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The Effectiveness of Preoperative Correction Techniques in Improving Nasal Deformity in Children With Unilateral
Shengyu Tang1, Yuxiang Zhong, Lishu Liao
1Oral Department, Children's Hospital, Chongqing Medical University, Chongqing, China.
Insights
Preoperative correction for unilateral complete cleft lip and palate (UCCLP) effectively increases nasal columella height and reduces nasal ala width. While improving nasal symmetry, it does not significantly alter nasal columella inclination.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Otolaryngology
Background:
- Infants with unilateral complete cleft lip and palate (UCCLP) often present with noticeable nasal deformities.
- These deformities can impact facial aesthetics and may require early intervention prior to surgical repair (cheilorrhaphy).
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of preoperative correction techniques for nasal deformities in infants with UCCLP.
- To evaluate the impact of these techniques on specific nasal parameters, including columella height, ala width, and columella inclination.
Main Methods:
- A comprehensive literature search was conducted across major databases (Medline, Cochrane Library, EMBASE, PubMed, CBM) up to January 31, 2019.
- Data extraction and quality assessments were performed by two independent authors.
- Key outcomes evaluated included nasal columella height, affected nasal ala width, and nasal columella inclination.
Main Results:
- Seven studies were included in the systematic review, with 5 studies (274 participants) contributing to the meta-analysis.
- Preoperative correction significantly increased nasal columella height (SMD: 2.64 mm; P < 0.0001).
- A significant reduction in the width of the affected nasal ala was observed (SMD: -5.14 mm; P = 0.008).
- The effect on nasal columella inclination was not statistically significant (SMD: -3.48 degrees; P = 0.09).
Conclusions:
- Preoperative correction techniques are effective in improving nasal deformities in infants with UCCLP.
- These methods lead to increased nasal columella height and reduced nasal ala width, thereby enhancing nasal symmetry.
- No significant improvement was noted for nasal columella inclination.
Objective:
Unilateral complete cleft lip and palate (UCCLP) is associated with apparent nasal deformities before the cheilorrhaphy. The aim of this study was to determine whether preoperative correction techniques are effective in the treatment of nasal deformities in infant with unilateral UCCLP used by the systematic review and meta-analysis.
Methods:
We searched Medline, Cochrane Library, EMBASE, PubMed, and Chinese BioMedical Literature Database (CBM) until January 31, 2019, to identify studies that compared the effectiveness of preoperative correction techniques in the treatment of nasal deformities in infant with UCCLP. Two authors individually extracted the data and performed the quality assessments. The height of nasal columella, the width of the affected side nasal ala and the inclination of the nasal columella were evaluated.
Results:
Seven articles were incorporated into the systematic review, and 5 (274 participants) in the meta-analysis according to the inclusion criteria. The preoperative correction could increase the height of nasal columella in children with UCCLP [SMD: 2.64 mm; 95% confidence intervals (CI); (1.35 mm, 3.94 mm); P < 0.0001]. Moreover, the preoperative correction resulted in reduced width of the affected side nasal ala [SMD: -5.14 mm; 95% CI; (-8.96 mm, -1.31 mm); P = 0.008]; However, the evidence was insufficient to determine a significant effect on the inclination of the nasal columella [SMD: -3.48 degrees; 95% CI; (-7.56 degrees, 0.59 degrees); P = 0.09].
Conclusions:
Preoperative correction for children with UCCLP can increase the height of nasal columella, reduce the width of the affected side nasal ala, improve the nasal symmetry, and reduce nasal deformity, however, no significant effect could be observed for the inclination of the nasal columella.
