Surgical correction of unilateral cleft lip nasal deformity

Fifty-five patients with unilateral. cleft lip nasal deformities were operated on from March 1992 to June 1996. Thirty-one patients were male and 24 were female. Three patients were 2 to 5 years of age, 7 patients were 6 to 10 years old, 12 patients were 11 to 15 years old, 13 were 16 to 20 years old, and 20 were greater than 21 years of age. The average follow-up period was 16 months. Combined operative procedures, depending on the severity of the cleft lip nasal deformity, were the following: (1) a reverse-U incision and Z-plasty for a mild vestibular web, (2) a reverse-U incision and V-Y plasty for a moderate vestibular web, (3) open rhinoplasty incision combined with a reverse-U incision and V-Y plasty for severe flattening or buckling of the cleft lower lateral cartilage, (4) lower lateral cartilage suspension or repositioning with or without an onlay cartilage graft; (5) alar base advancement, (6) bone graft on the piriform aperture, (7) septoplasty and corrective rhinoplasty, and (8) columella lengthening with an auricular composite graft. a nasal splint was applied for 3 to 6 months in every patient to maintain the corrected nostril contour, Most patients were satisfied with their surgical results. We suggest that to achieve a goad contour of the nose, bony and cartilaginous deformities should be corrected simultaneously with correction of the soft tissue.