Facial plast Surg 2003; 19(1): 029-040
DOI: 10.1055/s-2003-39134
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Repair of the Unilateral Cleft Lip/Nose Deformity

J. Madison Clark1 , Judith M. Skoner1 , Tom D. Wang2
  • 1Department of Otolaryngology/Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
  • 2Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland, OR
Further Information

Publication History

Publication Date:
09 May 2003 (online)

ABSTRACT

Successful surgical repair of the unilateral cleft lip and nose deformity, defined as normal orbicularis oris function and near-perfect symmetry of the repaired lip and nose, demands that the surgeon possess complete understanding of the embryology and anatomy of the midfacial defects. The surgical approach to repair of the unilateral cleft lip/nose should place great emphasis on achieving symmetry, not only with the lip segments but also perhaps even more importantly with the nasal tip. The reconstruction should recreate an intact fully functional orbicularis oris muscle across the cleft and camouflage the scar optimally. We have found that modification of the Millard rotation-advancement flap technique, with particular attention to the primary nasal repair, provides the best outcomes. In patients who have undergone primary repair of the lip and/or nose deformity, secondary rhinoplasty is generally required, regardless of the technique used at the primary repair. The degree of nasal deformity, however, is less severe following primary repair of the asymmetric nasal tip. We have found that the sliding flap cheliorhinoplasty, Wang's modification of the Vissarionov technique, provides excellent results for most secondary cleft rhinoplasties.