Correction of secondary unilateral cleft lip nasal deformity in adults using lower lateral cartilage repositioning, columellar strut, and onlay cartilage graft on the nasal tip with open rhinoplasty combined with reverse-U incision

2020 ◽  
Author(s):  
Byung Chae Cho ◽  
Jeong Woo Lee ◽  
Joon Seok Lee ◽  
Jong Ho Lee ◽  
Jeong Yeop Ryu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Open Rhinoplasty ◽  
Lateral Cartilage ◽  
Cartilage Graft ◽  
Lower Lateral Cartilage ◽  
Nasal Deformity ◽  
Nasal Tip ◽  
Columellar Strut

scholarly journals Composite correction of a unilateral cleft lip nose deformity and alveolar bone grafting

2009 ◽  
Vol 42 (S 01) ◽  
pp. S71-S78
Author(s):  
Nitin J. Mokal ◽  
Chintamani Kale ◽  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Septal Cartilage ◽  
Alar Cartilage ◽  
Open Rhinoplasty ◽  
Cartilage Graft ◽  
Nasal Deformity ◽  
Alveolar Bone Grafting ◽  
Alar Rim

ABSTRACT Background: Managing the cleft lip nasal deformity has always been a challenge. Even now, there is no single established universally accepted method of correction. The open alveolar gap and the ipsilateral hypoplastic maxilla are two major problems in achieving consistently good results in a cleft lip nasal deformity. In our study, after first assuring the orthodontic realignment of maxillary arches, we combined bone grafting in the alveolar gap and along the pyriform margin, with a formal open rhinoplasty approach. Methods: All the patients underwent orthodontic treatment for preparation of the alveolar bone grafting. During the process of alveolar bone graft, a strip of septal cartilage graft was harvested from the lower border of the septum which also helps to correct the septal deviation. The cancellous bone graft harvested from the iliac crest was used to fill the alveolar gap and placed along the pyriform margin to gain symmetry. Through open rhinoplasty along the alar rim and additionally using Potter's incision extending to the lateral vestibule, the lateral crura of the alar cartilage on the cleft side was released from its lateral attachment and advanced medially as a chondromucosal flap in a V–Y fashion, in order to bring the cleft-side alar cartilage into a normal symmetric position. The harvested septal cartilage graft was used as a columellar strut. The cleft nostril sill was narrowed by a Y–V advancement at the alar base and any overhanging alar rim skin was carefully excised to achieve symmetry. Results: The results of this composite approach were encouraging in our series of 15 patients with no additional morbidity and a better symmetry of the nose and airway especially in the adolescent age group. Conclusion: This concept of simultaneous approach when appropriate for nasal correction at the time of alveolar bone grafting showed an encouraging aesthetic and functional outcome.

The Isis Cruraplasty

1998 ◽  
Vol 15 (2) ◽  
pp. 137-141
Author(s):  
Steven Burres
Keyword(s):  
Surface Area ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Lateral Crus ◽  
Nasal Tip ◽  
Natural Configuration ◽  
Lateral Segment ◽  
Columellar Strut ◽  
Bulbous Nasal Tip ◽  
Tip Formation

Most of the reshaping techniques for a blunt, bulbous nasal tip reduce the curvature and surface area of tip lobule cartilage, and they reform the tip to add definition. Unfortunately, the assemblage of surgical maneuvers frequently reduces valued projection, and it may result in an unnatural tip formation with a distasteful pattern of contracture. Employing the Isis cruraplasty allows incremental tip enhancement and narrowing, while restoring or preserving the natural configuration. After lateral dome division and undermining of the medial portion of the lateral crus, the lateral segment of the lateral crus was transected incrementally and advanced to reenforce the deficiency in rim support. Sewing the medial flanges together created a cartilaginous platform that supported the Isis graft, and/or it accommodated a columellar strut, if indicated. The Isis cruraplasty conserves virtually all of the lower lateral cartilage without compromising the potential for tip reshaping and augmentation.

Cleft Rhinoplasty: Strategies for the Multiply Operated Nose

2018 ◽  
Vol 34 (03) ◽  
pp. 290-297
Author(s):  
Tsung-yen Hsieh ◽  
Raj Dedhia ◽  
Travis Tollefson
Keyword(s):  
Surgical Procedure ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Nasal Deformity ◽  
Internal Lining ◽  
Cleft Rhinoplasty ◽  
Cartilage Grafting ◽  
Definition Of ◽  
Cleft Nasal Deformity ◽  
Maxillary Deficiency

AbstractRhinoplasty, as a surgical procedure to improve the appearance of the nose while preserving or improving function, is complicated and difficult to master. Revision cleft rhinoplasty offers another tier of challenge. The symmetry, proportions, and definition of the nose are affected by the native cleft deformity but also previous surgical scars, cartilage grafts, and skin excisions. Our preferred approach is to use structural cartilage grafting to establish septal and lower lateral cartilage resiliency. Internal lining deficiency is addressed with skin or lining transfer, while excess nasal tip thickness is contoured to improve definition. Of the utmost importance, the cleft nasal deformity cannot be considered in isolation, but rather a combined amalgamation of the lip muscle and scar, dentofacial occlusion, and skeletal maxillary deficiency.

Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation

2020 ◽  
Vol 277 (5) ◽  
pp. 1371-1377 ◽  
Author(s):  
S. Bucher ◽  
S. Kunz ◽  
M. Deggeller ◽  
D. Holzmann ◽  
M. B. Soyka
Keyword(s):  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Tip Projection ◽  
Columellar Strut ◽  
Nasal Tip Projection

scholarly journals Lateral intercrural suture in the caucasian nose: Decreased domal divergence angle in endonasal rhinoplasty without delivery

2012 ◽  
Vol 16 (02) ◽  
pp. 232-235
Author(s):  
Marcos Mocelin ◽  
Caio Soares ◽  
Rogério Pasinato ◽  
Andreia Frota ◽  
Cezar Berger
Keyword(s):  
Prospective Study ◽  
Divergence Angle ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Lateral Crus ◽  
Basic Technique ◽  
Nasal Tip ◽  
Definition Of

Summary Introduction: Several techniques can be performed to improve nasal tip definition such as cartilage resection, tip grafts, or sutures. Objctive: To evaluate the outcome of lateral intercrural suture at the lower lateral cartilage by endonasal rhinoplasty with a basic technique without delivery in decreasing the angle of domal divergence and improving the nasal tip definition. Method: This prospective study was performed in 64 patients in which a suture was made on the board head of the lower lateral cartilage in the joint between the dome and lateral crus, using polydioxanone (PDS) with sharp, curved needle. Results: In all of the cases, better definition of the nasal tip was achieved by intercrural suturing for at least 6 months postoperatively. Conclusion: Lateral intercrural suture of the lower lateral cartilage provides improved nasal tip definition and can be performed by endonasal rhinoplasty without delivery in the Caucasian nose.

Objective Tools to Analyze the Lower Lateral Cartilage in Unilateral Cleft Lip Nasal Deformities

2011 ◽  
Vol 22 (4) ◽  
pp. 1435-1439 ◽  
Author(s):  
Mohamed A. Saleh ◽  
Ahmed Elshahat ◽  
Maher Emara ◽  
Heba Hussein ◽  
Lisa Gould ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage
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