Comparison of two different secondary rhinoplasties in patients with complete unilateral cleft lip and palate

The purpose of this study was to analysis the nostril symmetry and nasal stability following secondary rhinoplasty performed with either nasal septal cartilage implantation (G1) or simple alar cartilage suspension and internal fixation (G2) in patients with unilateral secondary cleft nasal deformity.

Nostril and alar symmetry were analyzed retrospectively in 13 consecutive patients in G1 and 17 in G2. Assessment of three indexes was first performed using photogrammetric measurements of photographs at pre-operation(T1), 7 days after repair (T2), and at least 6 months after repair (T3). The ratio of the cleft side to the noncleft side for nostril width, nostril height and alar height were used to assess symmetry. Changes in the mean ratios of the cleft side to the noncleft side at three different time points for three parameters were used to assess stability.

In both groups, the alar height was improved after operation and remained stable in the follow-up period. The nostril width significantly decreased in G1 and G2, remaining consistent in the follow-up for G1 but increasing in G2. The nostril height significantly increased in G1 and stabilized during the follow-up, while it decreased after operation and remained so throughout the follow-up for G2.

Both techniques can maintain stability more than six months after surgery, except for the nostril width with simple alar cartilage suspension and internal fixation technique. The nasal septal cartilage implantation technique may have advantages in improving the nasal symmetry of the nostril width and height.