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.
Written by admin on February 28, 2013
Orthod Craniofac Res. 2013 Feb;16(1):36-43. doi: 10.1111/ocr.12002. Epub 2012 Sep 17.
Offert B(1), Janiszewska-Olszowska J, Dudkiewicz Z, Brudnicki A, Katsaros C, Fudalej PS.
Author information:
(1)Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
OBJECTIVES: 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.
DESIGN: Retrospective case-control study.
SETTING: The Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
MATERIAL AND 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.
© 2012 John Wiley & Sons A/S.
DOI: 10.1111/ocr.12002
PMID: 23311658 [Indexed for MEDLINE]
