplasty (P < 0.001), with 65% of respondents utilizing autologous grafts in greater than three-quarters of their procedures.
Conclusions:
When comparing intermediate with definitive cleft rhinoplasty, we found significant increase in the use of open techniques, autologous cartilage use for augmentation of the nasal tip, dorsal nasal support, and columellar sup- port. The considerable variability among surgeons highlights the lack of consensus regarding SCR.
... Also, Masuoka et al. [55] showed that the mean successful postoperative columella /nose width ratio among their 15 patients was 23.5% ± 2.7% of the nose width. Recently, Broll et al. [56] analyzed the nasal measurements of patients operated on with different surgical techniques. Their control group (12 non cleft patients) had a mean columella width of 5.472% ± 0.1441% of face width. ...
Throughout history, attempts have been made to define the ideal facial proportions of beauty. Several criteria were proposed to determine facial attractiveness, including the golden ratio and neoclassical canons. The aim of this study was to determine the ideal proportions of the Caucasian face from a strictly mathematical standpoint using the golden ratio in order to establish new aesthetic standards universally recognized as perfection and thus update pre-existing ones. The study included 11 validated and known golden ratios in the horizontal dimensions of the face from previous studies, as well as the vertical fifths rule from the neoclassical canons. After superimposing the proportions, systems of linear equations as well as matrices were created. Many parameters were calculated to establish the ideal proportions of facial parameters. I was able to estimate the ideal proportions of facial parameters using a mathematical approach, while also pointing out the omnipresence of Fibonacci key ratios, both known and unknown. My approach also revealed the ubiquity of mathematical similarities and symmetry in the human face. The results presented in this study challenge current beauty standards from a new and entirely objective perspective. In order to confirm the formation of new beauty standards, future research should validate these findings from a more experimental approach through the analysis of real human faces defined as attractive.
Objective
This cross-sectional study utilizes 3-dimensional analysis to assess nasal morphology in patients with bilateral cleft lip and palate (BCLP) compared to controls across the timeline of cleft care.
Design
Retrospective comparative cross-sectional study.
Setting
Tertiary pediatric academic institution.
Patients and Participants
One hundred and twelve patients with BCLP and an equal number of age and sex-matched control participants.
Main Outcome Measure(s)
Nasolabial angle, nasal length, nasal protrusion, columella length, columella width, nasal tip width, alar width, and alar base width were collected at each time point. The measurements were collected pre-nasoalveolar molding (NAM) therapy, post-NAM therapy, post-primary cleft rhinoplasty, 1 year, 5 years, 10 years, and 15 years of age.
Results
Nasolabial angle and nasal tip width were significantly different from controls from pre-NAM through 15 years of age time points. Nasal length was not significantly different at any time point. Alar width and alar base width were significantly different from pre-NAM through 10 years of age time points. Nasal protrusion, columella length, and columella width were significantly different from pre-NAM through 5 years of age time points.
Conclusions
This study demonstrates that three-dimensional photogrammetry is effective in assessing the changes in nasal morphology that occur throughout the course of care in patients with BCLP from before cleft lip repair to the completion of nasal growth.
