New Flap from Non-Cleft to Cleft Side during Intermediate Rhinoplasty for Unilateral Cleft Lip Nasal Deformity

Document Type : Original Article

Authors

1 The Department of Plastic & Reconstructive Surgery; Faculty of Medicine, Tanta University

2 The 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.

Keywords

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