Three-dimensional evaluation of unilateral cleft rhinoplasty results

Overview

A cleft lip nose is asymmetric in three dimensions, which standard photographs capture poorly. Three-dimensional surface imaging can measure the change surgery makes with little burden on the patient. The authors present the measurement methods they use at their institution and apply them to secondary cleft rhinoplasty results.

Sections of note

• Methods article; the abstract gives no patient numbers or measured results.
• 3D imaging is described as accurate and reliable in the published literature.
• Measurements covered: symmetry, tip projection, rotation, volume, width and topographic width.
• The techniques are applied to unilateral cleft patients who had secondary rhinoplasty by the senior author.
• The abstract does not report how much symmetry improved.

What it means for a patient

• Surgeons at some centers can measure a cleft nose in three dimensions before and after surgery, giving an objective record of the change.
• The abstract describes the method, not the results, so it cannot tell a patient how much improvement to expect.
• Availability of 3D imaging varies between practices.

Why this paper matters

Cleft rhinoplasty outcomes have mostly been judged by eye. This paper brings quantitative 3D assessment to that problem from a group that developed the methods for general rhinoplasty. Reported outcome figures are absent from the abstract.

Terms

• Unilateral cleft lip: a birth gap on one side of the upper lip that distorts the nostril and tip.
• Secondary cleft rhinoplasty: the definitive nose operation done after earlier cleft repairs.
• 3D imaging: capturing the surface of the face as a digital model that can be rotated and measured.
• Tip projection: how far the tip stands out from the face.
• Tip rotation: how far the tip points up or down.
• Topographic width: the width of the nose measured along its curved surface rather than in a straight line.