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Master's Dissertation
DOI
10.11606/D.61.2014.tde-14012015-102615
Document
Author
Full name
Daiana Conceição Broll
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2014
Supervisor
Committee
Ozawa, Terumi Okada (President)
Freitas, Renato da Silva
Gomide, Marcia Ribeiro
Title in Portuguese
Avaliação nasal pós-cirurgia de alongamento de columela por meio de medidas antropométricas do nariz e análise facial em pacientes com fissura transforame incisivo bilateral (FTIB)
Keywords in Portuguese
Cirurgia
Columela
Estética
Fissura bilateral
Abstract in Portuguese
Os resultados das cirurgias corretivas estéticas para o alongamento da columela nem sempre obtém sucesso, persistindo algumas deformidades como o achatamento e alargamento nasal, columela curta e as grandes cicatrizes. Desta forma, a avaliação dos resultados cirúrgicos se faz necessária para alcançar a excelência na reconstrução nasal dos pacientes com FTIB. Assim, o estudo tem como objetivo avaliar a qualidade da estética nasal após a cirurgia de alongamento de columela por meio da análise objetiva e subjetiva da face dos pacientes operados no HRAC. Para isto, avaliamos 70 pacientes com FTIB após a cirurgia de alongamento de columela, apresentando idade atual a realização deste trabalho (6-12 anos) e 60 pacientes sem fissura na mesma faixa etária (grupo controle). A análise objetiva foi realizada por meio de 4 medidas antropométricas do nariz nos pacientes com FTIB operados e no grupo controle. Observou-se que a medida AL-AL (largura nasal) em pacientes com FTIB apresentou-se maior quando comparada ao grupo controle (p<0,05); diferentemente, SN-PRN (projeção da ponta nasal) e SN-C (comprimento da columela) demonstrou ser menor (p<0,05). Somente a medida Sn`-Sn`(largura da columela) foram semelhantes em ambos os grupos (p>0,05). Assim, demonstrando que mesmo após a cirurgia de alongamento de columela, não foram corrigidas a largura nasal, projeção da ponta nasal e comprimento da columela. Para analise qualitativa utilizou-se escores de 1 a 5 para avaliar a forma nasal (largura nasal), a projeção da ponta nasal e o comprimento da columela nos pacientes com FTIB antes e após a cirurgia. Observou-se que a aparência nasal melhorou após a cirurgia restabelecendo a harmonia e estética do nariz em grande parte dos pacientes. No entanto muitos pacientes continuaram com a aparência nasal pobre mesmo após a reparação cirúrgica. Da mesma forma, resultados semelhantes foram evidenciados na avaliação qualitativa da forma das narinas utilizando a classificação de Topinard. Desta forma, conclui-se que a cirurgia de alongamento de columela melhora a estética nasal, porém em muitos pacientes esta não conseguiu restabelecer por completo a forma nasal.
Title in English
Post nasal evaluation of columella lengthening surgery using anthropometric measures of the nose and facial analysis in patients with bilateral cleft lip and palate
Keywords in English
Aesthetics
Bilateral cleft
Columella
Surgery
Abstract in English
The results of aesthetic corrective surgeries for lengthening the columella are not always well succeed, remaining some deformities as nasal flattening and widening, short columella and large scars. In this way, the evaluation of surgical outcomes is needed to reach the excellence in nasal reconstruction in patients with bilateral cleft lip and palate. Thus, the present study aims to evaluate the quality of nasal aesthetics after surgical lengthening of columella by means of objective and subjective analysis of the face of the patients at HRAC For this, we evaluated 70 patients with bilateral cleft lip and palate after surgery columella elongation, current age presenting this work (6-12 years) and 60 patients without cleft at same age (control group). The objective analysis was performed using 4 anthropometric measurements of the nose in patients with bilateral cleft lip and palate operated and control group. It was observed that the measured AL-AL (nasal width) in patients with bilateral cleft lip and palate was higher compared to the control group (p<0.05); differently, SN-PRN (projection of the nasal tip) and SN-C (length of the columella) demonstrated to be lower (p<0.05). Just Sn-Sn (width of the columella) was similar in both groups (p>0.05). Thus, demonstrating that even after surgical lengthening the columella were not corrected nasal width, nasal tip projection and columella length. For qualitative analysis, we used scores 1-5 to evaluate the nasal form (nasal width), the projection of the nasal tip and columella length in patients with bilateral cleft lip and palate before and after surgery. It was observed an improvement in nasal appearance after surgery and aesthetic harmony restoring the nose in most patients. However many patients continued with poor nasal appearance after surgical repair. Similar results were found in the qualitative evaluation of the nostrils shape using Topinard classification. In this way, we conclude that lengthening surgery of nasal columella improves aesthetics, but in many patients it failed to restore completely the nasal form.
 
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Publishing Date
2015-01-15
 
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