Correction of Cleft Lip Nasal Deformity in Secondary Unilateral Cleft Lip Tip-Plasty

ABSTRACT

Many operative techniques for the repair of cleft lip nasal deformities have been reported. However, the situation with regard to nasal deformity is less satisfactorily understood than lip deformity, in which we have experienced significant improvement led by enhanced understanding of the total anatomic deformity of the primary cleft lip and the consequent refinement of surgical techniques. Our purposes in tip plasty are the restoration of nasal tip symmetry and correction of the obtuse angle of the cleft side nostril. Additionally, an inconspicuous scar is one of the merits of our method. The alar cartilage war exposed through both the alar rim and transcolumella incision, and then interalar loose connective tissue based superiorly was dissected and elevated. Cleft side alar cartilage was cross-hatched(Lipsett technique) on the deformed dome and relocated superomedially by a 4-0 vicryl fixation suture. The elevated intera1ar loose areolar tissue was used for augmentation of the alar dome. Conchal cartilage graft on cleft side dome and septoplasty were carried out in cases of specific necessity. We have performed this procedure in 19 patients, aged between 15 to 19. Average follow-up period was one year. Results have been rated good to excellent by patients and surgeons. There has been no recurrence of this deformity.