Correction of Unilateral Secondary Cleft Lip Nose Deformity by a Modified Tajima’s Method and Several Adjunctive Procedures Based on Severity

Abstract

It is generally accepted that the developmental deficiency of the unilateral perinasal skeleton, cartilages, and skin originates from the secondary cleft nasal deformity. To date, numerous attempts have been made to correct these deformities, but no clinical data are available about the simpler, comprehensive, and patient-customized methods for correction of the secondary cleft nasal deformity. In the correction of Asian patients with secondary cleft nasal deformity, the clinical experience with the simplified Tajima method and several adjunctive procedures based on the severity of the disorder were retrospectively reviewed. During the period January 1982 to May 2009, 197 consecutive patients underwent repair through the modified Tajima method followed by several adjunctive procedures. These series had no recurrence requiring surgery except for cases in which the nasal ala was depressed to some extent. The mean degree of patient satisfaction as rated on the 5-point Global Aesthetic Improvement Scale (GAIA) was 3.88±0.59. Various types of surgical procedures were performed using the modified Tajima method depending on the degree of alar cartilage displacement. These procedures were effective in achieving symmetry of the nasal tip for patients with secondary unilateral cleft lip.