Septal Integration Graft, a Modified Direct Type of Septal Extension Graft for the Treatment of Unilateral Cleft Lip Nose Deformity

Abstract

Background The purpose of this study was to evaluate the cosmetic outcomes and stability of septal integration grafts (SIGs), a modified direct type of septal extension graft, in patients with cleft lip nose deformity. Methods Seventy-three patients underwent SIGs between January 2002 and July 2017. The exclusion criteria were patients who lacked clinical photographs preoperatively or postoperatively. We reviewed data regarding the patient demographics, combined procedures, and complications as well as preoperative and postoperative clinical photography. Eleven measurement items were evaluated from basal and right lateral views with photogrammetry and 3-dimensional anthropometry using standardized clinical photographic techniques. Results Sixty-one patients were analyzed in this study. Twelve patients were excluded owing to a lack of postoperative photographs. The mean ± SD follow-up period was 26.70 ± 29.43 months (range, 6–134 months). Compared with the preoperative value, the nasal tip projection index, height of nose index, and nostril axis inclination significantly improved. The columellar length (Rt-Lt) index significantly decreased, which implied improved columellar deviation. Complications included hematoma (n = 1), wound dehiscence (n = 1), tearing of septal mucosa (n = 3), and silicone implant deviation (n = 2). Conclusions We used SIGs to correct nasal deformity in patients with cleft lip nose deformity. The SIG can minimize the amount of the graft used for septal extension and can effectively correct nasal tip and columella deformities.

Long-term facial changes and clinical correlations in patients with treated acromegaly: a cohort study

“…Although patient faces improved at the millimetre level in the current study, it had great aesthetic significance. The nose width (al-al) of patients with complete remission decreased by an average of 3.46 mm (2.30 to 4.62), while the nasofrontal angle increased by an average of 3.23° (1.35 to 5.11), which is a considerable improvement even for rhinoplasty (26). In facial morphology, there are significant differences between male and female faces, but the range of the difference is also within a few millimetres.…”

Three-Dimensional Evaluation of Deformed Noses in Patients With Unilateral Cleft Lip and Palate: A Meta-Analysis

“…Therefore, objective nasal morphology studies are essential for both pre- and post-operative assessments. Not surprisingly, the number of these studies is considerable and can be divided into 3 main categories: (1) studies evaluating the long-term effects of previous surgeries or interventions on the nasal morphology 11,19,23,24 ; (2) studies evaluating changes in the nasal morphology before and after certain corrective nasal surgeries 9,25 ; and (3) cross-sectional studies evaluating the characteristics of nasal deformities 8,12,14,26,27 . However, as a birth abnormality, CLP is uncommon, and several previous studies did not have large sample sizes and were therefore not representative for guiding clinical practice.…”

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

“…Severe nasal deformity even hinders the patients’ respiratory and pronunciation function. In recent years, rhinoplasty after cleft lip surgery in East Asian people has gradually developed, from simple prosthesis rhinoplasty before 10 years ago to now rib nose comprehensive plastic surgery, which helps to keep the nose shape more straight 1…”

“…In recent years, rhinoplasty after cleft lip surgery in East Asian people has gradually developed, from simple prosthesis rhinoplasty before 10 years ago to now rib nose comprehensive plastic surgery, which helps to keep the nose shape more straight. 1 Among them, autologous costal cartilage stands out for its sufficiency and strong support, offering various fine adjustments to the nasal tip support in accordance with the needs and resisting skin contraction effectively in the long term. Moreover, because the nasal cartilage of East Asians is generally weak and the nasal septal cartilage is short, the nose tip shaping of autologous costal cartilage came into being.…”