The last resort for reconstruction of nasal floor in difficult-to-repair alveolar cleft cases: a retrospective study.
OBJECTIVE
This article describes four new methods as the last resort for reconstruction of the nasal floor in difficult-to-repair alveolar cleft patients, including bone suture technique, vascularized interpositional periosteal-connective tissue flap from the palate (VIP-CT flap), anteriorly based inferior turbinate flap, and skinless subcutaneous nasolabial flap, with emphasis on indications and limitations.


METHODS
In a retrospective study, data were obtained from 214 patients referred to the Department of Oral and Maxillofacial Surgery, Mashhad Dental School, Iran, for alveolar cleft bone grafting in 2004-2013. Eighteen patients had been treated using special techniques other than direct suturing for reconstruction of the nasal floor during alveolar cleft bone grafting.


RESULTS
Eighteen patients had been treated using these techniques as the last resort for nasal floor reconstruction; including bone suture technique (50%), inferior turbinate flap (33.3%), VIP-CT flap (11.2%) and nasolabial flap (5.5%). All the patients had a unilateral alveolar cleft, 72.2% of which were located on the left side and 44.5% of the patients were female.


CONCLUSIONS
Nasal floor reconstruction in 8.4% of alveolar cleft patients needed special techniques and flaps.
Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran. Electronic address: rahpeymaa@mums.ac.ir.
Amin
A
Rahpeyma
Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, P.O. Box: 91735-984, Mashhad, Iran. Electronic address: khajehahmadis@mums.ac.ir.
Saeedeh
S
Khajehahmadi
D000293:Adolescent; D064728:Alveolar Bone Grafting / Q000379:methods; D000543:Alveoloplasty / Q000379:methods*; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D003238:Connective Tissue / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D009296:Nasal Cavity / Q000601:surgery*; D009297:Nasal Mucosa / Q000637:transplantation; D010521:Periosteum / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D040521:Subcutaneous Tissue / Q000637:transplantation; D013524:Surgical Flaps / Q000637:transplantation; D013536:Suture Techniques; D014420:Turbinates / Q000637:transplantation; D055815:Young Adult
Alveolar cleft; Bone suture; Inferior turbinate flap; Nasolabial flap; VIP-CT flap