Anthropometric Analysis of the Maxillary Bone and the Alar Base in Unilateral Cleft Lip with Secondary Nasal Deformity: Classification of a Piriform Margin Bony Depression

2014 ◽  
Vol 51 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Lei Zhang ◽  
Li Lu ◽  
Zeng-Jian Li ◽  
Qiang Liu ◽  
Ming-Liang Yang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Nasal Deformity ◽  
Maxillary Bone ◽  
Alar Base

The Performance of Secondary Nasal Alar Base Revision for Unilateral Cleft Lip by Single YV-Plasty (the Importance of Overcorrection During Surgery)

2021 ◽  
pp. 105566562110106
Author(s):  
Yoshitaka Matsuura ◽  
Hideaki Kishimoto
Keyword(s):  
Cleft Lip ◽  
Minimum Degree ◽  
Nasal Deformity ◽  
Simple Method ◽  
Primary Surgery ◽  
Base Revision ◽  
Alar Base ◽  
Anterior Nasal Spine ◽  
Nasal Floor ◽  
Case Basis

Although primary surgery for cleft lip has improved over time, the degree of secondary cleft or nasal deformity reportedly varies from a minimum degree to a remarkable degree. Patients with cleft often worry about residual nose deformity, such as a displaced columella, a broad nasal floor, and a deviation of the alar base on the cleft side. Some of the factors that occur in association with secondary cleft or nasal deformity include a deviation of the anterior nasal spine, a deflected septum, a deficiency of the orbicularis muscle, and a lack of bone underlying the nose. Secondary cleft and nasal deformity can result from incomplete muscle repair at the primary cleft operation. Therefore, surgeons should manage patients individually and deal with various deformities by performing appropriate surgery on a case-by-case basis. In this report, we applied the simple method of single VY-plasty on the nasal floor to a patient with unilateral cleft to revise the alar base on the cleft side. We adopted this approach to achieve overcorrection on the cleft side during surgery, which helped maintain the appropriate position of the alar base and ultimately balanced the nose foramen at 13 months after the operation. It was also possible to complement the height of the nasal floor without a bone graft. We believe that this approach will prove useful for managing cases with a broad and low nasal floor, thereby enabling the reconstruction of a well-balanced nose.

scholarly journals Problems In Cleft Lip Nose Patients Undergoing Augmentation Rhinoplasty With Rib Graft : A Case Report

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Nadia Kusumastuti ◽  
Gentur Sudjatmiko
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nasal Bone ◽  
Rigid Fixation ◽  
Nasal Deformity ◽  
Cross Sectional ◽  
Alar Base ◽  
Columellar Strut ◽  
Operative Result

Correction of a cleft lip nasal deformity remains a challenging procedure in reconstructive surgery. Many different procedures have been suggested to address the problem, but few techniques have worked well and consistently. We present a case of secondary cleft nasal deformity after repair of unilateral complete cleft lip and palate on the left side. The corrective procedures carried out included closed method rhinoplasty and dorsal nasal augmentation with rib graft which was fixed to the nasal septum with needle. The patient showed satisfactory immediate post-operative result, with correction of depressed alar base and satisfying dorsal and tip projection. However, 5 months post operative result showed deviation of nasal tip to the cleft side, which we suspected was due to: warping of the rib graft, soft tissue deficiency in the cleft side which exerts pulling forces to the warping graft, and lack of rigid fixation of the graft. After appraising pitfalls encountered in augmenting nasal dorsum of cleft patients with rib graft, we concluded that some preventive measures need to be done to avoid those problems, namely: balanced cross sectional carving of rib graft, cantilever graft with plate and screw to the nasal bone, and addressing pulling force from lack of soft tissue in the cleft side by adding columellar strut graft or alar contour graft.

The Effects of Alar Base Augmentation in Secondary Unilateral Cleft Lip Nasal Deformity

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yong Bae Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Moon Seok Kang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Nasal Deformity ◽  
Alar Base

Beware the Alar Base Optical Illusion in Assessment of Unilateral Cleft Lip Nasal Deformity

2020 ◽  
Vol 145 (2) ◽  
pp. 458e-460e
Author(s):  
Chad A. Purnell ◽  
Russell E. Ettinger ◽  
Raymond W. Tse
Keyword(s):  
Cleft Lip ◽  
Nasal Deformity ◽  
Optical Illusion ◽  
Alar Base

scholarly journals Commentary: Beware of Optical Illusion of the Alar Base in Unilateral Cleft Lip Nasal Deformity

2021 ◽  
Vol 9 (12) ◽  
pp. e3969
Author(s):  
Robert J. Knight ◽  
Russell E. Ettinger ◽  
Ezgi Mercan ◽  
Raymond W. Tse
Keyword(s):  
Cleft Lip ◽  
Nasal Deformity ◽  
Optical Illusion ◽  
Alar Base

Alar Base Augmentation Using Vomerine Bone Graft in Patients With Cleft Lip Nasal Deformity

2020 ◽  
Vol 85 (5) ◽  
pp. 511-515
Author(s):  
Bassem Elfeki ◽  
Amr Mohamed Elhussiny Khater ◽  
Ahmed Mohamed Bahaa El-Din ◽  
Omar Ossama Shouman ◽  
Rong-Min Baek ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Nasal Deformity ◽  
Alar Base

scholarly journals Bilateral cleft lip nasal deformity

2009 ◽  
Vol 42 (02) ◽  
pp. 235-241 ◽  
Author(s):  
Arun Kumar Singh ◽  
R. Nandini
Keyword(s):  
Cleft Lip ◽  
Current Trend ◽  
Peer Pressure ◽  
Nasal Deformity ◽  
Primary Surgery ◽  
Alar Base ◽  
Nasal Floor ◽  
Bilateral Cleft Lip ◽  
Cleft Nasal Deformity ◽  
Cleft Lip Nose

ABSTRACTBilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity.Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention.There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM) too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth.This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it's management both at the time of cleft lip repair and also secondarily, at a later date. It also discusses the practices followed at our centre.

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