Primary Rhinoplasty Does Not Interfere with Nasal Growth: A Long-Term Three-Dimensional Morphometric Outcome Study in Patients with Unilateral Cleft

Plast Reconstr Surg. 2020 May;145(5):1223-1236. doi: 10.1097/PRS.0000000000006744.

Abstract

Background: Primary rhinoplasty has not been universally adopted because the potential for nasal growth impairment remains an unsolved issue in cleft care. This study's purpose was to assess the long-term effects of primary rhinoplasty performed by a single surgeon in a cohort of patients with a unilateral cleft lip nose deformity.

Methods: Three-dimensional nasal morphometric measurements (linear, angular, proportional, surface area, and volume) were collected from consecutive patients (cleft group, n = 52; mean age, 19 ± 1 year) who had undergone primary rhinoplasty with the use of the Noordhoff approach between 1995 and 2002 and reached skeletal maturity. Normal age-, sex-, and ethnicity-matched subjects (control group, n = 52) were identified for comparative analyses.

Results: No significant differences (all p > 0.05) were observed for most measures, including nasal height, alar width, nasal dorsum angle, columellar angle, columellar-labial angle, nasal tip/height ratio, nasal index, alar width/intercanthal distance ratio, nasal surface area, and nasal volume. The cleft group displayed significantly (all p < 0.05) lower nasal bridge length and nasal tip projection, and greater nasal protrusion, tip/midline deviation, nasal tip angle, nasal tip protrusion width index, and alar width/mouth ratio values than the control group.

Conclusions: Primary rhinoplasty does not interfere with nasal growth as measured by three-dimensional photogrammetric analysis. Further imaging studies are required for the assessment of development in other anatomical nasal structures.

Clinical question/level of evidence: Therapeutic, IV.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Cleft Lip / surgery*
  • Female
  • Follow-Up Studies
  • Healthy Volunteers
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Nose / abnormalities
  • Nose / diagnostic imaging
  • Nose / growth & development*
  • Nose / surgery
  • Photogrammetry*
  • Retrospective Studies
  • Rhinoplasty / adverse effects*
  • Rhinoplasty / methods
  • Software
  • Treatment Outcome
  • Young Adult