Correction of Nasal Deformity in School Children Using Ear Cartilage for Bilateral Cleft Nasal Correction: an Alternative Method

Abstract

Marked nasal deformities, in particular a flattened nasal apex with wide nostrils and a short columella, may develop with facial growth after primary cheiloplasty in patients with cleft lip and palate. This study used auricular cartilage as an augmentation material for the nasal apex to improve the shape of the nose with good results. From July 2002 to August 2006, this technique was used for cheilorhinoplasty for 10 school children (mean age, 7 years 4 months); 8 patients had bilateral cleft lip and palate and 2 had bilateral cleft lip alone. Dissection was performed only at the nasal apex to create a space for cartilage grafting. Auricular cartilage obtained from the ear concha was used as an augmentation material. In all patients, the nasal apex was elevated and the nose was elongated. The shape of the overcorrected nasal apex became natural about 6 months after surgery. Good structural characteristics were maintained, as the nose shape was improved before the growth period in children, and recurrence of deformity of the nasal apex has not been noticed at the last follow-up (mean, 31 months). This technique for the correction of nasal tip deformity using ear cartilage as an augmentation material while minimising dissection prevented the development of a bulbous nose in patients with bilateral cleft lip and palate. It has been confirmed to be useful for cheilorhinoplasty in school children.