Rhinoplasty in the Cleft Lip Patient

Several important factors to consider in the surgical repair of the cleft lip nose are described: the importance of an adequate lip closure technique to ensure symmetry can prevent a more conspicuous deformity of the nose during growth, the consequences of secondary rhinoplasty in the growing nose in which the surgeon has to weigh the possible growth inhibition due to scar tissue against the possible functional and esthetic improvement, a systematic surgical approach in which the operative procedure is divided Into different steps, and the use of autogenous graft material. In the evaluation of 52 cleft lip patients (5 bilateral clefts, 47 complete unilateral clefts) who had undergone a secondary rhinoplasty, two specific postoperative problems were encountered: slight to moderate recurrence of the caudal septal deviation (in unilateral clefts) and restenosis of the nasal vestibule at the cleft side. Adjustment of the surgical technique and the use of a custom-made vestibulum device diminished these sequellae considerably.

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Role of cartilage correcting sutures in single-stage secondary rhinoplasty for unilateral cleft lip nose deformity

National Journal of Maxillofacial Surgery ◽

10.4103/njms.njms_282_20 ◽

2021 ◽

Vol 12 (2) ◽

pp. 193

Author(s):

Kshiteej Dhull ◽

Sunil Sharma ◽

ArchanaJai Singh Yadav

Keyword(s):

Cleft Lip ◽

Single Stage ◽

Secondary Rhinoplasty ◽

Nose Deformity ◽

Cleft Lip Nose

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Bolster Implementation of Custom-Made Plaster in the Reconstruction of Cleft Lip Nose

Journal of Craniofacial Surgery ◽

10.1097/scs.0b013e31822eab79 ◽

2011 ◽

Vol 22 (5) ◽

pp. 1983

Author(s):

Emin Kapi ◽

Mehmet Bozkurt ◽

Samet Vasfi Kuvat

Keyword(s):

Cleft Lip ◽

Custom Made ◽

Cleft Lip Nose

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A new operative procedure for primary and secondary repairs of the cleft-lip nose. (Japanese)Jpn.J. Plast. Reconstr. Surg. 27

Plastic & Reconstructive Surgery ◽

10.1097/00006534-198601000-00084 ◽

1986 ◽

Vol 77 (1) ◽

pp. 173

Author(s):

Kiyonori Harii

Keyword(s):

Cleft Lip ◽

Operative Procedure ◽

Cleft Lip Nose

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Secondary Rhinoplasty On Cleft Lip Nose

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i4.85 ◽

1970 ◽

Vol 1 (4) ◽

Author(s):

Gentur Sudjatmiko ◽

Prasetyanugraheni Kreshanti

Keyword(s):

Cleft Lip ◽

Healing Process ◽

Nasal Bone ◽

Upright Position ◽

Open Rhinoplasty ◽

Nasal Deformity ◽

Nasal Cartilage ◽

Secondary Rhinoplasty ◽

Cleft Lip Nose

By definition a secondary rhinoplasty is a procedure to correct the nasal shape deformity in cleft lip patients, which is performed not in conjunction with the labioplasty procedure. Several important factors to be considered in doing rhinoplasty procedures in cleft lip patients are: (1) Open rhinoplasty is more beneficial in assessing the whole nasal deformity, especially the nasal cartilage in cleft lip patients, (2) Releasing the latero-superior cartilage attached to the nasal bone and skin, which caused webbing inside the nostrils, (3) Addition of strut in columella as a pillar to adjust the dropping nose to the upright position, (4) Addition of cartilage plate whenever needed in the cleft side, (5) The nostril narrowing on the cleft side could be reduced by enlarging the nostril diameter, (6) The new nostril shape is maintained using a device (nasal retainer) for several weeks until the healing process is achieved, (7) The suture removal in nose is not as easy as of those in lip. The suture removal could be performed under mild sedation especially in uncooperative patients.

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Custom-Made Nasal Retainer Using Latex Nelaton Urine Catheter After the Cheiloplasty

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621992673 ◽

2021 ◽

pp. 105566562199267

Author(s):

Joon Seok Oh ◽

Jeehyeok Chung ◽

Jeong Hyun Ha ◽

Hyo Kyung Yoo ◽

Sukwha Kim

Keyword(s):

Surgical Procedures ◽

Cleft Lip ◽

Custom Made ◽

Median Cleft

Nasal retainers are common tools used in managing patients with cleft lip. The significance of nasal retainer in preventing nostril collapse or stenosis to maintain a symmetrical nose after the surgical procedures is already well known. We came up with a way to create a nasal retainer using a latex nelaton catheter. Custom-made nasal retainer using latex nelaton catheter was used postoperatively on a 10-month-old infant with median cleft lip after cheiloplasty. In postoperative day 7, her nostrils were large enough for premade silicone nasal retainer to fit. She was discharged with instructions given to use the retainer for 6 months. Custom-made nasal retainer can be used as an alternative to premade nasal retainers for patients with wide columella or small nostril cavities, or who cannot afford premade retainers.

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Repair of Asymmetric Bilateral Cleft lip: 1 Stage or 2 Stage

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211013978 ◽

2021 ◽

pp. 105566562110139

Author(s):

Xinran Zhao ◽

Yilai Wu ◽

Guomin Wang ◽

Yusheng Yang ◽

Ming Cai

Keyword(s):

Cleft Lip ◽

Outcome Measure ◽

Scar Tissue ◽

Anatomical Reduction ◽

Scoring Method ◽

Two Stage ◽

One Stage ◽

Significant Difference ◽

Bilateral Cleft Lip ◽

Surgery Outcomes

Objective: To verify the advantages and indications of 1-stage and 2-stage repair for asymmetric bilateral cleft lip (BCL). Design: Retrospective study. Setting: From January 2004 to December 2016 in our department. Patients: Patients with BCL. Main Outcome Measure(s): Over 6 months after the operation, the surgery outcomes were evaluated and graded by 2 experienced surgeons. Results: The result of surgery was evaluated using the scoring method of Mortier et al and Anastassov and Chipkov. Among 133 patients with asymmetric BCL, 61 (45.9%) had 1-stage repair and 72 (54.1%) had 2-stage repair. Sixty-eight (51.1%) patients had complete-incomplete cleft lip (CL), and those who underwent 1-stage repair showed a trend of better outcome ( P = .028). Fifty (37.6%) patients with incomplete-microform CL showed no significant difference between the outcomes of 2 surgery plans ( P = .253). In 15 (11.3%) patients with complete-microform CL, only one had 1-stage repair with a score of 8.5. The other 14 patients with 2-stage repair were scored 3.68 ± 1.28. Two-stage repair was preferable when the deformity degree was very different on 2 sides, as it could reduce unnecessary scar tissue and extend the nasal columella. One-stage repair could help to achieve the anatomical reduction of the orbicularis oris and a better contour of the vermilion tubercle. Conclusion: One-stage repair is recommended for patients with complete-incomplete CL and incomplete-microform CL. Two-stage repair for patients with complete-microform CL is preferred in our center, but more studies are required to support this conclusion.

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