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Primary rhinocheiloplasty: Comparison of open and closed methods of alar cartilage reposition

View Article: PubMed Central - PubMed

ABSTRACT

Aims:: To establish which rhinoplasty method for primary repairing of unilateral cleft lip (UCL) is better.

Settings and design:: Two patient groups with cleft lip were compared. Each group was operated on either by McComb's technique as closed rhinoplasty method or by Vissarionov–Kosin technique as an open method.

Subjects and methods:: First group included 29 patients and the second consisted of 31. All patients were operated on by single surgeon over 10 years. Randomization was based on wishes and intention of surgeon to use one of two methods. Evaluation of results was based on impartial data, and subjective information collected from respondents with different levels of knowledge about UCL. The objective scale was based on the evaluation of five noticeable residual deformations of nose that usually appear after primary lip-nose surgery: Alar flattening, low position of alar, widening or narrowing of nostril, and deformation of the upper part of nostril rim. Subjective evaluation was based on the opinion of respondents who were ranged every case depending on own judgment.

Statistical analysis:: Was performed using Fisher method and Chi-square by Statistica 10.0, StatSoft Inc.

Results:: Approach with general analysis indicated no difference between two methods. Despite of absence of clear differences between two groups we consider the closed rhinoplasty more favorable due to less damage to alar cartilages and no scars inside nostrils.

Conclusions:: We think that mentioned scarring may complicate secondary rhinoplasty, which is often needed to correct nose deformation.

No MeSH data available.


Related in: MedlinePlus

Types of secondary deformation alar nose: (a) flattening, (b) narrowing, (c) widening, (d) retraction, (e) unnatural shape of nostril
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Figure 1: Types of secondary deformation alar nose: (a) flattening, (b) narrowing, (c) widening, (d) retraction, (e) unnatural shape of nostril

Mentions: The valuation of the surgery result was based both on objective and subjective data. The data were collected from survey among respondents with different degree of awareness about unilateral cleft lip (UCL). Objective criteria included five most visible residual nose deformations such as flattening and retraction of ala nasi, narrowing, widening, and unnatural shape of nostril [Figure 1a–e]. Evaluation scale was based on complications. The result was considered “good” if patient had no more than one complication [Figure 2a–d], “satisfactory” if patient had two complications [Figure 3a–d]. The result was rated as “bad” in case of three or more complications [Figure 4a–d]. Three groups of respondents were surveyed to conduct subjective analysis of nose deformation. First group of respondents included plastic surgeons who continuously operated on patients with cleft lip and palate. We called this group “experts.” Second group of respondents consisted of doctors with a notion of cleft lip and palate treatment methods but by condition these doctors did not deal with UCL directly. We named this group “related” since their opinion was highly influenced by frequent contact with patients with cleft lip and palate. Third group included parents of children who had facial deformations but not cleft lip or palate. We called this group “unrelated” because they have never dealt with cleft lip and palate. Each group included five respondents. The surgery result was evaluated only on post-surgery photos. This condition was introduced with intention to avoid “sudden change effect” which is likely to take place if pre- and post-surgery images are compared. This effect is especially big in cases where deformation is significant. Subconsciously, we generally notice drastic changes in patients’ image and cannot evaluate minimal defects which, after all, contribute greatly to the residual deformation. Moreover, respondents did not know to which group the patient belonged. All the respondents were asked to rate treatment result as good, satisfactory, or bad based on personal opinion.


Primary rhinocheiloplasty: Comparison of open and closed methods of alar cartilage reposition
Types of secondary deformation alar nose: (a) flattening, (b) narrowing, (c) widening, (d) retraction, (e) unnatural shape of nostril
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979335&req=5

Figure 1: Types of secondary deformation alar nose: (a) flattening, (b) narrowing, (c) widening, (d) retraction, (e) unnatural shape of nostril
Mentions: The valuation of the surgery result was based both on objective and subjective data. The data were collected from survey among respondents with different degree of awareness about unilateral cleft lip (UCL). Objective criteria included five most visible residual nose deformations such as flattening and retraction of ala nasi, narrowing, widening, and unnatural shape of nostril [Figure 1a–e]. Evaluation scale was based on complications. The result was considered “good” if patient had no more than one complication [Figure 2a–d], “satisfactory” if patient had two complications [Figure 3a–d]. The result was rated as “bad” in case of three or more complications [Figure 4a–d]. Three groups of respondents were surveyed to conduct subjective analysis of nose deformation. First group of respondents included plastic surgeons who continuously operated on patients with cleft lip and palate. We called this group “experts.” Second group of respondents consisted of doctors with a notion of cleft lip and palate treatment methods but by condition these doctors did not deal with UCL directly. We named this group “related” since their opinion was highly influenced by frequent contact with patients with cleft lip and palate. Third group included parents of children who had facial deformations but not cleft lip or palate. We called this group “unrelated” because they have never dealt with cleft lip and palate. Each group included five respondents. The surgery result was evaluated only on post-surgery photos. This condition was introduced with intention to avoid “sudden change effect” which is likely to take place if pre- and post-surgery images are compared. This effect is especially big in cases where deformation is significant. Subconsciously, we generally notice drastic changes in patients’ image and cannot evaluate minimal defects which, after all, contribute greatly to the residual deformation. Moreover, respondents did not know to which group the patient belonged. All the respondents were asked to rate treatment result as good, satisfactory, or bad based on personal opinion.

View Article: PubMed Central - PubMed

ABSTRACT

Aims:: To establish which rhinoplasty method for primary repairing of unilateral cleft lip (UCL) is better.

Settings and design:: Two patient groups with cleft lip were compared. Each group was operated on either by McComb's technique as closed rhinoplasty method or by Vissarionov–Kosin technique as an open method.

Subjects and methods:: First group included 29 patients and the second consisted of 31. All patients were operated on by single surgeon over 10 years. Randomization was based on wishes and intention of surgeon to use one of two methods. Evaluation of results was based on impartial data, and subjective information collected from respondents with different levels of knowledge about UCL. The objective scale was based on the evaluation of five noticeable residual deformations of nose that usually appear after primary lip-nose surgery: Alar flattening, low position of alar, widening or narrowing of nostril, and deformation of the upper part of nostril rim. Subjective evaluation was based on the opinion of respondents who were ranged every case depending on own judgment.

Statistical analysis:: Was performed using Fisher method and Chi-square by Statistica 10.0, StatSoft Inc.

Results:: Approach with general analysis indicated no difference between two methods. Despite of absence of clear differences between two groups we consider the closed rhinoplasty more favorable due to less damage to alar cartilages and no scars inside nostrils.

Conclusions:: We think that mentioned scarring may complicate secondary rhinoplasty, which is often needed to correct nose deformation.

No MeSH data available.


Related in: MedlinePlus