Bone Morphogenesis of the Piriform Aperture in Cleft Lip Patients Without Alveolar Cleft

Abstract

There appear to be fewer abnormalities in the bony development of the upper jaw in patients who have cleft lip without cleft alveolar, hard or soft palate, and special care does not appear to be necessary. However, we have observed bone defects or bone deformity and asymmetry of the piriform aperture among patients undergoing long-term follow-up fa. r cleft lip without cleft hard or soft palate. There were six patients, two male and four female. Five patients had a right-sided cleft lip and one had a left-sided cleft lip. All patients were diagnosed as cleft lip, but no evidence of cleft palate was found. On three-dimensional CT scans taken at 5 to 17 years of age, deformity of the piriform aperture was observed. Auto logous bone grafting was performed in two of the patients and an artificial bone substitute was used in another two patients. Two patients did not undergo any treatment of the bony abnormality. In patient s who have unilateral cleft lip without cleft palate, we have found that good development of the external nose is often impossible even when the nasal cartilage has developed and the recess at the base of the ala nasae is repaired. However, when attention is also paid to the shape of the piriform aperture and deformity is found in the hard tissue that supports the nasal cartilage, it is important to improve its morphology by inserting autologous or artificial bone grafts.