Anthropometric Characteristics of the Face in Patients with Congenital Defects of Alveolar Process on Maxilla before Surgical Intervention

Abstract

The purpose of the study was to investigate the anthropometric parameters of the nasolabial complex in patients with different sizes of the congenital defect of the alveolar process before surgical intervention. Materials and methods. To achieve the goal, a clinical assessment of the nasolabial complex was carried out in 54 children with clefts of upper lip and palate (aged 10 to 19 years). The next indicators were included: the length of the nasal wing, the width of the bottom in the nostril, the vertical displacement of the nasal wing and their ratios. The children were divided into three subgroups, depending on the size of the bone defect, which involved the planning of a different type of surgical intervention: 1 (n=13) – recovery of the defect without osteoplasty, 2 (n=11) – osteoplasty using the mandibular symphysis tissue, 3 (n=30) – osteoplasty using an autograft from tibia. Results and discussion. Clefts of upper lip and palate are accompanied by numerous anatomical and functional disorders in the maxillofacial system. Reconstruction of the maxilla alveolar processes on the cleft side is a necessary stage of the complex rehabilitation of the patient. The degree of severity of functional disorders in cases of clefts of upper lip and palate depends on many factors and conditions – the form and size of the cleft, the patient's age, concomitant local and general somatic pathology, as well as the success of the performed complex treatment. Fixation of the patient's rehabilitation process by photography and analysis of clinical photos are important components of evaluation of treatment results. The volume of the congenital (residual) defect of the alveolar process on maxilla directly affects the level of facial asymmetry which is reflected in changes in the ratios on the affected and healthy side – the length of the nasal wing, the width of the nostril, the angles of the base of the nasal wing. Such anthropometric data may be crucial points in the selection of surgical intervention methods and the use of different autologous transplants. The obtained results are consistent with similar studies by Ajami S., 2020, which established pronounced differences in the structure of the nasolabial complex even under the conditions of full and timely rehabilitation of children with congenital cleft of the upper lip and palate, compared to the ethnic anthropometric norm of healthy patients. And the sooner the integrity of the upper lip is restored, the better the symmetry of the nasolabial complex is achieved. Alveolar process plasty significantly equalizes the symmetry of the nose and upper lip in patients with congenital cleft of the upper lip and palate, which was shown by three-dimensional anthropometric studies in a number of clinics around the world. Conclusion. Anthropometry (photogrammometry) of the nasolabial complex on the face is an additional method in diagnostic that is necessary to make the correct clinical decisions during the planning of reconstructive interventions on the maxilla in case of clefts of lip and palate