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The correction of alar-columella web deformities in unilateral cleft-lip nasal deformities with web graft technique
Ju Young Go1, Goo-Hyun Mun, Sa Ik Bang
1Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
Background:
Among the many secondary deformities in cleft-lip nose, the alar-columella web is unsightly and is a recurrent deformity. The purpose of this article is to revisit the correction of alar web deformity in patients with cleft-lip nasal deformities and to introduce our web graft technique.
Methods:
Thirteen patients with alar webbing underwent surgery between June 2012 and February 2013. The age range of the patients at the time of surgery was 14-29 years. An open rhinoplasty incision, including a reverse-U incision, was made and cartilage work was performed. After the cleft side was equalized with the dome angle of the healthy side, we used contralateral alar or auricular cartilage grafts as a stiff batten to stabilize the converted web skin. The web graft was fixed to the cleft-side web skin's inner side with at least three sutures to maintain the tucking of the vestibular skin. The follow-up period ranged from 1 to 20 months.
Results:
The postoperative frontal and basal views showed that the nostrils and columella had better shape. Most patients demonstrated correction of the drooping alar rim and satisfactory symmetry of the nostrils.
Conclusion:
A web graft supports the vestibular lining of the reverse-U incision and increases the strength of the new concavity of the tucked skin. We expect that a long-lasting concave web contour could be achieved with this technique.
