Related Experiment Video
Updated: Aug 20, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
A Systematic Review of Primary Rhinoplasty in Patients With Bilateral Cleft Lip
Bianca Di Chiaro1, Gaia Santiago2, Chiara Santiago2
1Division of Plastic & Reconstructive Surgery, Loyola University Medical Center.
Insights
Primary rhinoplasty (PR) during bilateral cleft lip repair is supported by current literature. This approach shows positive outcomes, normal nasal growth, and reduces the need for future surgeries.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- The timing of primary rhinoplasty (PR) during cleft lip repair remains debated.
- Previous systematic reviews supported PR in unilateral cleft lip repair.
- This review investigates the efficacy of PR in bilateral cleft lip repair.
Approach:
- A systematic review was performed following PRISMA guidelines.
- Searched PubMed and Embase for studies on PR during bilateral cleft lip repair.
- Included 12 studies evaluating nasal outcomes, excluding syndromic cases and non-original research.
Key Points:
- Nine of 12 studies supported PR at the time of bilateral cleft lip repair.
- Eight studies found no nasal growth restriction following PR.
- Four studies showed 77% of 158 patients avoided secondary rhinoplasty.
Conclusions:
- Available literature supports PR in bilateral cleft lip repair for subjective and objective outcomes.
- PR does not appear to restrict nasal growth and reduces revision rates.
- Further large-scale studies are needed to confirm these findings.
Background:
Primary rhinoplasty (PR)at the time of cleft lip repair is controversial. We previously performed a systematic review that supported PR during unilateral cleft lip repair. We now aim to determine whether the same idea translates to care of patients with bilateral cleft lip.
Methods:
A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. PubMed and Embase databases were searched for studies that met our inclusion criteria: (1) English language, (2) human subjects, (3) rhinoplasty at the time of bilateral cleft lip repair, and (4) evaluation of nasal outcome. Studies were excluded in case of: (1) inclusion of a large proportion of syndromic patients, (2) case reports, (3) editorials, (4) letters, (5) reviews, and (6) exclusive to unilateral clefts. Out of 281 studies that showed up on initial search, 12 were included in our review. Research quality and level of evidence rating were determined for each study.
Results:
Of the 12 included studies, 9 supported PR at the time of bilateral cleft lip repair; 8 studies evaluated nasal growth and found no restriction over time; 4 studies followed 158 patients to an average of 15 years and showed 77% did not need secondary rhinoplasty.
Conclusion:
Although the available literature supports PR in patients with bilateral cleft lip with respect to subjective and objective outcomes, nasal growth, and reducing the need for secondary/revision rhinoplasty, there are significant limitations, necessitating large volume studies.
