Al Hazzab, A., Shalaby, H., El Nemr, A., Khedr, M. (2022). New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(4), 381-387. doi: 10.21608/ejprs.2022.269081
Ali A Al Hazzab; Helmy A Shalaby; Ayman El Nemr; Mohamed Khedr. "New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 4, 2022, 381-387. doi: 10.21608/ejprs.2022.269081
Al Hazzab, A., Shalaby, H., El Nemr, A., Khedr, M. (2022). 'New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(4), pp. 381-387. doi: 10.21608/ejprs.2022.269081
Al Hazzab, A., Shalaby, H., El Nemr, A., Khedr, M. New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(4): 381-387. doi: 10.21608/ejprs.2022.269081
New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity
1The Department of Plastic & Reconstructive Surgery; Faculty of Medicine, Tanta University
2The Department of Geral Surgery; Faculty of Medicine, Tanta University
Abstract
Background: Nasal distortion associated with a cleft lip < br />is known as cleft lip nasal deformity. Because of the asymmetry, the characteristics of unilateral and bilateral cleft lip nasal deformity differ. Surgical correction is staged based on the time of the surgery: Primary, intermediate, and secondary repair. We performed intermediate cleft rhinoplasty using a septum based adipofascial flap from non-cleft to cleft side of the nose as a new flap. Objectives: To reduce the tip asymmetry and maintaining new medial position of the corrected lower lateral cartilage. Patients and Methods: Twenty-one patients with unilateral cleft lip nasal deformity aged 4 to 12 years participated in this prospective study. They were treated with an intermediate cleft rhinoplasty that included a new flap technique. Subjective and objective assessments were performed before and after surgery. Results: The average ages were 7.5±2.9 years, with 16 males and 5 females, 17 left side and 4 right side clefts, and 15 patients with accompanied lip redo. A significant improvement achieved in one year post-operative subjective assessment score (p-value <0.001). There was a significant difference in comparing both sides Pronasale-Subnasale distance (Prn-Sn distance) pre-operative (p-value <0.01). After surgery by one month and one year, a non-significant difference in both sides Prn-Sn distance was noticed (p-value >0.1, >0.2 respectively). Conclusion: Intermediate cleft rhinoplasty provides more symmetrical nasal growth, which reduces the need for secondary rhinoplasty. It helps youngsters with unilateral cleft lip nose in their psycho-social issues. During intermediate cleft rhinoplasty, a new adipofascial flap was used to improve the tip symmetry and reduce the risk of relapse.
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