Facial Plast Surg 2002; 18(4): 253-262
DOI: 10.1055/s-2002-36493
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Correction of the Cleft-Lip Nasal Deformity

Charles W. Shih, Jonathan M. Sykes
  • Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA
Further Information

Publication History

Publication Date:
08 January 2003 (online)

ABSTRACT

Correction of the cleft-lip nasal deformity is a difficult task that requires a clear understanding of the associated complex anatomic abnormalities. These deformities tend to accentuate as nasal growth continues. Primary tip rhinoplasty in the unilateral deformity improves nasal tip symmetry and decreases the need for intermediate surgery. Intermediate rhinoplasty in the bilateral deformity is performed when nasal tip projection is markedly diminished. In both the unilateral and bilateral deformity, definitive rhinoplasty utilizing the open-structure rhinoplasty approach allows maximum exposure for placement of structural grafts to improve tip projection, definition, support, and function. In this article, the pathologic anatomy of the unilateral and bilateral cleft nasal deformity is described. The philosophy and timing of repair are discussed. Finally, the techniques used by the authors to address both the aesthetic and functional problems are outlined.

REFERENCES

  • 1 Sykes J M, Senders C W. Pathologic anatomy of cleft lip, palate and nasal deformities. In: Meyers AD, ed. Biological Basis of Facial Plastic Surgery New York: Thieme Medical Publishers 1993: 57-71
  • 2 Fara M. The musculature of cleft lip and palate. In: McCarthy J, ed. Plastic Surgery, vol 4 Philadelphia, PA: WB Saunders 1990
  • 3 Park B Y, Lew D H, Lee Y H. A comparative study of the lateral crus of alar cartilage in unilateral cleft lip nasal deformity.  Plast Reconstr Surg . 1998;  101 915-919
  • 4 Sykes J M, Senders C W. Surgical treatment of the unilateral cleft nasal deformity at the time of lip repair.  Fac Plast Surg Clin North Am . 1995;  3 69-77
  • 5 Latham R. The pathogenesis of the skeletal deformity associated with unilateral cleft lip and palate.  Cleft Palate Craniofac J . 1969;  6 404-414
  • 6 Crockett D, Bumsted R. Nasal airway, otologic, and audiologic problems associated with cleft lip and palate. In: Bardach J, Morris HL, eds. Multidisciplinary Management of Cleft Lip and Palate Philadelphia, PA: WB Saunders 1990: 672
  • 7 Bernstein L. Early submucous resection of nasal septal cartilage: a pilot study in canine pups.  Arch Otolaryngol . 1973;  97 272-285
  • 8 McComb H K, Coghlan B A. Primary repair of the unilateral cleft lip nose: completion of a longitudinal study.  Cleft Palate Craniofac J . 1996;  33 23-31
  • 9 Mulliken J B. Primary repair of bilateral cleft lip and nasal deformity.  Plast Reconstr Surg . 2001;  108 181-194
  • 10 Sykes J M, Senders C W, Wang T D, Cook T A. Use of the open approach for repair of secondary cleft lip-nasal deformities.  Fac Plast Surg Clin North Am . 1993;  1 111-126
  • 11 Toriumi D M, Johnson C M. Open structure rhinoplasty.  Fac Plast Surg Clin North Am . 1993;  1 1-22
  • 12 Wang T D, Madorsky S J. Secondary rhinoplasty in the unilateral cleft lip nose.  Arch Fac Plast Surg . 1999;  1 40-45
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