Abstract
BackgroundFor a better understanding of common suspension sutures during primary cleft lip nasal rhinoplasty, the biomechanical consequences of those sutures need to be demonstrated.MethodsA finite element model of the infant specimen was established. The closure of cleft lip and four different specific suspension sutures were simulated by loading different forces on the model: 1. F1 to simulate the suture fastening both medial crura together; 2. F2 to simulate the suture which sewed both medial crura and the non-cleft-side upper lateral cartilage together; 3. F3 to simulate the suture elevating the alar cartilage cranially; 4. F4 to simulate the suture elevating the alar cartilage superiorly. The deformation and stress distribution consequent to each maneuver were analyzed in details.ResultsThe deviation of columella was restored through the closure of cleft lip. Different suspension sutures had different biomechanical effects on the nasal structure. All suspension sutures had the function on elevating the alar cartilage. F2 had no function on restoring the collapse of the nasal tip. The suture which fastened both medial crura together leaded to the lowest stress on the skin envelope.ConclusionsEach suspension suture had its characteristics respectively. The simulation suggested that F1, the suture which fastened both medial crura, could be the most potential maneuver for cleft lip rhinoplasty because it can symmetrically restore the shape of the nose without incurring a significant increase in stress.
Highlights
For a better understanding of common suspension sutures during primary cleft lip nasal rhinoplasty, the biomechanical consequences of those sutures need to be demonstrated
Our recent studies demonstrated the necessary maneuvers in a competent cleft lip rhinoplasty [12], and relapse would occur according to selected surgical techniques [11]
The finite element model was established basing on the micro-MRI of an infant specimen with unilateral cleft lip nasal deformity
Summary
For a better understanding of common suspension sutures during primary cleft lip nasal rhinoplasty, the biomechanical consequences of those sutures need to be demonstrated. Different surgical maneuvers have been applied to restore the anatomical nasal structure, but the outcomes were indistinguishable because most of the analyses for surgical outcomes were retrospective and the measurement criteria were arduous to unify. The biomechanics for cleft lip nose correction and a better understanding of different. For understanding the biomechanics of rhinoplasty better, finite element analyses have been validated as a rewarding method [5,6,7,8,9,10,11,12,13]. Our recent studies demonstrated the necessary maneuvers in a competent cleft lip rhinoplasty [12], and relapse would occur according to selected surgical techniques [11]
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