Long-Term Three-Dimensional Morphometric Outcome Study of Nasal Bone in Cleft Patients

Area of Science:

• Craniofacial surgery
• Orthodontics
• Plastic surgery

Background:

• Nasal deformities are common in cleft lip and palate patients.
• Previous research has primarily focused on soft tissue or overall skeletal structures, neglecting specific nasal bone morphology.
• Understanding nasal bone characteristics is crucial for effective surgical and orthodontic interventions.

Purpose of the Study:

• To compare nasal bone features, specifically piriform width, nasal width, and nasomaxillary angle, among adult patients with unilateral cleft lip (with or without cleft palate), bilateral cleft lip and palate (BCLCP), and healthy controls.
• To evaluate the impact of cleft type and palate involvement on nasal bone morphology.

Main Methods:

• Retrospective study including adult patients (≥16 years) with nonsyndromic clefts and controls (18-45 years).
• Nasal bone dimensions (piriform width, nasal width, nasomaxillary angle) were measured using computed tomography (CT) scans.
• Statistical comparison using the Wilcoxon rank sum test was performed among unilateral cleft lip, BCLCP, and control groups.

Main Results:

• Patients with BCLCP showed significantly greater mean piriform width and nasomaxillary angle compared to controls.
• No significant differences in mean nasal width were observed among the groups.
• Nasal bone morphology was not significantly affected by isolated cleft lip or the presence/absence of a cleft palate.

Conclusions:

• Adults with BCLCP present with distinct nasal bone morphology, characterized by a wider and lower nose.
• These findings suggest that surgical interventions targeting bony nasal width reduction may be more advantageous than soft tissue treatments for BCLCP patients.
• Further research into the specific biomechanical implications of these bony differences is warranted.