Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities

Smolka, Koord; Eggensperger, Nicole; Iizuka, Tateyuki; Smolka, Wenko (2008). Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities. Journal of oral and maxillofacial surgery, 66(12), pp. 2577-84. Maryland Heights, Mo.: Elsevier 10.1016/j.joms.2008.06.044

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PURPOSE: The aim of the study was to evaluate the clinical outcomes of secondary functional cheilorhinoplasty of residual lip and nasal deformities caused by muscular deficiency in cleft patients. PATIENTS AND METHODS: During a 4-year period, 31 patients underwent cheilorhinoplasty, including complete reopening of the cleft borders and differentiated mimic muscle reorientation. In 21 patients, remarkable residual clefts of the anterior palate were also closed. Simultaneous alveolar bone grafting was performed in 15 patients. The minimum follow-up was 1 year. Cosmetic features evaluated were spontaneous facial appearance and changes in position of the nasal floor and the philtrum. The width of the alar base was measured. For functional outcomes, deficiency during mimic movements was evaluated, using standardized photographs taken preoperatively and postoperatively. The final results, judged according to defined criteria with several clinical factors, were compared. RESULTS: Cosmetic and functional improvement was achieved in all patients. In young patients (aged 4 to 9 years), the improvements were noteworthy. There were no differences in outcomes between the groups with and without simultaneous grafting, except for unilateral cases with minor muscular deficiency, in whom bone grafting before cheilorhinoplasty led to better results. CONCLUSION: In cases of major muscular deficiency, early cheilorhinoplasty should be performed at age 7 years, without waiting for the usual timing of bone grafting. In minor and moderate cases, the operation can ideally be done in combination with bone grafting.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery
UniBE Contributor:	Smolka, Koord Maximilian Wilke, Iizuka, Tateyuki, Smolka, Wenko
ISSN:	0278-2391
ISBN:	19022138
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:05
Last Modified:	05 Dec 2022 14:20
Publisher DOI:	10.1016/j.joms.2008.06.044
PubMed ID:	19022138
Web of Science ID:	000261351400021
URI:	https://boris.unibe.ch/id/eprint/28147 (FactScience: 117586)