Anatomical Reconstruction of the Nasal Floor in Complete Unilateral Cleft Lip Repair

Chang, Lan Sook; Son, Yoosung; Baek, Rong Min; Kim, Baek Kyu

doi:10.1097/sap.0000000000001093

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Patient dissatisfaction about obvious scars on upper lips ( N =3). [ 22 , 23 ] 20 A semi-open rhinoplasty technique Tajima incision on the cleft side and a Rim incision on the contralateral side Complete UCL 45 AB (along the scar line) Complete UCL Straight-Line Advanced Release Technique (StART) 72 AB (along the scar line) 5 years Symmetry between the sill areas, minimal scar in all cases NCR [ 9 ] Unilateral or bilateral complete cleft Performing 2 medial and lateral upper lip mucosal flaps. The medial flap was sutured to the lateral nasal mucosa, forming the upper layer of the nasal floor.…”

Section: Resultsmentioning

confidence: 99%

“…On the contrary, nasal sill area augmentation has not received much attention so far, although the use of this technique is quite practical for cases, such as uni/bilateral cleft lip or cleft lip and palate, traumatic lesions, congenital asymmetry of the nostril size, secondary revision surgeries, and reconstruction of defects caused by malignancies (e.g., basal cell carcinoma) [7]. So far, few methods and techniques have been introduced for the nasal sill graft procedure [5,[8][9][10]. Therefore, in this study, we aimed to introduce our novel sill graft technique that can be safely used for most of the aforementioned cases.…”

Section: Introductionmentioning

confidence: 99%

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Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

Adham

Keyhan²,

Fallahi

et al. 2021

Maxillofac Plast Reconstr Surg

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Background Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques. Methods Our technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area. Results A total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area. Conclusion Based on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

Adham

Keyhan²,

Fallahi

et al. 2021

Maxillofac Plast Reconstr Surg

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“…Because reshaping and repositioning the ala is the most important step in secondary repair, the paucity of alar tissue is an obstacle for many repair methods. Tissue deficiency is related to inter‐individual variability, scarring from the primary repair, over‐resection of the redundant tissue from previous operations, 1 and malformation of the tissue attached to the collapsed bony structure 2,3 . This usually results in tension of the sutured skin in commonly used techniques such as advancement flap and z‐plasty.…”

Section: Introductionmentioning

confidence: 99%

A New Algorithm for Secondary Repair of Unilateral Cleft Lip Nasal Deformity

Chen,

Wang,

et al. 2023

The Laryngoscope

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ObjectivesFollowing primary surgery for unilateral cleft lip palate (UCLP), cleft lip nasal deformities (CLNDs) (nasal asymmetry, collapsed nasal alae, and a widened alar base) are generally inevitable and often require secondary rhinoplasty. However, reconstructing a cleft nose with an alar tissue deficiency remains challenging for rhinoplasty surgeons.MethodsThe manifestations of common deformities are described herein, and a secondary rhinoplasty technique for unilateral CLNDs using a nasolabial flap (NLF) has been proposed for patients with alar tissue deficiency. Secondary rhinoplasties were performed in 12 patients with unilateral CLNDs between 2020 and 2021 using a NLF. Photogrammetric measurements were performed preoperatively and postoperatively. A total of 12 flaps were successfully transferred. Ten patients were followed up for >1 year.ResultsSignificant postoperative decreases in nasal alar width were measured in both the base view (p < 0.050) and the frontal view (p < 0.050). Despite the additional facial scars that occurred in some cases, all patients were satisfied with the aesthetic effects.ConclusionsThe NLF achieved satisfactory results in secondary rhinoplasty of unilateral CLND for patients with nasal tissue deficiencies in whom the surgeon weighed the potential benefits over postoperative scarring.Level of Evidence4 Laryngoscope, 2023

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Section: Introductionmentioning

confidence: 99%

“…For nasal deformity, deficiencies of tissues are the key intrinsic factors, especially deficiency of soft tissue in nasal floor(Chang et al, 2017; Mittermiller et al, 2018; Tse et al, 2019). Numerous methods have been used, including straight-line closures, lateral advancement flaps, straight-line closures, and C-flaps(Stal et al, 2009; Morselli et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Labial-Nasal Evaluation for Nasal Floor Reconstruction With the New Triangular Flap in Unilateral Cleft Lip Repair

Liu

Yao

et al. 2021

The Cleft Palate Craniofacial Journal

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In this study, we present a modified technique for primary cleft lip repair with a rotation triangular flap from the cleft lateral side to reconstruct the nasal floor; and evaluate the outcome compared with traditional Millard repair. 40 patients with unilateral cleft lip were included in this research. The patients were divided into 2 groups; 17 patients treated with the Millard technique, and 23 patients treated with the newly modified technique. 14 measurement indexes were employed to evaluate the nose-lip morphology of postoperative patients with UCCL in standardized photographs preoperatively, postoperatively and 1-year follow-up. For lip symmetry, statistical significance was detected in the measurements of the vertical philtral height ratio indicating that the newly modified technique resolve the shortage of lip height on the cleft side 1-year follow-up. ( P < .05). In addition, statistical significance was detected in the 1-year postoperative columellar angle, alar width ratio, nostril width ratio, nostril height ratio, and nostril shape (cleft) ( P < .05), showing more successful repair of the nose compared with the traditional repair. The modified unilateral cleft lip repair with rotation triangle flap from the cleft lateral side was beneficial in the correction of lip and nasal deformity in and had positive effects on labial symmetry.

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Anatomical Reconstruction of the Nasal Floor in Complete Unilateral Cleft Lip Repair

Abstract: Nasal floor reconstruction is important in complete unilateral cleft lip repair. Our technique provides a naturally shaped, symmetrical nasal floor without conspicuous scarring.

Cited by 6 publications

References 20 publications

Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

A New Algorithm for Secondary Repair of Unilateral Cleft Lip Nasal Deformity

Labial-Nasal Evaluation for Nasal Floor Reconstruction With the New Triangular Flap in Unilateral Cleft Lip Repair

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