Study Of Effect Of One-stage Rhinoplasty With Nasal Split In Unilateral Complete Cleft Lip Patients

Recently, scholars pay more attention to secondary nasal deformity with cleftlip. However, there still has been controversial about correction time of secondarynasal deformity with cleft lip. Some scholars claim that repairing secondary nasaldeformity with cleft lip while repairing cleft lip; others support that correction ofnasal deformities should be taken after developed of nasal cartilage. The method ofnasal split (NS) maintaining outcomes of operating has been used gradually inrhinoplasty, but clinical effect of nasal split in unilateral complete cleft lip (UCCP)patients has not been objective evaluation. Three-dimension sensing (3DSS) hasbeen widely applied to measure in facial soft tissue and evaluate to result ofrepairing, especially suit for infant patients.So we design to use three-dimension sensing (3DSS) and reverse engineeringsoftware (RES) to evaluate the clinical effect of one-stage rhinoplasty with nasalsplit (NS) in unilateral complete cleft lip (UCCP) patients. The specific method、results and conclusion are as follows: Methods72patients（40males,32females, ranged from3to4months in age with meanage of3.4months）unilateral complete cleft lip (UCCP) patients. Those patientswere divided into experimental groups which contain36cases and control groupswhich contain36cases according to whether to do simultaneous rhinoplasty withnasal split (NS). Experiment group was rectified by improved Millard, thenSeparating nasal alar cartilage on the surface and inferior surface of its to nasal tipand nasal fornix, and cutting its abnormal attachment to lateral crus of nasal alarcartilage and base of nasal columella so as to rectify deformed nasal alar cartilage.At last, suspling and fixing unhealthy nasal alar cartilage at nasal fornix、nasalvestibule and lateral crus of nasal alar with5-0#absorption line, then wearing nasalsplit(NS) in order to maintain effect of postoperation. Control group was rectifiedby improved Millard without one-stage rhinoplasty and nasal split (NS).1to2.6years after operation, data of nasal-morph were collected and reconstructioned bythree-dimensional sensing system (3DSS) and measured by importing these datainto reverse engineering software (RES) Geomagic Studio10.0. Student,s test wereused for statistics analysis with SPSS13.0software package, then analysis clinicaleffect of simultaneous rhinoplasty with nasal split (NS) in unilateral complete cleftlip (UCCP) patients.ResultsThere was significant difference in the asymmetry ratio of height（0.093±0.072，0.333±0.097，P<0.05）and width （0.100±0.058，0.212±0.107，P<0.05）of nostrils、length of ala nasi （0.064±0.048，0.131±0.066，P<0.05）andbasis of nose（0.053±0.049，0.120±0.062，P<0.05）、skewness of nasal tip（1.557±0.534，3.011±0.823，P<0.05），experimental groups are superior than control groups. There was no significant difference in alar base-subnasale distance（0.235±0.114，0.193±0.114，P>0.05）、alar base-angle of lips distance(0.110±0.077,0.091±0.068, P>0.05) and flank-curvature of nose(0.170±0.149,0.213±0.105, P>0.05), there was no definite weather experimental groups are superior than controlgroups.Conclusion1．Methods of simultaneous rhinoplasty with nasal split (NS) in unilateralcomplete cleft lip (UCCP) patients can get stable effect range from1to2.6yearsafter operating. Although some patients cannot reach to normal nasal morphous, it ispossible that this method can reduce the degree of secondary nasal deformity andcreate condition for next restitution. NS can reduce and prevent secondary collapseof ala nasi and narrow of nostril unhealthy side caused by scar contracture, witheffect of support of ala nasi and inducing local nasal morphology to normal.2．There is no significant difference between location of crus of nasal alar andshape of nose dorsum in two groups. There is close relation to patients with theseverity degree of malformations and anatomical differences.3. To evaluate clinical effect of simultaneous rhinoplasty with nasal split (NS)in unilateral complete cleft lip (UCCP) patients by three-dimension sensing system(3DSS) can get objective and accuracy results.