Summary
Background
Nasal tip features of cleft lip nose cannot be defined well using conventional measurement
methods. Therefore, we developed a new method in which vertical nasal tip (the pronasale)
position is evaluated based on the Frankfurt-Horizontal plane. This measurement was
applied to bilateral cleft lip patients in early childhood.
Methods
Cone beam computed tomography (CT) records of bilateral cleft lip patients after primary
rhinoplasty aged from 5 to 8 years (n = 13) were investigated retrospectively. As age-matched controls, data from a normal
group (n = 17) and complete unilateral cleft lip group after primary rhinoplasty (n = 19) were included. In each group, nasolabial angle (β), nasal tip angle (α), nasal width (al-al), columellar length (sn-c′ ), nasal tip
protrusion (sn-prn), and vertical nasal tip position (sn′-prn′/sn′-n′) were investigated.
Results
With the exception of vertical nasal tip position and nasal width, the measurement
data of the bilateral cleft lip patients were acceptable. In the bilateral cleft lip
group, however, vertical nasal tip position was significantly higher and nasal width
was significantly larger than those in the normal and unilateral groups (P < 0.0001 and P = 0.0298; P = 0.0001 and P = 0.0002, respectively).
Conclusions
In cleft lip nose, the lower lateral cartilage that normally composes the nasal tip
domes is splayed out, causing cephalic positioning of the pronasale. Nasal tip collapse
was more severe in bilateral cleft lip than in the unilateral group. These results
were compatible with the fact that many bilateral cleft lip patients require augmentation
rhinoplasty after adolescence even after primary rhinoplasty.
Keywords
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Article info
Publication history
Published online: September 26, 2011
Accepted:
August 19,
2011
Received:
June 24,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
