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Evaluation of Nostril Morphology in Individuals with Repaired Unilateral Cleft Lip at Children Hospital 1, Ho Chi Minh City

Hoang Nguyen, Kieu Tho Nguyen, Chuong Nguyen, Nguyen Dinh Pham, Thuong Chi Bui, Quan Ngoc Hong Nguyen and Helen Thanh Nhi Dang

Objective: The purpose of this study was to evaluate nostril morphology in individuals with repaired unilateral cleft lip.

Method: This was a prospective cross-sectional study. Unilateral cleft lip patients following primary lip repair in Children Hospital 1 from August 2016 to December 2017 were taken on standardized photographs in the area of the nose preoperatively and postoperatively. All patients agreed for disclosure of their medical records, and have been approved by ethical committees.

Results: There were totally 35 patients who underwent primary lip repair. Cleft lip was consistently more common in males at a 3:2 ratio. The mean age was 3.94 months (minimum age=1 month, maximum age=8 months). Unilateral cleft lip showed a left predominance (65.7% on the left; 34.3% on the right). A significant difference (p<0.05) in the width of the nasal base, the height and the width of the nostril, columella height and columella angle. In contrast to those results, no significant difference could be identified in the width of columella (1.9 mm preoperatively, 2 mm postoperatively). A significant difference (p<0.05) between the cleft side and the unaffected side was seen in nostril height, columella width (the coefficient of asymmetry (CA) was 19.2%; 16.2% respectively). In contrast, no significant asymmetry regarding columella height and nostril width (CA=10.5% and 13.3% respectively).

Conclusion: Millard technique has become more common and has some merits for labial esthetic. However, this technique has not resulted in lasting improvement in the nostril height, the columella width and the width of the nasal base yet. Anthropometric nasal measurements can support the role of primary rhinoplasty as guiding surgeons to correct some nasal structures, as well as set timing of repair, standard rhinoplasty protocols in secondary cleft rhinoplasty.