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Primary Rhinoplasty Does Not Interfere with Nasal Growth: A Long-Term Three-Dimensional Morphometric Outcome Study in
Hyung Joon Seo1, Rafael Denadai1, Natthacha Vamvanij1
1From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University.
Insights
Primary rhinoplasty for unilateral cleft lip nose deformity does not impede nasal growth. Three-dimensional analysis showed minimal long-term effects on nasal dimensions, supporting its use in cleft care.
Area of Science:
- Plastic surgery
- Craniofacial surgery
- Pediatric plastic surgery
Background:
- Primary rhinoplasty in cleft care is debated due to concerns about potential nasal growth impairment.
- Unilateral cleft lip nose deformity presents unique surgical challenges.
- Long-term outcomes of primary rhinoplasty on nasal growth require further investigation.
Purpose of the Study:
- To evaluate the long-term effects of primary rhinoplasty on nasal growth in patients with unilateral cleft lip nose deformity.
- To compare nasal morphometric measurements between patients who underwent primary rhinoplasty and a control group.
Main Methods:
- Three-dimensional nasal morphometric analysis was performed on 52 patients (cleft group) who had primary rhinoplasty using the Noordhoff approach.
- A control group of 52 age-, sex-, and ethnicity-matched subjects was used for comparison.
- Measurements included linear, angular, proportional, surface area, and volume parameters.
Main Results:
- Most nasal measurements showed no significant differences between the cleft and control groups.
- The cleft group exhibited significantly lower nasal bridge length and nasal tip projection.
- The cleft group also showed greater nasal protrusion, tip/midline deviation, and specific ratio values compared to controls.
Conclusions:
- Primary rhinoplasty, as performed in this study, does not appear to interfere with overall nasal growth based on 3D photogrammetric analysis.
- Further research using advanced imaging is recommended to assess the development of other nasal anatomical structures.
- These findings support the consideration of primary rhinoplasty in managing unilateral cleft lip nose deformities.
Background:
Primary rhinoplasty has not been universally adopted because the potential for nasal growth impairment remains an unsolved issue in cleft care. This study's purpose was to assess the long-term effects of primary rhinoplasty performed by a single surgeon in a cohort of patients with a unilateral cleft lip nose deformity.
Methods:
Three-dimensional nasal morphometric measurements (linear, angular, proportional, surface area, and volume) were collected from consecutive patients (cleft group, n = 52; mean age, 19 ± 1 year) who had undergone primary rhinoplasty with the use of the Noordhoff approach between 1995 and 2002 and reached skeletal maturity. Normal age-, sex-, and ethnicity-matched subjects (control group, n = 52) were identified for comparative analyses.
Results:
No significant differences (all p > 0.05) were observed for most measures, including nasal height, alar width, nasal dorsum angle, columellar angle, columellar-labial angle, nasal tip/height ratio, nasal index, alar width/intercanthal distance ratio, nasal surface area, and nasal volume. The cleft group displayed significantly (all p < 0.05) lower nasal bridge length and nasal tip projection, and greater nasal protrusion, tip/midline deviation, nasal tip angle, nasal tip protrusion width index, and alar width/mouth ratio values than the control group.
Conclusions:
Primary rhinoplasty does not interfere with nasal growth as measured by three-dimensional photogrammetric analysis. Further imaging studies are required for the assessment of development in other anatomical nasal structures.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
