Effect of alveolar bone grafting on nasal morphology, symmetry, and nostril shape of patients with unilateral cleft lip and palate

Cleft Palate Craniofac J. 2011 Jan;48(1):20-7. doi: 10.1597/09-007. Epub 2010 Feb 19.

Abstract

Objective: To evaluate nasal morphology, symmetry, and nostril shape in patients with unilateral cleft lip and palate following mixed-dentition alveolar bone grafting.

Design: Prospective stereophotogrammetric study.

Setting: Hospital-based.

Patients: Thirty-nine patients with a history of repaired unilateral cleft lip and palate who received an iliac crest alveolar bone graft were recruited prospectively to participate in the study. Each patient served as his/her own control.

Interventions: Partial facial impressions of all patients were acquired before and a minimum of 6 months after the alveolar bone grafting procedure. Image acquisition and analysis of the casts constructed from these models were carried out using three-dimensional stereophotogrammetry.

Main outcome measures: Surface-based registrations and linear measurements were performed to assess nasal morphology and nostril shape. A modified Procrustes technique was used to determine the change in nasal symmetry. A two-tailed, paired t test and an analysis of covariance were used to assess statistical significance.

Results: Significant side-to-side asymmetry exists in the nasal region of patients with unilateral cleft lip and palate, both before and after alveolar bone grafting. No significant changes were observed between pre-alveolar bone graft and post-alveolar bone graft images based on linear measurements, asymmetry scores, and registrations. Gender and surgeon were not significant factors.

Conclusion: Under the conditions of this study, mixed-dentition alveolar bone grafting appears to have no significant long-term effect on nasal morphology, symmetry, or nostril shape.

MeSH terms

  • Adolescent
  • Alveolar Bone Grafting*
  • Child
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Facial Asymmetry / surgery
  • Facial Expression
  • Female
  • Humans
  • Ilium / transplantation*
  • Imaging, Three-Dimensional
  • Male
  • Nose / abnormalities
  • Nose / surgery
  • Photogrammetry
  • Pilot Projects
  • Prospective Studies
  • Rhinoplasty / methods*
  • Treatment Outcome