Correction of unilateral cleft lip nasal deformity using the sliding sulcus procedure

The nose can be conceptualized as a soft-tissue structure, the orientation of which depends externally on its osseous foundation and internally on the shape and position of its cartilaginous struts. If the soft-tissue envelope of the cleft nose can be given volumetric symmetry, if it can be positioned correctly in space, and if physical forces imposed on it by cleft pathology (i.e., abnormal muscle insertion), then the internal rearrangement or augmentation of the cartilaginous components can await definitive operation later in childhood. The sliding sulcus operation is a subperiosteal procedure designed to address the problems of division, deficiency, displacement, and distortion, taking advantage of its unique ability to mobilize tissues from the maxilla. Surgical techniques are presented with clinical examples.