Nose; Anomaly Clinical Trial
Official title:
Objective Assessment for Cleft Lip Nasal Deformity Correction
Rhinoplasty remains one of the most challenging procedures in plastic surgery, and patients with cleft lip nasal deformity pose an even greater challenge, in which biggest issue is to achieve caudal nose harmony and creation of symmetrical nostrils with patent normal nasal function
Cleft lip and palate represent the most common birth defects affecting the head and neck
region. It has been estimated, based on global birth rates that a child born with a cleft
every 2.5 minutes .which is associated with varying degrees of nasal deformity grading from
mild to severe inadequate function, shape and appearance of the nose. Functional impairment
of the nose has been reported in 70% of cases with cleft lip. It negatively affects patients'
personal and professional lives, physical activity, well-being and general quality of life.
However, historical interest in cleft lip and palate was traced to pre-Columbian artisan; the
interest in the associated nasal deformities only began with rhinoplasty techniques
introduced in the 19th century. That's why despite the great improvement achieved in primary
repair of cleft lip and nasal deformity, the secondary cleft and nasal deformity still occur
in significant number of patients, and the surgical management of the nasal deformity remains
a functional and aesthetic dilemma for patients, their families and for reconstructive
surgeons.
Lake of objective assessment of the initial severity and the changes introduced by growth and
by surgical treatment lead to inability to optimize a treatment of cleft lip nasal deformity,
hence there is no perfect surgical technique exists and surgeons must tailor approaches to
individuals and evolve techniques to best serve each patient.
Although surgery can give dramatic effect, the lack of objective assessment of different
surgical procedures results in decision that is based on the experience of the surgeon.
Secondary rhinoplasty is done after facial growth is completed. This is around 14 to 16 years
old in female patients and 16 to 18 years old in male patients. Surgical techniques rely on
well-accepted open rhinoplasty principles and are applied for unilateral or bilateral cleft
nasal deformities.
Careful complete analysis followed by logical plan for each case is the key stone for
success.
Multislice CT Flesh mode will be used for measuring some angles and ratios of the nose and
its relation to the face. The results will be recorded at the spread sheet and the
preoperative and post operative results will be compared. Other parameters can also be
measured, as long as user records the measurements manually.
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