Nasal Morphological Changes after Facial Maturation in Patients with Unilateral Cleft Lip Following Primary...

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Plastic Surgery

Background:

• The Tajima overcorrection technique is a standard for primary rhinoplasty.
• A recurring minor, stable asymmetry is observed in patients treated around age 1.
• Longitudinal analysis is needed to understand long-term nasal morphology after this procedure.

Purpose of the Study:

• To longitudinally analyze the outcomes of primary overcorrected rhinoplasty.
• To investigate the long-term trajectory of nasal morphology in patients with unilateral cleft lip.
• To provide insights into the stability and improvement of nasal asymmetry post-surgery.

Main Methods:

• Retrospective study of 146 patients with nonsyndromic unilateral cleft lip.
• Patients underwent cheiloplasty with primary Tajima overcorrected rhinoplasty.
• Longitudinal analysis of nostril morphology using digital photographs at ages 1, 5, 10, 15, and 18 years.
• Symmetry assessed via anthropometric measurements (nostril height, base height, width, nasal width, columella angle).

Main Results:

• Nostril asymmetry improved over time in both complete and incomplete unilateral cleft lip patients.
• Nostril height, nostril width, nasal width, and columella angle showed significant variation with time (P < 0.01).
• Nostril base height remained stable throughout the observation period.

Conclusions:

• Adequate cleft-side nasal height is critical during primary rhinoplasty.
• The findings offer guidance for surgeons on optimal timing for secondary rhinoplasty.
• This is particularly relevant for cases with suboptimal primary outcomes.