Cleft Lip Rhinoplasty - A Review

Abstract

Cleft lip nasal deformity presents an extreme challenge to the facial plastic surgeon. The deformity is complex and involves all tissue layers, including skeletal platform, inner lining, osseocartilaginous structure, and overlying skin. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. Secondary repair of the cleft lip nasal defect requires an understanding of the pathological nasal anatomy associated with congenital clefting. The basic cleft nasal deformity is characteristic and defendant upon the original extent of clefting of the lip. However, the secondary nasal defect varies greatly and is a result of: 1) the original malformation, 2) any interim surgery performed, and 3) growth of the nose and face. The cleft surgeon must therefore have a treatment philosophy and technique flexible enough to reconstruct a variable range of associated nasal problems. By reviewing the literature, this article described and summerised the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity.