Comparative Study of Corretive Operationof Unilateral Secondary Cleft Lip Nose Deformity According to the Shape of Nostril.

Bae, Yong Chan; Kim, Jong Hyun; Nam, Soo Bong; Hwang, So Min; Jeon, Jae Yong

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(5):838-843.
Published online September 1, 1999.

Comparative Study of Corretive Operationof Unilateral Secondary Cleft Lip Nose Deformity According to the Shape of Nostril.

Yong Chan Bae, Jong Hyun Kim, Soo Bong Nam, So Min Hwang, Jae Yong Jeon

Abstract

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.