Quantitative analysis of aesthetic outcomes of morphofunctional septorhinoplasty for secondary cleft lip nasal deformity.

The main aim of this study was to assess nasal symmetry after morphofunctional septorhinoplasty, more specifically, symmetry of the alar base and nostrils, and nasal projection, in patients with unilateral and bilateral cleft nasal deformities. Secondary cleft rhinoplasty was performed using morphofunctional septorhinoplasty techniques in 150 patients with unilateral and bilateral cleft lip and nose deformities. Nasal changes were analysed by measuring nasal tip projection, nostril height, nostril width, alar base width, and nasal gap area preoperatively and postoperatively on standard submentovertex view 2-dimensional photographs. In the unilateral cleft group there were statistically significant improvements (p<0.001) in ratios of nasal height and width (p=0.024) and nasal gap area, and in nasal tip projection and alar base width. In the bilateral cleft group there were statistically significant improvements in nasal gap area ratio (p=0.009), nasal tip projection, and alar base width. The morphofunctional septorhinoplasty technique improved aesthetic outcomes.

Comprehensive evaluation of postoperative morphological and functional satisfaction of secondary cleft lip rhinoplasty in Chinese Han population / 中华医学美学美容杂志

Objective:To evaluate the improvement of nasal appearance, symptoms and psychological burden in patients with secondary cleft rhinoplasty by using retrospective research methods, through preoperative and postoperative questionnaires.Methods:Twenty-three cleft lip patients that underwent surgery in our unit since April 2016 were enrolled in this study. The self-designed questionnaire was used to explore the changes of patients before and after the operation. The questionnaire star was utilized to collect the data, and after the data was sorted and summarized, SPSS 20.0 was used for analysis and statistics.Results:The average follow-up time was 28.9 months. The total score of ROE satisfaction before surgery was 46.74 points, while after surgery it reached 63.04 points ( t=4.10, P<0.01); the self-scores of nasal shape were significantly improved after surgery; but there was no significant change in the ventilation function in the VAS scale before and after the operation; the nasal symptoms and psychological status in the SNOT-22 questionnaire, such as, nasal congestion, embarrassment, depression, restlessness and irritability, were significantly improved ( P<0.05). Conclusions:Our semi-autonomous designed questionnaire can be used to effectively evaluate the satisfaction, nasal shape, and symptoms of patients with nasal deformity secondary to cleft lip. Data analysis shows that our secondary cleft lip rhinoplasty for cleft lip and palate can improve patients′ satisfaction after the repair, as well as nose shape and function, at the same time the psychological burden caused by it.

Clinical Practice Patterns and Evidence-Based Medicine in Secondary Cleft Rhinoplasty: A 14-Year Review of Maintenance of Certification Tracer Data From the American Board of Plastic Surgery.

OBJECTIVE: To evaluate evolving practice patterns in secondary cleft rhinoplasty. DESIGN: Retrospective review of data submitted during Maintenance of Certification (MOC). SETTING: Evaluation of MOC data from the American Board of Plastic Surgery. PARTICIPANTS: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. INTERVENTIONS: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. MAIN OUTCOME MEASURES: Practice patterns were compared to EBM trends during the study period. RESULTS: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experienced no complications, with the most common complications being asymmetry (10%) and vertical asymmetry of alar dome position (6%). Cartilage graft was used in 68% of cases, with 32% employing septal cartilage. Change in practice patterns between 2006 to 2012 and 2013 to 2020 demonstrated increase in dorsal nasal surgery (26% vs 43%, P = .034), use of osteotomies (14% vs 38%, P = .010), septal resection and/or straightening (26% vs 48%, P = .034), and turbinate reduction (8% vs 30%, P = .007). CONCLUSIONS: These tracer data provide long-term data by which to evaluate evolving practice patterns for secondary cleft rhinoplasty. When evaluated relative to EBM literature, future research to further improve outcomes can be better directed.