NASAL GROWTH IN COMPLETE BILATERAL CLEFT-LIP AND PALATE

Forty-four lateral cephalograms from a sample of 15 white males with b ilateral cleft lip and palate (BCLP) were evaluated to determine the g rowth pattern of the nose, identify timing of the nasal growth spurt, assess growth of the underlying bony elements relative to the nasal gr owth, and ascertain the relationship of the nose to the rest of the fa cial profile. The cephalograms (taken at ages 7.5 to 16.6 years) were divided into five groups according to age of subject. Fifteen variable s related to soft tissue nose, nasal bone, maxilla, and facial convexi ty were assessed. Results of this investigation were as follows. First , the nose of subjects with BCLP grew more downward than forward. Seco nd, the growth spurt occurred between the ages of 12 and 16 years. Thi rd, forward growth of the nose was almost always found, whereas the ma xilla becomes more retrusive. Fourth, the angle of soft tissue nasion (N')-pronasale (Prn)-soft tissue pogonion (Pog') had an average decrea se of 3.56 degrees from age 8 to 16 years. Individual data showed that 12 of 15 patients had a decrease of this angle, whereas 3 had a small increase; 10 of the 12 with a decrease demonstrated an increase of bo th sella-nasion (SN')-Prn and SN'-Pog'. The remaining 2 showed an incr ease of SN'-Prn and a decrease of SN'-Pog'. Thus, the profile of the n ose (N'-Prn-Pog') became more convex over the observed period, which a t least in part seemed to be due to the horizontal development of the nose itself.