Cleft Nasal Deformity and Rhinoplasty

Kaufman, Yoav; Buchanan, Edward P.; Wolfswinkel, Erik M.; Weathers, William M.; Stal, Samuel

doi:10.1055/s-0033-1333886

Cited by 24 publications

(28 citation statements)

References 31 publications

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“…Successful surgical correction is often surgeon dependent and often based on their training and experience. In addition, the absence of a standardized link between the subject's age, physical development, and amount of revisions needed has led to disagreement in cleft rhinoplasty timing and techniques (Buchanan et al, 2012). Multiple studies have reported conflicting views regarding the utilization of cartilage grafting from various donor sites (Ozaki et al, 2006;Wee et al, 2015;Lu et al, 2017;Zhang et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Pagan

Sterling

Andrews

2020

The Cleft Palate Craniofacial Journal

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Objective: To compare cartilage grafting outcomes in intermediate versus definitive cleft rhinoplasty. Design: A retrospective chart review was conducted. The χ2 and Fisher exact tests were used for statistical analyses. Results were considered statistically significant at P < .05. Participants: All subjects who underwent revision cleft rhinoplasties between July 2011 and June 2019 were included. Subjects with syndromic conditions were excluded. Results: A total of 46 subjects with a cleft nose deformity underwent 65 rhinoplasty procedures. The ages averaged 17 years (range 5-50) with 34 (73.9%) males and 12 (26.1%) females. In the intermediate group, 6 (28.6%) subjects required cartilage grafting as part of 6 cleft rhinoplasties, whereas 15 (71.4%) subjects underwent a total of 26 cleft rhinoplasties that did not require grafting. In the definitive group, 18 (76%) subjects required cartilage grafting over 21 cleft rhinoplasties, whereas 7 (24%) subjects underwent a total of 9 cleft rhinoplasties where cartilage grafting was not required. The difference between the number of subjects requiring cartilage grafting in the intermediate versus the definitive group was statistically significant ( P = .007). Ear concha and nose were the most frequently used cartilage donor sites, with no observed complications. Conclusions: Cartilage grafting was significantly more common in the definitive rhinoplasty group. Intermediate cleft rhinoplasty during the 5- to 13-year age period was effective, with a low-risk profile. In our experience, ear concha and nose were the preferred cartilage donor sites, with effective results and an excellent safety profile.

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Section: Introductionmentioning

confidence: 99%

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Pagan

Sterling

Andrews

2020

The Cleft Palate Craniofacial Journal

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“…By contrast, many studies have reported normal nose growth after primary rhinoplasty. [ 24 25 ] Yoshimura et al . [ 23 ] performed an observational study with a small sample size.…”

Section: Discussionmentioning

confidence: 99%

Primary unilateral cleft lip nasal deformity repair using V-Y-Z plasty: An anthropometric study

Rossell-Perry

2017

Indian J Plast Surg

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Background:Secondary nose deformity after unilateral cleft lip repair is a common problem. Loss of tip projection on the cleft side of unilateral cleft lip nasal deformity can be difficult to correct due to lack of adequate support. The purpose of this study is to evaluate the surgical outcome after using V-Y-Z plasty to address unilateral cleft lip nasal deformities.Methods:A cross-sectional study of one surgeon's outcome of 58 performed primary complete unilateral cleft lip nasal deformity repairs. All these patients met the study criterion of having anthropometric measurements at the cleft and non-cleft side of the nose performed at least 1 year postoperatively.Results:Since 2012, 32 consecutive patients have undergone primary anatomical repair of the cleft nasal deformity in patients with a complete unilateral cleft. We have not found statistically significant differences between the cleft and non-cleft nostril dome height and columella length measured at least 1 year postoperatively.Conclusions:The findings suggest that the V-Y-Z plasty is a good alternative to create a more symmetric nasal tip in patients with primary unilateral cleft lip nasal deformity. Additional studies are required to evaluate functional and long-term outcomes after primary rhinoplasty in patients with unilateral cleft lip.

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“…The profundus, while present, is hypoplastic and, rather than projecting anteriorly giving rise to a cutaneous-vermilion junction or white roll, terminates within the vermillion mucosa. 14 , 28 , 29 , 31 , 35 In addition, the course of the cleft segment’s paranasal muscle fibers from the ala to the anterior nasal spine is interrupted, contributing to nasal deviation. 36 , 37 These aberrant muscular insertions create facial imbalance further intensified by the degree of the retropositioned and hypoplastic maxillary cleft segment.…”

Section: Anatomy Of the Cleft Lip Nasal Deformitymentioning

confidence: 99%

“…Unopposed muscular forces result in an asymmetric nasal tip via displacement of the caudal septum, the cleft medial crural footplate, and columella toward the noncleft side and compensatory bowing of the septum, flaring of the cleft side LLC, and widening of the alar base towards the cleft side. 28 , 29 , 31 The LLC’s change in position affects its attachment to the upper lateral cartilage (ULC) and weakens both the upper lateral cartilage and scroll region.…”

Section: Anatomy Of the Cleft Lip Nasal Deformitymentioning

confidence: 99%

How to Get Consistently Good Results in Cleft Lip Repair

Kamel

Segal

Tsai

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary: This article serves as a practical guide for plastic surgeons focusing on repair of primary cleft lip and nasal deformity. We discuss the key anatomic disruption present in cleft lip and nasal deformity and the goals of primary repair. In addition, our preferred surgical technique for unilateral and bilateral cleft lip and nasal deformity is summarized along with technical pearls and pitfalls.

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Cleft Nasal Deformity and Rhinoplasty

Cited by 24 publications

References 31 publications

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Primary unilateral cleft lip nasal deformity repair using V-Y-Z plasty: An anthropometric study

How to Get Consistently Good Results in Cleft Lip Repair

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