How does the nasolabial change in patients with unilateral cleft lip and/or palate following primary repair using a modified rotation-advancement technique: a 5-year anthropometry study

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This retrospective study analyzed nasolabial changes in 69 patients who underwent primary cleft repair using a modified rotation-advancement technique. Photogrammetric measurements were taken preoperatively (T0), immediately postoperatively (T1), one year postoperatively (T2), and five years postoperatively (T3). The ratio of labial width decreased from T2 to T3. The medial-oblique labial height on the affected side showed growth from T1 to T2 but slowed by T3. The ratio of lateral-oblique labial height remained stable and the crista philtra height symmetry improved. However, the ratios of nasal sill, heminasal, and nostril width decreased c onsistently from T1 to T3. The nostril height grew near-symmetrically from T1 to T2, with acceleration thereafter, yet still smaller than the unaffected side at T3. The nostril area on the affected side grew more slowly. The nasal tip deviation angle changed minimally at T2 but showed medial displacement by T3. The columellar angle remained stable, while the affected columellar height showed delayed growth and remained shorter than the unaffected side at T3. There were no significant differences in nasolabial growth between patients with or without cleft palate/alveolar, and complete cleft lips displayed similar growth patterns to those of incomplete forms. In conclusion, to achieve symmetry of the nasal sill and nostril, an overcorrection of the alar base and alar contour on the cleft side was necessary during primary repair. Additionally, the initial severity of the deformity had minimal impact on long-term surgical outcomes.

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