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

Abstract

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.

The Surgical Nasoalveolar Molding: A Rational Treatment for Unilateral Cleft Lip Nose Deformity and Literature Review

“…Based on the available scientific evidence and our experience during the last 20 years, good nose symmetry and alveolar cleft improvement can be obtained using an adequate surgical technique without presurgical treatment regardless of the severity of the cleft, as demonstrated in the present study (Tables 1 and 2 ; Figs. 4 – 7 , 9 – 16 ). Similar outcomes have been reported by different authors.…”

“…Long-term significant changes were observed with regard to pre- and postoperative columellar angle and alveolar cleft lip, whereas nonstatistically significant differences were found between the cleft and noncleft sides regarding nostril dome height, nasal base width, alar base position, columellar length, lip height, and vermilion height (Tables 1 and 2 ; Figs. 4 – 7 , 9 – 16 ). Observed differences in the lip width are associated with congenital hypoplasia on the cleft side of the lip.…”

“…Nose repair was based on vestibular lengthening using the V–Y–Z technique. 9 ( See Video 1 , which displays the V–Y–Z surgical technique for primary complete cleft lip nose repair.) This method expands the nasal vestibule in a way similar to how a presurgical orthopedic molds the nose (Figs.…”

“…The repaired muscles of the upper lip modify the caudal septum and cleft segments as a surgical orthopedic (surgical NAM concept). 9 …”

Cleft Lip and Palate Patient Rhinoplasty

“…The primary target of this surgery is to obtain a symmetrical nasal tip and alar base [4]. There are many described techniques to correct the asymmetrical unilateral nasal deformity, including V-Y-Z plasty [2,9]. In general, the lower lateral cartilage is released and repositioned [2][3][4]6].…”