Effect of early correction of nasal septal deformity in unilateral cleft lip and palate on inferior turbinate hypertrophy and nasal patency

Piccin, Ottavio; Burgio, Luca; Summo, Valeria; Antoniazzi, Elisa; Morselli, Paolo Giovanni

doi:10.1016/j.ijporl.2018.03.002

Cited by 14 publications

(22 citation statements)

References 23 publications

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“…Previous research has shown a positive influence on nasal airflow with cleft rhinoplasty. Several publications demonstrate that turbulent airflow and nasal obstruction can be reduced by correcting septal deviation and nasal tip projection (Massie et al, 2016;Zhan et al, 2017;Pinto et al, 2018). In our study, 10 subjects in the definitive group received tip grafts and 9 received columellar grafts in order to improve nasal tip support and projection.…”

Section: )mentioning

confidence: 66%

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Pagan

Sterling

Andrews

2020

The Cleft Palate-Craniofacial Journal

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Objective: To compare cartilage grafting outcomes in intermediate versus definitive cleft rhinoplasty. Design: A retrospective chart review was conducted. The χ2 and Fisher exact tests were used for statistical analyses. Results were considered statistically significant at P < .05. Participants: All subjects who underwent revision cleft rhinoplasties between July 2011 and June 2019 were included. Subjects with syndromic conditions were excluded. Results: A total of 46 subjects with a cleft nose deformity underwent 65 rhinoplasty procedures. The ages averaged 17 years (range 5-50) with 34 (73.9%) males and 12 (26.1%) females. In the intermediate group, 6 (28.6%) subjects required cartilage grafting as part of 6 cleft rhinoplasties, whereas 15 (71.4%) subjects underwent a total of 26 cleft rhinoplasties that did not require grafting. In the definitive group, 18 (76%) subjects required cartilage grafting over 21 cleft rhinoplasties, whereas 7 (24%) subjects underwent a total of 9 cleft rhinoplasties where cartilage grafting was not required. The difference between the number of subjects requiring cartilage grafting in the intermediate versus the definitive group was statistically significant ( P = .007). Ear concha and nose were the most frequently used cartilage donor sites, with no observed complications. Conclusions: Cartilage grafting was significantly more common in the definitive rhinoplasty group. Intermediate cleft rhinoplasty during the 5- to 13-year age period was effective, with a low-risk profile. In our experience, ear concha and nose were the preferred cartilage donor sites, with effective results and an excellent safety profile.

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Section: )mentioning

confidence: 66%

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Pagan

Sterling

Andrews

2020

The Cleft Palate-Craniofacial Journal

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“…The easiest evidence to evaluate is when PR recipients were compared with patients who only had a lip repair, leaving the nose untouched. 16,24,25,27,29 The aforementioned studies had follow-up periods ranging from 5 to 10 years. Morselli et al 25 showed a significantly improved nostril thickness and decrease in septal deviation in those undergoing primary repair.…”

Section: Discussionmentioning

confidence: 99%

“…The results of PR during cleft lip repair were assessed subjectively in 10 publications. 7,12,[14][15][16][17][18][19][20][21] Outcomes were assessed in multiple ways, including five-point visual assessment scores, [17][18][19] the author or surgical team, 7,12,14,15,20,21 or the Nasal Obstructive Symptom Evaluation (NOSE) questionnaire, 16 as shown in Table 2.…”

Section: Subjective Outcomesmentioning

confidence: 99%

“…15 The NOSE questionnaire revealed that those who underwent repair with septorhinoplasty had a NOSE score of 21.4 versus 70.8 for the cheiloplasty without septorhinoplasty group, indicating that nasal obstruction was of less concern in the septorhinoplasty group. 16…”

Section: Subjective Outcomesmentioning

confidence: 99%

“…32 Nasal endoscopy showed that 85% of patients who underwent rhinoseptoplasty had no significant septal deviation and a mean Friedman turbinate hypertrophy grade of 0.45 compared with 100% septal deviation and a turbinate grade of 2.8 in those who underwent cheiloplasty without rhinoseptoplasty. 16 Two studies had designs that could not evaluate whether PR had positive or negative results per se, but showed that PR does not result in complete facial symmetry 31 and results in some relapse after 9 months. 33 Volume 151, Number Nine studies evaluated nasal and development over time.…”

Section: Objective Outcomesmentioning

confidence: 99%

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Primary Cleft Rhinoplasty: A Systematic Review of Results, Growth Restriction, and Avoiding Secondary Rhinoplasty

Zelko

Zielinski

Santiago

et al. 2022

Plastic &Amp; Reconstructive Surgery

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ince the first reports of cleft lip repair, surgeons have continued to innovate to maximize functional and aesthetic results. During a large portion of this time, there was a fear that correcting the cleft nasal deformity would disturb nasal or maxillary development. In the 1950s, Gelbke 1 challenged this idea by performing a primary rhinoplasty during cleft repair. His invasive approach ultimately led to poor results, which propagated concerns about early nasal interventions. Embryologic research by Latham 2 in 1970 led to further apprehension regarding primary rhinoplasty through the "septal concept of facial growth." His experiments demonstrated that the nasal septum, by means of the septopremaxillary ligament, transmits a force that induces growth of the maxilla.In the 1970s, physicians began to revisit primary rhinoplasty (PR) during cleft lip repair.McComb postulated that the procedure could Background: Primary rhinoplasty during correction of unilateral cleft lip continues to be a topic of debate because of concerns that early nasal intervention may affect nasal and maxillary development over the long term. This study aims to determine the volume and quality of evidence for and against primary unilateral cleft rhinoplasty. Methods: A systematic review was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were pulled from PubMed and EMBASE and screened by title and abstract. Studies with human participants undergoing rhinoplasty at the time of unilateral cleft lip repair and some evaluation of the nasal outcome were included. Studies with a large proportion of syndromic patients, case reports, editorials, letters, reviews, studies exclusive to bilateral clefts, and studies not available in English were excluded. Those that met criteria were then systematically reviewed. Results: Twenty-five articles were included. Ten articles that assessed the results of primary rhinoplasty subjectively all supported cleft lip repair with primary rhinoplasty. Sixteen articles assessed the results of primary rhinoplasty objectively, with 15 supporting primary rhinoplasty during cleft lip repair. Eight of nine studies that evaluated nasal growth and development over time found no restriction in nasal development. Five studies with a follow-up period of at least 6 years found that the percentage of patients who avoided revision rhinoplasty ranged from 43% to 100%. There were significant risks of bias in the majority of studies. Conclusion:The majority of studies reviewed support that primary rhinoplasty during unilateral cleft lip repair results in good outcomes with limited or no effect on nasal growth.

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Current State of the Art in Unilateral Cleft Lip Repair with Primary Nasal Overcorrection: Lo’s Modified Noordhoff’s Procedure

Denadai¹,

2022

Current Concept in Cleft Surgery

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Effect of early correction of nasal septal deformity in unilateral cleft lip and palate on inferior turbinate hypertrophy and nasal patency

Cited by 14 publications

References 23 publications

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Primary Cleft Rhinoplasty: A Systematic Review of Results, Growth Restriction, and Avoiding Secondary Rhinoplasty

Current State of the Art in Unilateral Cleft Lip Repair with Primary Nasal Overcorrection: Lo’s Modified Noordhoff’s Procedure

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