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The nasal base in cleft lip rhinoplasty
Gerhard Rettinger1, Michael O'Connell
1University Clinic for Otorhinolaryngology, Ulm, Germany. gerhard.rettinger@medizin.uni-ulm.de
Facial Plastic Surgery : FPS
|August 2, 2002
Summary
Correcting the nasal base in cleft lip (CL) rhinoplasty requires addressing the nasal vestibule. An external approach with cartilage grafting yielded more stable results for symmetry and breathing.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Craniofacial Surgery
Background:
- Cleft lip (CL) rhinoplasty often focuses on ala repositioning, neglecting the nasal vestibule.
- Inner lining deficiency of the nasal vestibule is a common issue in unilateral CL noses.
Purpose of the Study:
- To compare the outcomes of two distinct surgical techniques for correcting the nasal base in unilateral cleft lip rhinoplasty.
- To evaluate the impact of addressing nasal vestibule lining deficiency on surgical results.
Main Methods:
- Forty-two patients underwent an endonasal approach with lateral crus mobilization and repositioning.
- Twelve patients had an external approach with lateral crus reconstruction using a chondrocutaneous flap and ear composite grafts for vestibule lining.
Main Results:
- The external approach group demonstrated more stable results regarding nasal symmetry.
- The external approach group showed improved breathing outcomes compared to the endonasal group.
- Addressing the lateral vestibule wall defect with grafts proved effective.
Conclusions:
- Unilateral CL noses often present with both ala deformities and nasal vestibule lining deficiency.
- An external approach incorporating vestibule reconstruction may offer superior long-term stability and functional improvement in CL rhinoplasty.