title: Three-dimensional analyses of nasal forms after secondary treatment of bilateral cleft lip-nose deformity in comparison to those of healthy young adults.
abstract: OBJECTIVE
  To 3-dimensionally analyze outcomes after the secondary treatment of bilateral cleft lip-nose deformity at the Department of Oral and Maxillofacial Surgery, Kagoshima University Hospital, Kagoshima, Japan.
  
  
  METHODS
  Ten Japanese male young adults with bilateral cleft lip with or without palate (BCL±P) who had undergone definitive nose correction and were followed up for 1 to 4 years were enrolled in this study. Ten unaffected race- and gender-matched young adults were used as controls. All patients underwent secondary correction of the nose by open rhinoplasty through a bilateral reverse-U incision, columellar strut graft, and medial-upward advancement of the nasolabial components with vestibular expansion by use of a free mucosal graft. In 3 patients with an extremely short columella, an inferiorly based small pedicle flap from rim skin rotated into the columellar base was added for columella lengthening. Nasal forms were periodically measured by use of a 3-dimensional noncontact laser scanner. The angular and linear measurements and the curvature of the alar groove arch were compared between patients and control subjects.
  
  
  RESULTS
  Comparison of the preoperative and postoperative nasal forms showed significant improvements in the nasal dorsum and tip angles, as well as nasal height. The size of the nasal alar grooves was also increased to the same size range as the control subjects. There were persistent differences between postoperative columellar angle and nasal width in patients and those in the control subjects.
  
  
  CONCLUSIONS
  Our surgical procedures can provide an acceptably protruded nasal form for patients with BCL±P without damaging the upper lip tissue, but further improvement to prevent nasal tip overprojection may be useful.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan. nakamura@dent.kagoshima-u.ac.jp
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nakamura
authors.forename: Takako
authors.initials: T
authors.lastname: Okawachi
authors.forename: Etsuro
authors.initials: E
authors.lastname: Nozoe
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Nishihara
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Matsunaga
mesh_terms: D000293:Adolescent; D002356:Cartilage / Q000637:transplantation; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods*; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007834:Lasers; D008046:Lip / Q000601:surgery; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D055171:Nasal Cartilages / Q000473:pathology / Q000601:surgery; D009297:Nasal Mucosa / Q000601:surgery; D009666:Nose / Q000473:pathology*; D009667:Nose Deformities, Acquired / Q000601:surgery*; D010781:Photography / Q000379:methods; D011183:Postoperative Complications; D012225:Rhinoplasty / Q000379:methods; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult