Evaluation Of Repaired Effect For Secondary Nasal Deformity After Unilateral Cleft Lip Surgery

BackgroundCleft lip(CL)with or without cleft palate is a common congenital malformation in plastic surgery and oral and maxillofacial surgery,with an average global incidence of 0.2 ‰-2.3 ‰.Unilateral cleft lip is nine times more common than bilateral cleft lip.The treatment of unilateral cleft lip can be traced back to 390 BC.From the initial straight pull suture technique to the current rotary advancement technique and its modified technique,a series of lip and nose deformities will be left after the stage I repair of unilateral complete cleft lip(UCCP).Relatively speaking,the function and cosmetic effect of stage ? surgical lip can be well restored,the cosmetic effect of nasal deformity repair is poor,and the surgical methods of UCCP secondary nasal deformity repair are diversified.Autogenous cartilage graft or prosthesis graft is commonly used,but there is no recognized optimal repair technique.In recent years,bionics,mechanical principles,anatomical subunits and other concepts have been mentioned in the literature.Bionic repair uses biomechanical principles to reconstruct the rhinomuscular biomechanical complex,without the need for autologous cartilage ·or prosthesis implantation,to achieve the effect of anatomical repair of lip and nose deformities,which may become a new direction of exploration for cleft lip nasal deformity repair in the future,but its effect remains to be evaluated,and there is a lack of a unified and effective evaluation criteria.With the development of 3D Scanning technology,current Three-Dimensional Printing(3DP)technology is closely related to medicine,especially in the departments of orthopedics and cardiology.The Three-dimensional scanning system(3DSS)is applied to the data acquisition and calculation in various specialties.In the past,the evaluation of the effect of maxillofacial soft tissue surgery in plastic surgery often relied on subjective judgment or direct human body measurement tools for measurement.Due to the easy deformation of soft tissue to touch,poor repeatability and large error,the three-dimensional scanning system improved the repeatability and accuracy of measurement.The hand-held 3D scanner was more preferred due to its characteristics of safe and harmless,convenient carrying,fast image acquisition and high flexibility of operation.Objective1.To investigate the surgical effect of bionic repair of secondary nasal deformity after unilateral cleft lip surgery by three-dimensional scanning technique.2.To investigate the improvement of nasal obstruction symptoms,safety,and satisfaction evaluation of bionic repair of secondary nasal deformity after unilateral cleft lip surgery.MethodsForty-five patients with secondary nasal deformity after unilateral cleft lip surgery who were admitted to the People's Hospital of Zhengzhou University from April 2016 to June 2017 were selected as the study subjects.The data of maxillofacial anteroposterior and head-up positions were collected by 3D scanner before operation and during follow-up 6-12 months after operation,the changes of aesthetic indicators were compared and analyzed,and the surgical effect was evaluated;the improvement of nasal obstruction symptoms in patients with secondary nasal deformity after unilateral cleft lip surgery was evaluated by NOSE score;the surgical safety was evaluated by observing the healing of surgical incision and the incidence of adverse events such as nasal septal perforation,hematoma,abscess,cerebrospinal fluid leakage,and incision infection;and the surgical satisfaction was evaluated by the postoperative nasal morphology satisfaction questionnaire.Results1.There were significant differences in nasal morphology before and after surgery(P<0.05);there was significant difference in nasal symmetry before and after surgery(P<0.05);there was significant difference in the area of affected and unaffected nostrils after surgery(P<0.05),and the differences in nostril height and nostril width had no statistical significance(P>0.05);2.There was no statistically significant difference in preoperative and postoperative nasal nasal ventilation(P>0.05);3.Of the 45 patients who participated in this study,one patient had poor healing of the upper lip incision,scar healing after multiple dressing changes,and satisfactory results after anti-scar injection therapy;no other adverse events occurred,and the incidence of adverse events was low(1/45).4.Patients who participated in the study had high satisfaction with overall nasal morphology after surgery(95.6%).Conclusion1.Three-dimensional scanning technology solves the difficult problem of easy deformation of soft tissue touch,increases the repeatability and accuracy of measurement,and provides a new method for nasal morphometry and aesthetic evaluation of nasal deformity treatment.2.Bionic repair of nasal deformity secondary to unilateral cleft lip has good effect,safety and high patient satisfaction,which provides a new idea for the repair of secondary nasal deformity after unilateral cleft lip surgery and can be widely used in clinical practice.