EN
TÜRKÇE
Poster - 25
Nasal profile development following early combined nasal correction in children with unilateral cleft lip and palate.
Abduvoris Abduvaliev
Tashkent Dental State Institute
Purpose.Early repositioning of cleft-affected nasal cartilages during primary repair may guide balanced growth, yet evidence is limited. We tested whether adding closed alar and septal repositioning to primary repair improves five-year nasal profile in unilateral cleft lip–palate (CLP).
Method. Seventy infants (mean 112 ± 13 days) were randomised to lip repair with simultaneous nasal correction (early-nasal, n = 35) or lip repair alone (control, n = 35). Three-dimensional stereophotogrammetry at 6 months, 1 year and 5 years yielded dorsum angulation, nasal-tip projection ratio and a nasal symmetry index (lower = better). Secondary outcomes were need for secondary nasal surgery, caregiver satisfaction and adverse events. Intention-to-treat mixed-effects modelling adjusted for baseline cleft width (α = 0.05).
Results Sixty-five children (early-nasal = 33, control = 32) completed follow-up. Mean dorsum angulation at 5 years was 19.4° ± 2.8 vs 24.1° ± 3.0 (difference –4.7°, 95 % CI –5.9 to –3.5; p < 0.001). Nasal-tip projection ratio was higher (0.67 ± 0.06 vs 0.59 ± 0.07; p < 0.001) and symmetry index lower (0.11 ± 0.04 vs 0.18 ± 0.05; p < 0.001). Secondary nasal surgery was required in 9 % vs 34 % (risk ratio 0.27; p = 0.01). Complication rates were equivalent.
Conclusion. Adding closed alar and septal repositioning to primary repair significantly improves five-year nasal profile and lowers revision surgery without added morbidity in unilateral CLP. Early combined nasal correction should be considered standard practice pending multicentre validation.