Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare the postoperative outcome of the new and classical muscular reconstruction technique combined with nasal internal-fixation method for secondary deformity post unilateral cleft lip repair. A rationale is provided for the further surgical improvement of secondary deformities.@*METHODS@#Sixty patients aged 4-18 years with secondary unilateral cleft lip-nose deformity were involved in this research. The deformities of 28 patients were repaired using the muscular force balance technique through nasal internal fixation method, and 32 were repaired using classical muscular reconstruction technique. Two-dimensional analysis was used to evaluate the nose-lip morphology of pre- and post-operative patients through standardized photographs seven days after surgery.@*RESULTS@#Compared with preoperative nasal morphology in the muscular force balance technique group, the 7-days postoperative results of this group showed the significantly improved short-term outcomes in the correction of columellar deflection, alar rim angle, nasal shape, and the symmetry of alar base width, nostril width, nostril height, alar rim angle (@*CONCLUSIONS@#The new muscular reconstruction technique with nasal internal-fixation method has a significant effect on nasal repair.

Preoperative Nasal Molding and Unilateral Cleft Lip Repair By Mohler'S Technique

Various techniques of unilateral cleft lip repair are being developed. Nowadays, rotation-advancement flap technique is most widely used for the repair of unilateral cleft lip. This procedure places a premium on the conservation of tissue and preservation of natural landmarks. Millard's technique however occasionally can produce a scar that crosses the philtrum obliquely in the upper third of the philtral unit. In Mohler's technique, the marking of the medial segment has been altered in uppermost portion by utilizing tissue from the columellar base. That is to say, cutback on columellar tissue is utilized at approximately 90 degrees. After full-thickness release of the medial lip segment, the C flap is advanced into donor defect of the columellar base and is also used to lengthen the shortened columella. This results in the placement of a scar that will simulate the mirror image of the non-involved phitral column. And another advantage of this technique is the possibility of primary nasal correction including wide dissection of alar cartilage through cutback incision on columellar base without need of additional incision for nasal dissection. In addition, preoperative nasal molding was performed with a special NAM(nasoalveolar molding) appliance by orthodontist during preoperative period. The authors performed 27 cases of the correction of the unilateral cleft lip using this technique between July 2000 and December 2001. All the patients showed satisfactory results by achieving enough rotation of medial lip segment without scar that crosses the philtral column and satisfactory correction of primary nasal deformity.