Plastic and Reconstructive Surgery, Global Open (Mar 2019)

Columella Elongation Surgery Outcome in Complete Bilateral Cleft Lip and Palate

  • Daiana Broll, DDS,
  • Telma V. de Souza, MD, PhD,
  • Eudes Nobrega, MD,
  • Cristiane L. Luz, DDS, PhD,
  • Carlos E. Repeke, DDS, PhD,
  • Luiz C. da Silva, DDS, PhD,
  • Daniela G. Garib, DDS, PhD,
  • Terumi O. Ozawa, DDS, PhD

DOI
https://doi.org/10.1097/GOX.0000000000002147
Journal volume & issue
Vol. 7, no. 3
p. e2147

Abstract

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Background:. The evaluation of surgical outcomes is needed to achieve excellence in nasal reconstruction of patients with complete bilateral cleft lip and palate (BCLP). The study objective is to evaluate the quality of nasal aesthetics after the columella elongation surgery. Methods:. The sample of this study consisted of 70 patients with complete BCLP, operated on columella elongation surgery and analyzed at 6 to 12 years. The system for evaluation of nasal appearance after the columella elongation surgery was performed by objective and subjective analyses. Anthropometric Measurements:. Four anthropometric nose measurements were performed directly on the faces, and the same was performed in control group (60 children without oral clefts), paired by age and sex with the experimental group. The measurements were repeated 3 times (triplicate). Subjective Analysis:. Scores to evaluate nasal width, nasal tip projection, and length of the columella were applied before and after the columella elongation surgery by 5 raters from the rehabilitation team. Interrater and intrarater agreement was calculated by means of the kappa test. Results:. Nasal width in BCLP group was higher when compared to the control group (P 0.05). All scores of nasal aesthetics significantly improved after the columella elongation surgery. Conclusions:. Nose of the patients with BCLP is wider, is less projected, and has the shorter columella compared to that of the noncleft subjects. After secondary columella elongation surgery in BCLP, nasal width, nasal projection, and columella length significantly improved.