title: Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age.
abstract: OBJECTIVE
  To evaluate facial esthetics in patients with unilateral cleft lip and palate (UCLP) after alveolar bone grafting combined with rhinoplasty between 2 and 4 years of age.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  The Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
  
  
  METHODS
  Photographs of full faces and cropped images of five nasolabial components: nasal deviation, nasal form, nasal profile, vermillion border, and inferior view were assessed by 5 professional and 14 layraters in 29 children (23 boys and 6 girls; mean age = 5.3 years, SD 0.5; Early-grafted group) and 30 children (20 boys and 10 girls; mean age = 5.5 years, SD 1.0; Non-grafted group) with complete unilateral cleft lip and palate repaired with a one-stage closure. The groups differed regarding the timing of alveolar bone grafting: in the Early-grafted group, alveolar bone grafting in combination with rhinoplasty (ABG-R) was performed between 2 and 4 years of age (mean age = 2.3 years; SD 0.6); in the Non-grafted group, the alveolar defect was grafted after 9 years of age. No primary nose correction was carried out in any group. To rate esthetics, a modified five-grade esthetic index of Asher-McDade was used, where grade 1 means the most esthetic and grade 5 - the least esthetic outcome.
  
  
  RESULTS
  Esthetics of full faces and of all nasolabial elements in the Early-grafted group was significantly better than in Non-grafted group. The scores in the Early-grafted group ranged from 2.30 to 2.66 points, whereas in the Non-grafted group ranged from 2.66 to 3.17 points. All intergroup differences were statistically significant (p < 0.05).
  
  
  CONCLUSIONS
  Three years post-operatively, early alveolar bone grafting combined with rhinoplasty is favorable for facial esthetics in children with UCLP, but a longer follow-up is needed to assess whether the improvement was permanent.
authors: Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
authors: B
authors: B
authors: Offert
authors: J
authors: J
authors: Janiszewska-Olszowska
authors: Z
authors: Z
authors: Dudkiewicz
authors: A
authors: A
authors: Brudnicki
authors: C
authors: C
authors: Katsaros
authors: P S
authors: PS
authors: Fudalej
mesh_terms: D016025:Bone Transplantation; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D012225:Rhinoplasty; D012649:Self Concept; D018709:Statistics, Nonparametric