Correction of cleft lip nasal deformities with l-shaped iliac bone graft

ABSTRACT

Patients with a cleft lip nasal deformities hope for a pleasing nasal profile, a well-defined angular nasal tip, and symmetry of the nose. The main objective of the orrection of cleft lip nasal deformity is to achieve nasal symmetry and an improved nasolabial relationship. The present study was carried out to assess the effect and prognosis of correction of cleft lip nasal deformity with L-shaped iliac bone graft. We performed correction surgery of the severe cleft lip nasal deformity with the autogenous L-shaped iliac bone graft in five patients and described the technique of correction. The columella portion of the L-shaped graft provided stabilization, eliminating the see-saw effect of the bridge on the bony fulcrum of the bony bridge. The disadvantage of this technique was stiffening of the nasal tip, which included the distal end of the grafted bone. However, the nasal tip gradually becomes softer, probably due to resorption of the bony edge several months after the operation. We obtained stable and symmetric reconstruction of the supporting elements of the nose. These results suggest that L-shaped iliac bone graft is stable and esthetic reconstruction method for correction of the severe cleft lip nasal deformity.