Primary septoplasty in the repair of unilateral complete cleft lip and palate
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Published on: June 20, 2018
Srinivas Gosla-Reddy1, Krisztian Nagy, Maurice Y Mommaerts
1Hyderabad and Mangalore, India; Bruges-Ostend, Belgium; and Nijmegen, The Netherlands From the GSR Institute of Craniofacial Surgery; Bruges Cleft and Craniofacial Center; Departments of Cariology and Preventive Dentistry, Orthodontics and Oral Biology and Head Cleft Palate Craniofacial Unit, and Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center; and A. B. Shetty Memorial Dental College and Hospital.
Background:
The purpose of this study was to assess and compare nasal symmetry in patients who underwent correction of a complete unilateral cleft lip using the Afroze incision without and with primary septoplasty using a standardized two-dimensional photographic analysis.
Methods:
A prospective cohort study of 190 consecutive patients with complete unilateral cleft lip and alveolus with cleft palate treated with or without septoplasty using the Afroze incision technique was conducted at a high-volume center. Eighty-two patients operated on without primary septoplasty and 76 patients operated on with primary septoplasty were evaluated. Nasal symmetry was compared between patients using two-dimensional photographic analysis. Ratios between the cleft side and the non–cleft side for five parameters were used to assess symmetry: alar base–to–interpupillary line distance, columella-to–Cupid's bow distance, nostril gap area, nostril width, and nostril height. The Mann-Whitney U test was used to calculate differences between the two groups.
Results:
Patients operated on with primary septoplasty showed more nasal symmetry compared with patients operated on without septoplasty. This difference was statistically significant for columella-to–Cupid's bow distance, nostril gap area, and nostril height (p = 0.008, p < 0.001, and p < 0.001, respectively) and for the distance between alar base and the alar base–to–interpupillary line distance (p = 0.145) the difference was present but not statistically significant. For nostril width, no difference was found (p = 0.850).
Conclusion:
Patients treated with primary septoplasty showed better results in terms of nasal symmetry when analyzed using two-dimensional photographic analyses.
