Cosmetic and functional survey-based study of unilateral cleft lip nasal deformities

Unilateral cleft lip (UCL) presents some of the most challenging cosmetic and functional nasal deformities. A survey-based study of 231 UCL patients was conducted to evaluate nasal deformities and their impact on cosmetic and functional outcomes. The patients were classified into three groups according to the cleft lip type: occult, incomplete, and complete cleft lip. Nasal morphology and function were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale, Rhinoplasty Outcome Evaluation (ROE) questionnaire, and visual analogue scales (VAS) for nasal obstruction and olfactory function. Compared to the complete cleft lip patients, those with occult and incomplete cleft lip reported significantly less nasal obstruction (VAS: both P < 0.001; NOSE: both P < 0.001; ROE nasal breathing satisfaction: P = 0.002 and P < 0.001) and better olfactory function (VAS: both P < 0.001). There were no significant differences in scores for ROE appearance-related items among the groups. Nasal function is related to the severity of the cleft lip, with poorer functional outcomes in complete cleft lips than in incomplete or occult cleft lips. These results highlight the importance of objective nasal functional assessment in all UCL patients and support the need for individualized treatment strategies based on cleft severity.