Septoplasty retards midfacial growth in a rabbit model

Wong, Kenny; Filatov, S V; Kibblewhite, Douglas J.

doi:10.1002/lary.20769

Cited by 22 publications

(17 citation statements)

References 11 publications

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“…Animal models have suggested that bony septal resection before skeletal maturity significantly decreases facial growth. 23 However, Ortiz-Monasterio and Olmedo 24 demonstrated no detrimental effects in their longterm follow-up. Our current treatment plan for cartilaginous and bony septoplasty is to defer intervention until the time of full facial maturity.…”

Section: Discussionmentioning

confidence: 97%

Airway Obstruction and the Unilateral Cleft Lip and Palate Deformity

Friel¹,

Starbuck²,

Ghoneima³

et al. 2015

Annals of Plastic Surgery

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Section: Discussionmentioning

confidence: 97%

Airway Obstruction and the Unilateral Cleft Lip and Palate Deformity

Friel¹,

Starbuck²,

Ghoneima³

et al. 2015

Annals of Plastic Surgery

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“…This observation was supported by the findings that the nasal septum responds to hormones and growth factors and has an intrinsic ability to grow. Additionally, extirpation of the nasal septum has been shown to impair midface development in rats and rabbits (10,36). However, such experimental approaches were criticized, as facial development is slower in humans than in the animal models used; thus, the observed midface malformations were attributed to surgical trauma.…”

Section: Discussionmentioning

confidence: 99%

Matrix Gla protein deficiency impairs nasal septum growth, causing midface hypoplasia

Marulanda

Eimar

McKee

et al. 2017

Journal of Biological Chemistry

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Genetic and environmental factors may lead to abnormal growth of the orofacial skeleton, affecting the overall structure of the face. In this study, we investigated the craniofacial abnormalities in a mouse model for Keutel syndrome, a rare genetic disease caused by loss-of-function mutations in the matrix Gla protein () gene. Keutel syndrome patients show diffuse ectopic calcification of cartilaginous tissues and impaired midface development. Our comparative cephalometric analyses of micro-computed tomography images revealed a severe midface hypoplasia in mice. reporter studies demonstrated that the promoter is highly active at the cranial sutures, cranial base synchondroses, and nasal septum. Interestingly, the cranial sutures of the mutant mice showed normal anatomical features. Although we observed a mild increase in mineralization of the spheno-occipital synchondrosis, it did not reduce the relative length of the cranial base in comparison with total skull length. Contrary to this, we found the nasal septum to be abnormally mineralized and shortened in mice. Transgenic restoration of expression in chondrocytes fully corrected the craniofacial anomalies caused by MGP deficiency, suggesting a local role for MGP in the developing nasal septum. Although there was no up-regulation of markers for hypertrophic chondrocytes, a TUNEL assay showed a marked increase in apoptotic chondrocytes in the calcified nasal septum. Transmission electron microscopy confirmed unusual mineral deposits in the septal extracellular matrix of the mutant mice. Of note, the systemic reduction of the inorganic phosphate level was sufficient to prevent abnormal mineralization of the nasal septum in compound mutants. Our work provides evidence that modulation of local and systemic factors regulating extracellular matrix mineralization can be possible therapeutic strategies to prevent ectopic cartilage calcification and some forms of congenital craniofacial anomalies in humans.

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“…Sarnat 17 stated that the nasal septum is the facial growth-center and discussed various experimental surgical methods. Maxillofacial growth, particularly maxillary growth, is a multifac- torial process involving sutural growth, bone remodeling, and muscular interaction [18][19][20][21] . Many researchers now consider the nasal septum theory as the only logical interpretation ; growth of a jaw face by classi cation of the two-dimensional nasal septum form.…”

Section: Discussionmentioning

confidence: 99%

Nasal Septum Morphology in Unilateral and Bilateral Cleft Lip and Palate Determined by 3D Cephalometry

Yamaya

Yamamoto

Seki

et al. 2017

Showa Univ J Med Sci

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: We examined vomer morphology using 3-dimensional 3D analysis and investigated the in uence of the surrounding sutures clefts and maxilla on nasal septum vomer morphology. We evaluated 60 patients who visited our institution. Patients underwent lateral cephalometry and cone-beam computed tomography CBCT upon initial examination. Patients with no signi cant differences in cranial growth were selected and divided into 3 groups of 20 : the bilateral cleft lip and palate BCLP , unilateral cleft lip and palate UCLP , and non-cleft Control groups. We investigated vomer and facial morphologies by using 2-dimensional 2D cephalometry and we also determined vomer morphology by using 3D cephalometry. Results were analyzed using Bonferroni multiple comparison, logistic regression analysis, and factor analysis. Vomer morphology was signi cantly different between the 3 groups. Sagitally, the vomer shape was a narrow quadrilateral that tapered at one end in the BCLP group, trapezoidal in the Control group, and intermediate, like a parallelogram, in the UCLP group. The vomer width was signi cantly greater in the BCLP group. P 0.05 . A signi cant difference was only found in the posterior vomer width between the UCLP and Control groups. The vomer volume was signi cantly larger in the BCLP group. The volume in the UCLP group was larger than in the Control group, but this was not signi cant. Factor analysis revealed that vomer morphology could be clearly distinguished between the 3 groups. Cleft-associated differences in the vicinity of the vomermaxilla palatine bone fusion may in uence vomer formation and may cause the differences observed in vomer morphology between the 3 groups. This suggests that cleft and maxillary morphologies may affect nasal septum morphology.

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Septoplasty retards midfacial growth in a rabbit model

Abstract: These data demonstrate midfacial growth retardation after conservative septoplasty in young rabbits, and that this retardation could not be averted by replacing the resected cartilage with a porous polyethylene graft. These data are in agreement with human studies.

Cited by 22 publications

References 11 publications

Airway Obstruction and the Unilateral Cleft Lip and Palate Deformity

Airway Obstruction and the Unilateral Cleft Lip and Palate Deformity

Matrix Gla protein deficiency impairs nasal septum growth, causing midface hypoplasia

Nasal Septum Morphology in Unilateral and Bilateral Cleft Lip and Palate Determined by 3D Cephalometry

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