Effect of primary repositioning of the nasal septum on facial growth in unilateral cleft lip and palate.

OBJECTIVE: The objective of this study is to evaluate whether manipulation of the nasal septum, its release, and changing of its abnormal position in infancy has an impact on maxillary growth and facial development in patients with unilateral cleft lip and palate.

DESIGN: Roentgencephalometric investigation.

SETTING: Cleft Centre at the Clinic of Plastic Surgery, Prague.

PATIENTS: Two consecutive groups of male patients (n = 32 and 30) with complete unilateral cleft lip and palate without associated malformations at 15 years of age.

INTERVENTIONS: The patients were operated on by the same team of surgeons and by the same method (lip: Tennison and primary periosteoplasty; palate: pushback with pharyngeal flap surgery), with the exception of complete primary repositioning of the nasal septum performed only in one group.

MAIN OUTCOME MEASURES: Roentgencephalometric data of both series of patients were compared with a t-test. All measurements were performed by one investigator.

RESULTS: Patients with primary repositioning of the nasal septum had a more favorable nasal prominence and better vertical growth of the upper and whole face in posterior height. Better growth in anterior height was only suggested; maxillary retrusion was equal in both groups.

CONCLUSIONS: Primary repositioning of the nasal septum has a favorable effect on nasal development, and it neither deteriorates nor markedly improves maxillary growth in patients with unilateral cleft lip and palate.