Abstract
Objective
To systematically evaluate reported nasal morphological changes following Le Fort I osteotomy in individuals with cleft lip and palate (CLP).
Design
Systematic review.
Setting
Not applicable.
Participants
Adolescents (>16 years) and adults with nonsyndromic CLP undergoing maxillary orthognathic surgery.
Interventions
Le Fort I osteotomy, performed either in isolation or in combination with bilateral sagittal split osteotomy.
Main Outcome Measures
Postoperative nasal morphological changes, including alar base width, nasal tip projection, nasal length, and nasolabial angle. Additional synthesized outcomes included alar symmetry and soft tissue response ratios when available.
Results
Eight observational studies (one prospective, one cross-sectional, and six retrospective), including 201 individuals with CLP, were analyzed. Risk of bias was high in five studies and moderate in three. Across heterogeneous study designs and assessment methods, Le Fort I osteotomy was associated with improvements in alar symmetry and increases in the nasolabial angle (up to +16.0°). Alar widening (up to 3.0 mm) and variable changes in nasal tip projection, ranging from −2.22 to +2.40 mm, were also reported. Soft tissue responses varied substantially, with the nasal base following approximately 55% to 57% of maxillary advancement, nasal tip response ranging from −0.36 to +0.28 mm/mm of maxillary advancement, and nasolabial angle changes reaching 2.61° per millimeter of advancement.
Conclusions
Le Fort I osteotomy is associated with postoperative nasal morphological changes in individuals with CLP. Improvements in alar symmetry and nasolabial angle were reported, although alar widening and variable changes in nasal tip projection and nasal length were also observed. Given methodological heterogeneity and moderate-to-high risk of bias, findings should be interpreted cautiously.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
