Primary Cleft-Lip Rhinoplasty Using the Vestibular Z-Plasty Technique

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Surgery

Background:

• Congenital unilateral cleft lip often presents with associated nasal deformities.
• Primary rhinoplasty during cleft lip repair aims for optimal aesthetic and functional outcomes.
• Existing studies suggest primary rhinoplasty generally does not impede nasal growth.

Purpose of the Study:

• To evaluate the efficacy of the vestibular Z-plasty technique for primary nasal deformity repair in unilateral cleft lip patients.
• To assess the impact of this technique on nostril symmetry and nasal appearance.

Main Methods:

• A single surgeon performed vestibular Z-plasty on 12 consecutive unilateral cleft lip and palate patients with nasal deformities.
• The technique involves nasal vestibule lengthening via lateral Z-plasty to enhance nostril symmetry.
• Outcomes were assessed using anthropometric measurements with a minimum 1-year follow-up.

Main Results:

• Nostril symmetry was achieved in 75% (9/12) of cases at 1 year or longer follow-up.
• A significant revision rate (over 3mm asymmetry) was noted in 8.3% of patients.
• The vestibular Z-plasty technique demonstrated improvement in nostril appearance.

Conclusions:

• Vestibular Z-plasty is a viable surgical approach for improving nostril appearance in unilateral cleft lip nasal deformities.
• The technique shows potential for achieving good outcomes in primary cleft rhinoplasty.
• Longer follow-up periods and comparative studies are recommended to further validate efficacy.