Impact of Unilateral Alveolar Bone Grafting on Nasal Volume and Nasolabial Surface: A 3D Analysis.

ABSTRACT

OBJECTIVE: To determine possible effects of unilateral alveolar cleft closure on internal nasal volume and external nasolabial surface. DESIGN: Retrospective, single-arm, cohort study. SETTING: Institutional, tertiary care. PATIENTS Patients with complete unilateral cleft lip, alveolus, and palate (CUCLAP), who underwent closure of the alveolar cleft with autologous bone graft (ABG) at the age of 9-11 years, with cone beam computed tomography (CBCT) and/or three-dimensional (3D) stereophotogrammetry images taken before and one year after the ABG procedure. INTERVENTIONS: ABG-pocedure in patients with CUCLAP. MAIN OUTCOME MEASURES: The influence of ABG on the internal and external nasal morphology. RESULTS: A total of 28 patients (21M/7F, 14R/14L) were divided into internal (CBCT) and external (3D-stereophotogrammetry) measurement subgroups. The external nasolabial surface showed a significant decrease of the angle alar curvature right-subnasale-alar curvature left (-1.99°; P = .02; 95% CI -2.61, -0.36) and an increase of the linear measurement between these points (+1.01 mm; P = .03; 95% CI 0.11, 1.91). No significant differences were found when comparing the distance maps of the affected side with the non-affected side (P = .50, 95% CI -0.20, 0.29). CONCLUSIONS: Closure of the alveolar cleft in CUCLAP patients with ABG did not affect the internal nasal volume, but significantly affected the external nasal surface. The procedure resulted in the nose becoming wider because both alar curvatures moved caudally and laterally relative to the subnasale.