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BACKGROUND: The evaluation of surgical outcomes is needed to achieve excellence in nasal reconstruction of patients with complete bilateral cleft lip and palate (BCLP). The study objective is to evaluate the quality of nasal aesthetics after the columella elongation surgery. METHODS: The sample of this study consisted of 70 patients with complete BCLP, operated on columella elongation surgery and analyzed at 6 to 12 years. The system for evaluation of nasal appearance after the columella elongation surgery was performed by objective and subjective analyses. ANTHROPOMETRIC MEASUREMENTS: Four anthropometric nose measurements were performed directly on the faces, and the same was performed in control group (60 children without oral clefts), paired by age and sex with the experimental group. The measurements were repeated 3 times (triplicate). SUBJECTIVE ANALYSIS: Scores to evaluate nasal width, nasal tip projection, and length of the columella were applied before and after the columella elongation surgery by 5 raters from the rehabilitation team. Interrater and intrarater agreement was calculated by means of the kappa test. RESULTS: Nasal width in BCLP group was higher when compared to the control group (P < 0.05). Nasal tip projection (subnasal-pronasal) and columella length (subnasal-columella) were decreased in BCLP group compared to that of the controls (P < 0.05). Columella width was similar in both study groups (P > 0.05). All scores of nasal aesthetics significantly improved after the columella elongation surgery. CONCLUSIONS: Nose of the patients with BCLP is wider, is less projected, and has the shorter columella compared to that of the noncleft subjects. After secondary columella elongation surgery in BCLP, nasal width, nasal projection, and columella length significantly improved.
RESUMO
INTRODUCTION: In this study, we examined the relationships among breastfeeding duration, nonnutritive infantile sucking habits, Class II facial patterns with mandibular retrusion, and Class II dental relationships. METHODS: A sample of 249 children in the mixed dentition was examined by 2 orthodontists. Data about the duration of breastfeeding and nonnutritive sucking habits were obtained by written questionnaires answered by the parents. RESULTS: The chi-square test did not indicate a statistically significant association between breastfeeding duration and mandibular deficiency or Class II malocclusion. However, statistically significant associations were found between short breastfeeding duration (<6 months) and nonnutritive sucking habits, and between nonnutritive sucking habits and Class II malocclusions. CONCLUSIONS: These findings point to the hypothesis that nonnutritive sucking habits may work as a dominant variable in the relationship between breastfeeding duration and the occurrence of Class II malocclusion. However, the prevention of mandibular deficiency should not be listed as one of the advantages of breastfeeding.