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A Systematic Review

Perry van der Heijden, MD; Astrid G. Korsten-Meijer, MD, PhD; Bernard F. van der Laan, MD, PhD; Hero P. Wit, PhD; Sieneke M. Goorhuis-Brouwer, PhD

Arch Otolaryngol Head Neck Surg. 2008;134(12):1288-1293.

Objective  To define the end of the nasofacial growth spurt in order to schedule rhinoseptoplasty in patients with cleft without disturbing nasofacial growth.

Data Sources  We searched the PubMed and Cochrane bibliographic databases from inception through December 31, 2007, using the primary indexing term facial growth with the confining search terms growth AND (face OR nose) AND (cephalometry OR anthropometry). The reference lists of the retrieved articles were searched for missed relevant studies. Articles written in English, German, or Dutch were included in the review.

Study Selection  Studies of white adolescents without genetic disorders or malformations whose growth patterns had been followed up from at least 12 years of age until 18 years of age, with intervals between relevant measurements not longer than 2 years, were selected for this review.

Data Extraction  A reviewer performed data extraction by obtaining raw study data from the selected studies or by requesting them from the authors.

Data Synthesis  Growth velocity curves were fit to different relevant measures for nasofacial growth. The end of the nasofacial growth spurt was defined as the age at which these growth velocity curves have their steepest descending slope. This definition yielded an average age of 13.1 years for adolescent girls and 14.7 years for adolescent boys. Because no information could be found for the spread in age of nasal growth spurt of individuals, 2 SDs of the age distribution for body height growth velocity were added. This resulted in 98% of white adolescent girls being nasally mature at the age of 15.8 years and 98% of white adolescent boys being nasally mature at the age of 16.9 years.

Conclusion  Rhinoseptoplasty can safely be performed after the age of 16 years in girls and 17 years in boys.

Author Affiliations: Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, and Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands.

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