Clinical Analysis Of Nasal Floor Reconstruction By Oral Mucosal Flap In Unilateral Complete Cleft Lip Patients

PURPOSE:To explore the effect of applying oral mucosal flap to repair nasal floor in Unilateral Complete Cleft Lip,Analysis the symmetry effect of nasal floor and alar shape in onestage operation.METHODS:16 with unilateral complete cleft lip received treatment at school of Stomatology,Medical College of Qingdao University from September 2014 to September 2016 were retrospectively analyzed.Their nasal floor was repaired with oral mucosal flap.Photographs were taken before repair,1 week and 1 year after surgery.10 Professionals were selected for subjective evaluation to children after operation with visual analogue scale,The symmetry ratio of nasal floor and alar shape were calculated to analyze the clinical effects.SPSS 19.0 software package was used for statistical analysis.RESULTS:There was no oral-nasal fistulas(ONFs)and nasal floor notches in 16 cases.The nasal wing collapse was improved obviously.10 professional staff conducted a subjective evaluation,and the results of the 1-week post-operation evaluation were as follows :The average score of lip shape was 46.375,the average score of nasal morphology was 46.06,and the average score of nasal floor morphology was 46.125.and the results of the 1-year post-operation subjective evaluation of the lip shape was 44.9,nasal shape was 43.31,and the nasal shape of nasal floor was 43.44.Objective evaluation: one year after operation,the symmetry ratio of nasal floor width and nostril width was 0.79 ±0.15 and 0.86 ±0.17 less than that of one week after operation the ratio of nasal floor width(1.04 ±0.25)and the ratio of nostril width(1.08 ±0.18).One year after operation,the symmetrical ratio of nasal columnar height was 1.62 ±0.48 and the nostril height was 1.44 ±0.17 heigter than1 week after operation,the nasal columnar height and The nostril height was(1.10 ±0.22)and(1.03 ±0.19).The changes of the symmetry ratio of nasal floor width at one week after operation were 0.53 ±0.24.The changes of the ratio of nasal floor width to symmetry at one week after operation were 0.53 ±0.24,The change of nasal columnar high symmetry ratio was 1.16 ±0.74 at one week after operation.1 week after operation,there was no correlation between the width symmetry ratio of nasal floor,the height ratio of nasal column,the length-width ratio of nose,the width ratio of nostril,and the preoperative indexes(P > 0.05),and there was no correlation between the ratio of nasal base width and height ratio(P > 0.05).One year after operation,the symmetry ratio of nasal floor width was positively correlated with the ratio of nasal floor width before operation(r = 0.64,P = 0.007),and negatively correlated with the ratio of nasal length to width(r = 0.65,P = 0.006).1 year after operation,the symmetrical ratio of nasal floor width was 0.79 ±0.15,and the ratio of nostril width symmetry was 0.856 ±0.17,nostril height symmetry was 1.44±0.17,the symmetrical ratio of nasal column was 1.62±0.48.There was significant difference before and after operation.CONCLUSIONS:Nasal floor repair in children with non-syndromic unilateral complete cleft lip with oral mucosal flap in one-stage operation can not only be beneficial to reduce the incidence of oral and nasal fistulas,but also help to close the fissure of nasal floor,restore the shape of nasal floor and properly correct nasal deformity.