Kehrer, Andreas and Nijhuis, Tim H. J. and Lonic, Daniel and Heidekrueger, Paul I. and Kehrer, Michael and Taeger, Christian D. and Willemsen, Sten and Prantl, Lukas and van der Meulen, Jacques J. J. N. M. (2019) An Analysis of Aesthetic Refinements in 120 Secondary Cleft Rhinoplasties. ANNALS OF PLASTIC SURGERY, 83 (4). pp. 429-435. ISSN 0148-7043, 1536-3708
Full text not available from this repository. (Request a copy)Abstract
Background Secondary cleft nose rhinoplasty remains a challenging procedure. Cartilage memory and scar contraction are problematic factors. The need for more detailed procedures for secondary reconstruction in this patient population has arisen. Contemporary refinements demonstrate a highly structured approach. We conducted a retrospective study evaluating the aesthetic results of cleft patients who underwent secondary rhinoplasty. Methods In a retrospective study, a photometric analysis of cleft patients operated in the period 2003-2011 was conducted. Reconstructive methods were documented. Pre- and postoperative photographs of cleft rhinoplasty patients were evaluated using a standardized protocol. Nostril width ratio, columellar angle, tip projection ratio, and nasolabial angle served as objective instruments. The Unilateral Cleft Lip Surgical Outcomes Evaluation score was chosen for external photometric rating and rated blindly by 2 external individual plastic surgeons as independent nonbiased reviewers. The interrater and intrarater reliabilities were calculated using the Cohen kappa coefficient (kappa). Results A total of 120 secondary rhinoplasties in 85 uni- and bilateral cleft patients could be included. Mean follow-up was 20 months. A total of 60 (71%) patients needed additional bone grafting (chin/pelvis), and 23 (27%) patients a LeFort I osteotomy. In one third of the secondary rhinoplasties, a medial and/or lateral osteotomy was performed (34%). In one fourth (24%), an external septoplasty was considered necessary. In 55% (47 patients) of the cases, a columellar strut was used. Excluding bone grafts, a total of 173 other grafts (mean of 2 grafts/patient) were applied. Postoperative measurements for nostril width ratio and columellar angle were statistically significant. A structured approach with contemporary refinements is described in detail. Intra- and interrater reliabilities for photometric assessment according to the Unilateral Cleft Lip Surgical Outcomes Evaluation score are shown. Conclusions A structured approach for secondary cleft rhinoplasty yields satisfying, reproducible, and stable results.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRACORPOREAL SEPTOPLASTY; LIP; NOSE; REPAIR; cleft; cleft nose rhinoplasty; secondary rhinoplasty; cartilage graft; rotational advancement; nasal asymmetry |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Mar 2020 05:14 |
| Last Modified: | 26 Mar 2020 05:14 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26049 |
Actions (login required)
 |
View Item |
