Correction of secondary unilateral cleft lip nasal deformity in adults using lower lateral cartilage repositioning, columellar strut, and onlay cartilage graft on the nasal tip with open rhinoplasty combined with reverse-U incision

Cho, Byung Chae; Lee, Jeong Woo; Lee, Joon Seok; Lee, Jong Ho; Ryu, Jeong Yeop; Tian, Lulu; Choi, Kang Young; Yang, Jung Dug; Chung, Ho Yun

doi:10.1016/j.bjps.2020.10.060

Cited by 12 publications

(14 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The entire nasal tip and columella were lengthened using the columella strut and onlay graft on the tip, whereas the tip maintained its mobility. We found no complications with Medpor, such as extrusion or infection 45 …”

Section: Discussionmentioning

confidence: 51%

“…[39][40][41][42][43][44] We have operated on adult patients with secondary CLND for 15 years by repositioning both LLCs, the columella strut, and the nasal tip plasty through the open reverse-U incision. 45 For patients with severe secondary CLND associated with the hypoplastic cleft alar cartilage or alar rim deformities, we have combined the alar contour cartilage graft to correct the hypoplastic cleft alar cartilage or alar rim retraction with previous techniques to improve the lower aspect of the nose. We describe our surgical results in this study.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Correction of Severe Secondary Cleft Lip Nasal Deformity

Cho

Park

Ryu

et al. 2021

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

Background: The lower lateral cartilages (LLCs) are key elements for alar and tip support. Repositioning of both LLCs is an effective procedure for correcting a laterally spreading dome of LLCs and drooping nasal tip in cleft lip nasal deformity (CLND). The alar contour graft has become an essential component of rhinoplasty for correcting the concave or collapsed and retracted alar. Herein, onlay cartilage graft was combined with nasal tip plasty to correct hypoplastic cleft lateral crus or alar rim retraction, and with columella strut to obtain better aesthetic outcomes in patients with severe CLND. Methods: Seven patients with severe secondary unilateral CLND, including hypoplastic cleft lateral crus or alar rim retraction, underwent rhinoplasty from October 2013 to April 2020. Both LLCs were isolated and repositioned approximated medially using tip suture technique combined with columella strut. A septal cartilage onlay graft was applied on the hypoplastic cleft lateral crus. Cartilage graft on the nasal tip was performed to further project and enhance the nasal tip. Photogrammetric evaluation of the operated patients and statistical analysis of the obtained data were performed. Results: The average age at operation was 23.5 (range: 17-36) years. The follow-up period was 6-36 (mean, 14.3) months. All patients were enrolled by photogrammetric evaluation. Height of the medial nostril and short axis of the nostril on the cleft side were increased with a statistical significance of P < 0.05, indicating that depressed ala on the cleft side, which is a feature of CLND, was corrected similar to that of the noncleft side. Conclusions: The alar contour cartilage graft, as an effective adjunctive technique, improves the alar margin, prevents the alar rim from collapsing, and provides supports to the cleft-side alar rim. It can be a prophylactic measure to prevent postoperative retraction in patients with weakened LLCs. Lower lateral cartilage repositioning, columellar strut, and nasal tip plasty are useful for correcting severe secondary unilateral CLND

show abstract

Section: Discussionmentioning

confidence: 51%

mentioning

confidence: 99%

Correction of Severe Secondary Cleft Lip Nasal Deformity

Cho

Park

Ryu

et al. 2021

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…The selection of the graft site usually depends on a preoperative evaluation of patient factors and the surgeon's expertise. In 2020, a photogrammetry study was done for the correction of 34 secondary unilateral cleft lip nasal deformity patients operated with open rhinoplasty technique and auricular cartilage graft (Cho et al, 2020). Columellar strut, nasal tip graft, and onlay graft were performed and after the mean follow-up of 17 months, nasal tip projection was increased with symmetrical ala and columellar area without complications.…”

Section: Discussionmentioning

confidence: 99%

“…The technique of suspension suturing and underlying framework support could improve the outcome of the corrected deformed nose (Çakır et al, 2014). More recently, cartilaginous structure is the issue of interest in rhinoplasty (Cho et al, 2020; Liu et al, 2020; Okawachi et al, 2020). Cartilage graft when augmented in nasal dorsum gives a natural feeling to the nose and is resistant to infection and resorption as opposed to bone graft (Tosun et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Analysis of Definitive Secondary Unilateral Cleft Rhinoplasty Using Cartilage Graft

Hantawornchaikit

Arayasantiparb

et al. 2021

The Cleft Palate-Craniofacial Journal

View full text Add to dashboard Cite

Objective Three-dimensional assessment of nasal morphology in patients with unilateral cleft lip nose treated by cartilage graft augmentation. Design Retrospective study. Patients and Intervention Thirteen patients with unilateral cleft lip nose underwent definitive secondary rhinoplasty and postsurgical changes were examined using a three-dimensional (3D) laser scan. Main Outcome Measure Nasal dorsum length, nasal tip, alar width, and alar base width in frontal view; nasion depth, nasal tip projection, nasal dorsal angle, and nasal tip angle in lateral view; nostril width, nostril height, and nasal tip height in basal view were measured at preoperative (T1: within 6 months), short follow-up (T2: 2-10 weeks), and long follow-up (T3: 9-14 months). Results A significant change in alar width, alar base width, nostril width, and nostril height at the cleft side, nasal dorsum length, nasion depth, nasal tip projection, and nasal tip height was observed from T1 to T3 follow-up after rhinoplasty ( P < .05), whereas the nostril height at the noncleft side was also significantly increased at T2 follow-up but the mean change in height relapsed at T3 follow-up. Alar width, alar base width, and nostril width at the noncleft side, and nasal tip angle did not change significantly after surgery at any follow-up period. Conclusions 3D imaging evaluation after secondary cleft rhinoplasty demonstrated improved functional and aesthetic outcomes using a septal or conchal graft.

show abstract

“…Especially in the case of nasal surgery for a secondary deformity of a cleft lip, the scar contracture of alar cartilage makes autologous costal cartilage almost the only choice. 2,3 But using autologous costal cartilage for the surgery also has drawbacks such as the deformation of the cartilage. Even if the cartilage of the back of the hand cannot be completely deformed by reverse suturing, it can be used to avoid the deformation of the rib and medulla.…”

mentioning

confidence: 99%

Autologous Costal Cartilage With Expanded Polytetrafluorethylene (ePTFE) Implants for the Treatment of Nasal Deformity After Unilateral Cleft Lip Repair

Wang²,

Song³

2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Objective: To repair and reconstruct the secondary nasal deformity after unilateral cleft lip repair, we used autologous costal cartilage and expanded polytetrafluorethylene (ePTFE) to get a better nasal shape. Method: Nineteen patients with nasal deformity after unilateral cleft lip repair were treated from July 2018 to July 2021. During the operation, autologous costal cartilage was carved and formed and then implanted into the nasal tip and nasal columella, while the back of the nose was raised with ePTFE. Result: Nineteen cases were followed up for 6 to 30 months. No transplanted cartilage and swelling were exposed or discharged. The appearance was good, and the patients were satisfied. Conclusion: Autologous costal cartilage combined with ePTFE is an ideal treatment for nasal deformity after cleft lip repair.

show abstract

Correction of secondary unilateral cleft lip nasal deformity in adults using lower lateral cartilage repositioning, columellar strut, and onlay cartilage graft on the nasal tip with open rhinoplasty combined with reverse-U incision

Cited by 12 publications

References 38 publications

Correction of Severe Secondary Cleft Lip Nasal Deformity

Correction of Severe Secondary Cleft Lip Nasal Deformity

Three-Dimensional Analysis of Definitive Secondary Unilateral Cleft Rhinoplasty Using Cartilage Graft

Autologous Costal Cartilage With Expanded Polytetrafluorethylene (ePTFE) Implants for the Treatment of Nasal Deformity After Unilateral Cleft Lip Repair

Contact Info

Product

Resources

About