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• W2899721945 abstract "Sir: With great interest, we read the recent series of articles about rhinoplasty “The Smile Index: Part 1. A Large-Scale Study of Phenotypic Norms for Preoperative and Postoperative Unilateral Cleft Lip.”1 We would like to take the opportunity to further expand on the topic by presenting a new photogrammetry of nasal morphology for Asian patients with unilateral secondary cleft lip nasal deformity. Significant differences in nasal morphology exist among various ethnic groups.2 The nasal morphology was first classified by Farkas according to the measurement of the mesial inclination of the long axis of the nostril, and the results revealed that Caucasians belonged to types I and II, whereas the Asian population were mostly types III and V, especially type III in the Asian population, also known as mesorrhine; corresponding volunteers accounted for up to 28 of 53 of the total numbers (52.8 percent).3 Through the review of studies related to nasal morphology, many Asian scholars have systematically measured their countries and races with reference to the Farkas measurement system. It was found that, compared with Caucasians, the nose in the Asian population was round and prominent, and the width of the nasal ala was larger, but the tip of the nose was not obvious, and the nasal prominence was also small.4 Based on the comparative study of nasal anatomy, Chun et al. proposed that the round and prominent alar lobule was a unique feature of the Asian nose.5 Similar to nasal morphology, the evaluation of the aesthetic aspect of nasal morphology is also significantly different because of cultural background and racial influence. It has been proved that the nasal morphology of the Asian population is more in harmony with their facial features. Therefore, many scholars support that nasal plastic surgery should not refer to Western rhinoplasty methods and ideas, but maintain the unique Asian nasal morphologic characteristics. However, secondary cleft rhinoplasty techniques and objective evaluation of unilateral cleft lip–cleft nose are formed mostly in accordance with characteristics of the nasal types of Caucasians. Few studies are reported regarding the objective measurement methods reflecting the nasal characteristics of the Asian population. In this communication, we present a new standardized and objective photogrammetry on basilar view establishing the basis of the nasal characteristics of Asian patients with unilateral secondary cleft lip nasal deformity. To ensure reproducibility and accurate intergroup comparison, standardized photographs on basilar view of all subjects were captured by the same photographer with a Nikon D300s digital single-lens reflex camera (Nikon Corp., Tokyo, Japan). The grid screen in the viewfinder was used to help align each subject’s’ position. Photogrammetric analyses were performed with Image-Pro Plus 6.0 (Media Cybernetics, Inc., Rockville, Md.), following detailed descriptions of primary landmarks, constructs, and innovation parameters (Fig. 1). Coordinate system application was performed with the help of MB-Ruler version 4.0.Fig. 1.: Photogrammetric measurements of the innovation parameters. (Left) From top to bottom: parameter A, deviation of the nasal tip (the absolute distance ratio of the nasal tip between Prn-Ipr and Prn-Ipl); parameter E, the distance relationship of the columella between the two sides (the vertical distance ratio of the nasal columella between bilateral Nt to the Sn horizontal line); parameter D, the width relationship of the nasal floor between the two sides (the horizontal distance ratio of the nasal floor between bilateral Am to the Sn vertical line). (Right) From left to right: parameter C, the relationship of the ala-facial junction area (the mesial inclination angle of the ala between Ac-Al line and Ac horizontal line; parameter B, the convex contour of the alar lobule (the convex angle of the alar lobule between Prn-Sf line and Ac-Sf line).Consideration of the reliability and validity of two-dimensional photogrammetry as a method of evaluation has always been a controversial issue. We made it more accurate according to the following three aspects: (1) standard photographic technique was strictly obeyed by the experienced photographer; (2) linear magnification was maximally eliminated by constructing ratios; and (3) angular measurement error was maximally eliminated by constructing the angle from defined and presentative landmarks. Here are the descriptions concerning calculation and clinical meaning of innovation parameters. In addition, we made some relative preliminary assumptions about the results respectively: Parameter A: for the control group and for patient groups (preoperative and postoperative separately). This parameter reflected whether or not deviation of the nasal tip or nasal dorsum exists in this region. Parameter B: We selected the left angle as standard reference because a previous study showed that unilateral of cleft lip–cleft nose was susceptible to the left side. This parameter reflected the convex contour of alar lobule, normal or buckled. Parameter C: Similarly, we selected the left angle as the standard reference. This parameter reflected the relationship of the ala–facial junction area; flattening was the most common stigma. Parameter D: for the control group and for patient groups. This parameter reflected the width relationship of the nasal floor between the two sides. A widened nasal floor was the the most common stigma. Parameter E: for the control group and for patient groups. This parameter reflected the distance relationship of the columella between the two sides. A shortened columella was the most common stigma. This percentage could offer a value concerning the efficacy of surgical technique in secondary cleft rhinoplasty. We need to add that adjusting the reference ratios of linear measurements to the unilateral side for more accurate comparison. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. Ye-ping Li, Ph.D., D.D.S.Ren-kai Liu, Ph.D., D.D.S.State Key Laboratory of Oral DiseaseWest China College of Stomatology Bing Shi, D.D.S., Ph.D.Cheng-hao Li, Ph.D., D.D.S.State Key Laboratory of Oral DiseaseWest China College of Stomatology, and Department of Cleft Lip and Palate SurgeryWest China Stomatological HospitalSichuan UniversityChengdu, People’s Republic of China" @default.
• W2899721945 created "2018-11-16" @default.
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• W2899721945 date "2019-01-01" @default.
• W2899721945 modified "2023-10-17" @default.
• W2899721945 title "A New Photogrammetry of Nasal Morphology for Asian Patients with Unilateral Secondary Cleft Lip Nasal Deformity" @default.
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