An anatomical composite nasal lining subunit technique in primary cleft nose correction

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Otorhinolaryngology

Background:

• Current primary cleft nose correction techniques often result in long-term alar collapse.
• The nasal lining on the cleft side is frequently distorted and deficient, complicating surgical outcomes.

Observation:

• Nasal endoscopy revealed a triple structural overlap in the vestibular nasal subunit (lateral crus, valve, and vestibule).
• A two-dimensional topography of the anterior nasal airway lining was mapped in normal and unilateral cleft lip patients.

Findings:

• A novel nasal lining subunit-based surgical strategy was developed, utilizing a topographical map.
• The technique involves releasing lateral crural tethering and repositioning the cartilage/lining complex, with defects resurfaced by grafts.
• This approach achieved complete and stable nasal correction in a unilateral cleft lip patient at 1-year follow-up.

Implications:

• This subunit-based strategy offers a comprehensive solution for unilateral cleft nasal deformities.
• The proposed topographical map provides a foundation for refining surgical techniques and improving patient outcomes.
• The method demonstrates potential for stable, long-term correction, addressing a significant limitation of current approaches.