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Objective To assess the effectiveness of the Mulliken's method in bilateral complete cleft lip patients with 3dMD system and anthropometric landmarks.Methods Thirty-one infants with bilateral complete cleft lip received treatment in Hospital of Stomatology,Wuhan University between January 2014 and December 2016.Patients underwent primary cheiloplasty and nasoplasty by the same senior surgeon.Periodic review was taken to measure and record the 7 items in the nasolabial area with three-dimensional (3D) images.Results The labial and nasal deformities were restored after primary surgery.The upper lip and nose were corrected and obtained the symmetric shape.The columella was elongated to acquire favorable nasal tip.The arc of nasal fornix was upward.The ridge of the white lipwas continuous and integrated with full vermilion tubercle.Total length of upper lip (Sn-Sto),thickness of the vermilion tubercle (Ls-Sto),protrusion of the nasal tip (Nh) and columellar height (Ch) were markedly improved and there were no significant difference between the observation group and the control group.The significant differences between two groups occurred in values of the nostril width (Nw),which was greater than control group and white lip height (Sn-Ls) and lower than that of control group.Conclusions Mulliken's method during the primary cheiloplasty of the bilateral complete cleft lip shows better results in correction the nasal deformity and the ideal effects are achieved during follow-up.
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Objective This article reported a patient with severe bilateral nostril stenosis secondary to bilateral cleft lip nasal deformity correction surgery.Methods The surgical procedure included columellar flap and local soft tissue flap was transferred to nasal inside,columellar was narrowed,reconstruction of nasal dome,increased nostrils height and nasal vestibular mucosa area.Results Effective improvement of nasal profile and reduction of ventilation features obstacles was observed.Nasal retainer was used for half a year postoperatively.After two years' follow-up,it showed good results.Conclusions This article is to introduce the therapeutic process and detailed literature review of clinical study of nostril stenosis abnormalities.
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Objective@#To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction.@*Methods@#Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups.@*Results@#All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group.@*Conclusions@#Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.
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OBJECTIVE@#The purpose of the study is to investigate the relationship between dental calcification stages (DCS) and cervical vertebral maturation stages (CVMS) in patients with unilateral complete cleft lips and palates (UCLP) and to provide a theoretical basis for the treatment time selection of cleft lip and palate (CLP) patients.@*METHODS@#A total of 123 UCLP patients and 215 non-CLP subjects were selected. The DCS of the left mandibular canine, premolar, and second molar in non-CLP subjects and on both cleft sides of UCLP patients were assessed utilizing the Demirjian method. CVMS was observed utilizing the Baccetti method. The results were analyzed by Spearman rank correlation, and the correlation coefficients were compared.@*RESULTS@#There was a correlation between the CVMS and the DCS of the left mandibular canine, the first premolar, the second premolar, and the second molar in the non-CLP subjects and on both cleft sides of the UCLP patients (r=0.762-0.864, P0.05).@*CONCLUSIONS@#DCS can be utilized as a biological index to determine the growth development statuses. The correlation between the CVMS and the DCS of the mandibular first premolar was the highest.
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Female , Humans , Bicuspid , Calcinosis , Cervical Vertebrae , Pathology , Cleft Lip , Cleft Palate , CuspidABSTRACT
BACKGROUND: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. CASE PRESENTATION: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. CONCLUSIONS: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.
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Humans , Male , Cicatrix , Cleft Lip , Congenital Abnormalities , Constriction , Esthetics , Follow-Up Studies , Masks , Orthodontics , Orthognathic Surgery , Osteogenesis, Distraction , Osteotomy , Palate , Plastics , SurgeonsABSTRACT
The purpose of this study is to evaluate the effect of the presurgical infant orthopedics and the nasoalveolar molding in unilateral complete cleft lip and palate by the analytic system using standardized photographs. This study involved 34 patients with unilateral complete cleft lip and palate(24 male, 10 female, mean age 4.9 years) who underwent a rotation-advancement flap repair between 1995 and 1998 by single surgeon. Follow-up photographs were taken at a time average 3.8 years(2-7ears) after surgery. The patients were divided into three groups Group I(9 patients) consists of those who underwent cheiloplasty and primary rhinoplasty without presurgical infant orthopedics. Group II(10 patients) consists of those who underwent cheiloplasty and primary rhinoplasty with presurgical alveolar molding alone without nasal molding, and Group III(15 patients) consists of those who underwent presurgical alveolar molding with nasal molding without primary rhinoplasty. Facial proportions and angles were measured on standardized photographs using defined anthropometric points. All linear parameters were converted to the percentage values. In addition, the qualitative measurements were performed on scar quality, nostril symmetry and alar symmetry. Comparisons between group I and II and those between group II and III were made in all parameters. Results were analyzed by Mann-Whitney/ Wilcoxon rank sum test. Between group I and II, there was a significant increase in upper lip height symmetry in group II(p= 0.014). Between group II and III, upper lip height symmetry and Cupid's bow length symmetry significantly increased in group II(p=0.002, p=0.012). The other quantitative and qualitative parameters didn't make the difference between groups. In conclusion, the infant orthopedics increases upper lip height of cleft side and has the effect to obtain the upper lip symmetry. But the nasoalveolar molding has no effect to increase the nasal symmetry. So the nasoalveolar molding alone appears to be insufficient to replace the infant orthopedics with primary rhinoplasty.
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Female , Humans , Infant , Male , Cicatrix , Cleft Lip , Follow-Up Studies , Fungi , Lip , Nose , Orthopedics , Palate , RhinoplastyABSTRACT
To manage a unilateral complete cleft lip and palate, lip adhesion along with the positioning of a passive alveolar molding appliance was performed in infants at 4 to 6 weeks of age. The lip adhesion creats a force acting on the cleft alveolus. Thereafter, the greater segment of the alveolus is guided by the appliance, while the lesser segment of the alveolus is prevented from collapsing. Definite cheiloplasty was then performed at 4 to 5 months of age and palatoplasty at 12 months of age. Twenty-five patients with a unilateral complete cleft lip and palate were treated using this protocol from 1994 to 2002. Fifteen were male and ten were female. The mean follow-up period was one to nine years. Dental cast measurements were performed at lip adhesion, definite cheiloplasty and palatoplasty in 18 patients, 3 to 9 years in 19 patients. The alveolar gap, length of maxillary alveolar cleft, width of maxillary alveolar cleft and palatal gap were 10.1 +/-4.2mm, 6.1+/-0.9mm, 10.2+/-4.8mm, 13.4+/-2.9mm at lip adhesion, 3.1+/-1.4mm, 2.6+/-0.8mm, 2.7+/-1.6mm, 9.6+/-1.5mm at definite cheiloplasty, and 0.2+/-0.1mm, 1.5+/-0.7mm, 0.2+/-0.1mm, 8.3+/-1.1mm at palatoplasty respectively. Measurements at palatoplasty were decreased with statistical significance(p<0.05). Twenty- three patients developed good symmetrically aligned alveolar segments plus a symmetric platform for the nose. However, two patients developed poor maxillary orthopedics because of the displacement of the appliance by the patient. On the following maxillary dental cast from 8 to 9 years, intercanine width and canine arch length were within the normal value. However, intermolar width and molar arch length was decreased slightly compared to the normal with a statistical significance (p<0.005). In conclusion, lip adhesion and passive alveolar molding appliance achieve a normal position and stabilizing the arch, a symmetrical platform. However, longer follow- up is necessary until 15 years old for permanent dental arch establishment.
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Adolescent , Female , Humans , Infant , Male , Cleft Lip , Dental Arch , Follow-Up Studies , Fungi , Lip , Molar , Nose , Orthopedics , Palate , Reference ValuesABSTRACT
The present study was carried out to evaluate the postoperative results of Millard rotation-advancement repair (MR) and lip adhesion followed by Millard rotation-advancement repair (LAMR) in unilateral complete cleft lip. Twenty patients with unilateral complete cleft lip underwent MR or LAMR at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 6 years (January 1994 to December 1999) were analyzed. The surgical results following the operation were assessed on the basis of scoring, vertical lip length, and scar hypertrophy. The mean score was better in LAMR group (74.74+/-1.09, n=13) than in MR group (66.50+/-1.14, n=7) for both lip and nose segments. Scar hypertrophy developed in MR group with 28.6% and in LAMR group with 23.1%. No significant difference was noted in the ratio of lip length between LAMR and MR groups (0.84+/-0.08 and 0.73+/-0.10). These results suggest that LAMR is better than MR in repairing the unilateral complete cleft lip.
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Humans , Cicatrix , Cleft Lip , Hypertrophy , Lip , Nose , Surgery, OralABSTRACT