Web Uni-Limb Z-Plasty for Correction of Alar Web Deformity in Unilateral Cleft Lip Nasal Deformities: Photogrammetric Analysis.

Han, Kihwan; Kim, Daejin; Park, Mushik; Kim, Junhyung; Son, Daegu

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(6):740-746.
Published online November 1, 2011.

Web Uni-Limb Z-Plasty for Correction of Alar Web Deformity in Unilateral Cleft Lip Nasal Deformities: Photogrammetric Analysis.

Kihwan Han, Daejin Kim, Mushik Park, Junhyung Kim, Daegu Son

Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea. kihwanhan54@gmail.com

Abstract

PURPOSE
In the treatment of the unilateral cleft lip nasal deformities, the correction of the low-nostril height and short-columella are very difficult problems. We report the treatment outcomes of web uni-limb Z-plasty used for correction of unilateral cleft lip nasal deformities by using photographic analysis. METHODS: A total of 36 patients with unilateral cleft lip nasal deformities were enrolled in this study, who underwent web uni-limb Z-plasty and were followed up for at least 6 months. First, a triangular flap was made on the medial side of alar-columella web. The nostril apex of cleft side was corrected to a higher point compared to noncleft side by 2 mm. The flap was transposed into the defect of the vestibule. To reduce the bulging of the flap, horizontal cinching sutures were added. Postoperative outcomes were evaluated by using photographic analysis. 2 indices and 1 angle were measured on their photographs taken before and after the surgery. Symmetry was also evaluated by means of the noncleft side to cleft side index. For anthropologic assessment, observers described postoperative outcomes, using Ordinary Scale Method.
RESULTS
The postoperative values obtained in photographic analysis improved compared to preoperative ones. More improving anthropologic assessment was shown in post-than pre-operative.
CONCLUSION
Although, further long term follow up is needed, we found this technique to be an effective procedure to the symmetry of nostril apex level and the lengthening of columella in the unilateral cleft lip nasal deformities.

Keywords: Cleft lip; Alar nasal cartilage