Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

Cleft Palate Craniofac J. 2021 Jun;58(6):773-778. doi: 10.1177/1055665620962693. Epub 2020 Oct 12.


Objective: The study addresses whether the growth of the nasal dorsum is disturbed by cleft treatments, for cleft lip only (CL) and cleft lip with cleft palate (CLP).

Design: A total of 576 patients with cleft (278 CL, 298 CLP) and 333 individuals without orofacial clefts were retrospectively enrolled. Cleft lip only group was treated with a modified Millard technique combined with Tajima incision for rhinoplasty at 3 to 6 months. The CLP group underwent the same lip repair technique and then underwent a Sommerlad palatoplasty at 9 to 12 months. Lateral cephalometric radiographs of all individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn test was used to analyze the difference (P < .001).

Results: Compared with control, in CL, nasal bone angle and nasal dorsum angle increase by age similarly (5-18 years, P > .05); the total dorsum is significantly shorter (5-18 years, P < .001), while the upper nasal dorsum length is similar (except in 5-6 years), and the lower nasal dorsum is shorter (5-18 years, P < .001). In CLP, nasal bone angle develops insufficiently as children grow (8-18 years, P < .001); the nasal dorsum angle is notably smaller (5-18 years, P < .001); nasal bone length is not significantly different except 11 to 13 years (P < .05); nasal dorsal length is similar at skeletal maturity (17-18 years, P > .05), although it is shorter during 8 to 16 years (P < .05); the upper nasal dorsum is overdeveloped (14-18 years, P < .05), whereas the lower nasal dorsum is underdeveloped (5-18 years, P < .001).

Conclusion: Treatments in both CL and CLP could be the important factors in disturbing the growth of cartilaginous portion of the nasal dorsum (including nasal tip) and the nasal dorsum height.

Keywords: cephalometric; cleft nose; cleft treatment; nasal deformity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cephalometry
  • Child
  • Child, Preschool
  • Cleft Lip* / diagnostic imaging
  • Cleft Lip* / surgery
  • Cleft Palate* / diagnostic imaging
  • Cleft Palate* / surgery
  • Humans
  • Nose / diagnostic imaging
  • Nose / surgery
  • Retrospective Studies
  • Rhinoplasty*
  • Treatment Outcome