Effect of Alveolar Bone Grafting on Nasal Morphology, Symmetry, and Nostril Shape of Patients with Unilateral Cleft Lip and Palate

Abstract

Objective To evaluate nasal morphology, symmetry, and nostril shape in patients with unilateral cleft lip and palate following mixed-dentition alveolar bone grafting. Design Prospective stereophotogrammetric study. Setting Hospital-based. Patients Thirty-nine patients with a history of repaired unilateral cleft lip and palate who received an iliac crest alveolar bone graft were recruited prospectively to participate in the study. Each patient served as his/her own control. Interventions Partial facial impressions of all patients were acquired before and a minimum of 6 months after the alveolar bone grafting procedure. Image acquisition and analysis of the casts constructed from these models were carried out using three-dimensional stereophotogrammetry. Main Outcome Measures Surface-based registrations and linear measurements were performed to assess nasal morphology and nostril shape. A modified Procrustes technique was used to determine the change in nasal symmetry. A two-tailed, paired t test and an analysis of covariance were used to assess statistical significance. Results Significant side-to-side asymmetry exists in the nasal region of patients with unilateral cleft lip and palate, both before and after alveolar bone grafting. No significant changes were observed between pre–alveolar bone graft and post–alveolar bone graft images based on linear measurements, asymmetry scores, and registrations. Gender and surgeon were not significant factors. Conclusion Under the conditions of this study, mixed-dentition alveolar bone grafting appears to have no significant long-term effect on nasal morphology, symmetry, or nostril shape.