Evaluation of Cleft Lip Bony Depression of Piriform Margin and Nasal Deformity with Cone Beam Computed Tomography: “Retruded-like” Appearance and Anteroposterior Position of the Alar Base

Abstract

The authors' study suggests that bony depression does not necessarily lead to postoperative alar depression. The postoperative cleft lip alar position can be maintained independently of the collapsed lesser segment of the maxilla. In addition, in many cleft lip newborns the cleft alar crease is hypoplastic, and the paranasal triangle is easily elevated by operative manipulation because of the muscular dysfunction. This shallowness leads to a "retruded" appearance. For improvement, preservation of the paranasal triangle and alar crease plasty are important.

Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: A systematic review of the literature

“…5 (14%) papers reported CBCT imaging in maxillofacial trauma, mainly for mandibular fractures 84,164,180 , but also for facial trauma 12,54 . CBCT was used to assess cleft pathology in 6 (17%) papers mainly for general assessment of the cleft region 7, 77,112,176 , but also to evaluate an alveolar bone graft 43 and to assess nasal deformity and the bony depression of the piriform margin 108 . 4 (11%) papers described the use of CBCT imaging in orthognathic surgery 13,14,160,161 , and another 4 (11%) in intra-operative imaging [51][52][53]77 .…”

Cone‐beam computed tomography of the maxillofacial region—an update

“…There have not been a lot of papers published but they are increasing in their number as CBCT is becoming more readily available. CBCT was successfully used to compare the anteroposterior positions of the cleft-side piriform margin and alar base with those of the non-cleft side in 52 postoperative unilateral cleft lip patients with no alveolar bone graft (32). CBCT can be used in combination with 3D soft tissue data obtained with stereophotogrammetry, structured light systems and laser acquisition systems for diagnostic, treatment planning and post-treatment evaluation purposes (33).…”

Correction of the Vestibular Web during Primary Repair of Unilateral Cleft Lip

“…15,16 The piriform ligament is a fibrous connection between the upper and lower lateral cartilages and the nasal aperture. 17,18 In a cleft lip, these fibers pull the lower lateral cartilage, particularly the tail of the lateral crus, into the vestibule, thus contributing to formation of the web.…”