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Our aim was to develop and validate a new method to assess objectively and quantitatively the morphology of the nostrils after nasal or nasolabial surgery. We used digital analysis using specific mathematical algorithms to assess several geometric measurements, particularly of facial asymmetry, expressed in adimensional units. Forty-five patients with no facial anomalies (control group) were used initially to evaluate the method and to obtain variables for statistical reference. Thirty-five patients operated on for unilateral cleft lip and palate (cleft group) were then analysed and compared with the control group. Individual scores were obtained for each patient, computed, and correlated with those established by a lay panel. Statistical analysis showed good sensitivity and reliability (R>0.8).

We aimed to evaluate retrospectively changes in the nasal appearance after secondary bone grafting in children with complete unilateral cleft lip and palate in 41 consecutive patients. Basal view photographs were analysed by a software program (ASYMNOS, for asymmetry of nostrils, available on simple request) that computes comparative functions between both nostrils and gives an objective score. These data were compared with those of a control group. The measurements and scores were calculated for each group, and then the global objective scores were correlated with the subjective scores that resulted from an independent external panel that ranked the aesthetic aspects of the nostrils. There was a significant improvement in the nasal symmetry postoperatively that resulted from a decrease in height between the nostrils, and a positive correlation between the objective and subjective scores.

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