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Two-stage bone grafting for nasal correction in late-presenting patients with unilateral cleft: A 3-year comparative
Jiaqi Jian1, Meilin Yao1, Chong Zhang1
1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
Objectives:
We evaluated the long-term impact of a two-stage bone grafting technique on nasal morphology in patients with unilateral cleft lip and palate (UCLP) who missed the optimal timing for alveolar bone grafting.
Methods:
We retrospectively analyzed 148 patients with UCLP (≥12 years) who underwent secondary nasolabial repair between 2018 and 2022. Patients were categorized into three groups: non-grafting repair (n=50), conventional secondary alveolar bone grafting (SABG, n=50), and two-stage bone grafting (n=48). Nasal morphology was assessed using standardized two-dimensional photogrammetry at baseline and at least 3 years postoperatively.
Results:
At 3 years, the two-stage grafting group exhibited superior outcomes in nasal morphology. In terms of nasal symmetry, the columellar angle improved to a mean of 86.99° (vs. 84.43° in conventional SABG, p<0.05). Key indicators for alar base form also showed improvement: the nasal alar base internal angle was 133.52° (vs. 137.04°, p<0.05) and nasal alar base angle was 1.58° (vs. 2.10°, p<0.05). No significant differences existed between the conventional SABG and non-grafting groups (all p>0.05). Safety was excellent across all the groups.
Conclusions:
For late-presenting patients with UCLP, two-stage bone grafting offers more effective and lasting correction of secondary nasal deformities than conventional SABG or non-grafting methods.
