A Retrospective Study Of Postoperative Effect Of Nasolabial Deformity Secondary To Congenital Unilateral Cleft Lip

Objective: To investigate the surgical effect of using autologous costal cartilage transplantation to correct the nasolabial deformity secondary to congenital unilateral cleft lip and correlated influence factors.The clinical fundamental was supplied to optimize the proposal for sequence therapy of nasolabial deformity secondary to cleft lip.Methods: 82 patients who diagnosed with nasolabial deformity secondary to congenital unilateral cleft lip were conducted a retrospective study in the department of plastic and reconstruction surgery,Tongji hospital affiliated to Huazhong university of science and technology.The objective indexes postoperatively were evaluated from three aspects such as symmetric index of alar protrusion(anterior and lateral nasal position),symmetric index of nostril height(submental nasal position)and symmetric index of lip peak height(anterior lip position).The influence factors were analyzed including patients’ basic condition and related nasolabial indexes for instance clinical grading of cleft lip and inclination of nostril.The facial images before surgery and more than half a year after operation with two-dimension photography and 3-D scanning were retained.The data of nasal lips was collected using vernier calipers for direct measurement principally and Einscan-pro + 3D scanning.Chi-square test,Fisher’s exact test and rank sum test were used for distribution analysis.And Logistic regression and linear regression were used for multivariate regression analysis.P < 0.05 was set as statistically significant difference.Results: The single factor analysis of symmetric index of alar protrusion showed that statistically significant differences with the patients who underwent primary repair of cleft lip early(P=0.047)and the clinical grading(P=0.001),respectively.Multivariate Logistic regression analysis showed that patients who had undergone primary repair of cleft lip had a more significant clinical effect(P=0.037,OR=6.16,95% CI: 0.82-46.30)when compared to those never did.For the symmetric index of height in nasal-mid facial,the higher the index,the more significant the postoperative effect(P=0.048,OR=1941.36,95% CI:1.06-3552802).Meanwhile,the higher the height of the columella,the better the postoperative effect of the nasal position(P=0.018,OR=5.06,95% CI: 1.32-19.34).The results of postoperatively symmetric index of nostril height(nasal submental position)and postoperatively symmetric index of lip peak height(anterior position of lip)were statistically significant to the clinical grading of cleft lip(P=0.001).The correlation analysis showed that there were a negative linear correlation between them.Conclusion: The surgical effect of using autologous costal cartilage transplantation to correct the nasolabial deformity secondary to congenital unilateral cleft lip was negatively correlated with the clinical grading of cleft lip.The effect of the secondary nasolabial deformity could improved by primary repair of cleft lip early and enhanced height of the affected alar as well as columella.