Dermal fat graft versus bone graft for maxillary augmentation in cleft Rhinoplasty

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Author(s): Dr. Farkhandah Muhammad Iqbal, Prof. Mirza Shehab Afzal Beg, Dr. Iqra Khan

Received: 19/04/2022 | Revised: 19/01/2023 | Published: 24/02/2023 | Pages: 8-12 |


ABSTRACT

 

Background:Secondary cleft lip Rhinoplasty is a difficult surgery to perform due to its abnormal anatomical features. There is an anomalous insertion of orbicularis oris in alar base on cleft side along with maxillary deficiency. The collapsed lateral crura and malar region needs structural support for better symmetry. The maxillary augmentation can be done via autogenous iliac bone graft, costal cartilage graft, dermal fat graft and alloplastic materials.The objective of the study is to compare the outcome of dermal fat graft  with bone graft for maxillary augmentation.

Methodology:This was a retrospective study done at Liaqat national hospital , Karachi. All patients who presented to outpatient department for cleft rhinoplasty between July, 2015 to December, 2020 were included. Outcome was assessed using visual analog score by surgeon, patient and an independent assessor, after all patient had completed 6-month follow-up. Data analysis was done with SPSS version 21.

Result:38 patients were included in the study. 20 had maxillary augmentation with dermal fat graft. 18 had bone graft. Mean Visual Analogue Score for iliac bone graft was 7.5 whereas for dermal fat graft it was 8.3.

Conclusion:Patients who had maxillary augmentation with dermal fat graft showed better results on visual analogue score as compared to patients who had augmentation with iliac bone graft.

 

Keywords:Maxillary augmentation, Cleft rhinoplasty, Dermal fat graft, Bone graft