What happens to columellar angle after cleft lip surgery?

Purpose to evaluate post operative columelar angle changes after cleft lip repair. Methods observational, descriptive and cross-sectional study. Were evaluated 11 childrens in first and second year old, with unilateral cleft lip, of both genres, who underwent surgery to correct the lip defect. Were examined child’s nasal area and upper lip and identified anthropometric points pronasale, subnasale and glabella, then photographic documentation was performed for photogrammetric analysis. Photos were taken preoperatively and 4 months after surgery. Images obtained by photogrammetry were evaluated with graphics program Image J, through angular study tools. Results the mean of angles measured preoperatively was 55.41 degrees, and at the postoperative was 78.80 degrees, realizing an approximation to the vertical plane (p<0.0001). Cleft lip and palate patients had a variation of 32 degrees when compared pre and post-operative measurements, while in patients with only cleft lip or cleft lip and alveolus the changes where minors (0.75 and 25 degrees respectively). Conclusion occurs a columellar angle verticalization after cleft lip surgery. Patients that had greater increase to the angle were those who had more complex deformities.

本研究旨在评估唇裂修复术后鼻小柱角的变化情况。本研究为观察性、描述性的横断面研究，纳入11名年龄为1~2岁的单侧唇裂患儿，涵盖两性，均已接受唇缺损矫正手术。研究人员对患儿的鼻部区域及上唇进行检查，确定鼻前棘点（pronasale）、鼻下点（subnasale）及眉间点（glabella）三处人体测量标志点，随后进行摄影记录以开展摄影测量分析，分别于术前及术后4个月拍摄照片。通过图像分析软件Image J的角度测量工具，对摄影测量获取的图像进行分析。结果显示，术前测量的角度均值为55.41°，术后均值为78.80°，角度与垂直平面的贴合度显著提升（p<0.0001）。唇腭裂患儿的术前与术后角度测量值差值为32°，而仅唇裂或唇牙槽裂患儿的角度变化幅度相对较小，分别为0.75°和25°。结论：唇裂手术后可实现鼻小柱角的垂直化调整，角度提升幅度更大的患儿，其鼻部畸形程度也更为复杂。