Evaluation of primary correction of unilateral cleft lip nasal deformity with open or closed rhinoplasty

Abstract

Nasal deformities in cleft lip patients are caused by displacement of alar cartilage, abnormal positioning of the columella, nasal septum and lower skeleton of the nose. Previously, primary correction of nasal deformity in cleft lip was thought to cause developmental impairment of the nose. Hence, late correction was preferred. However, late rhinoplasty is more difficult and less successful in these patients. Hence, simultaneous correction of the nose is probably desirable and widely accepted now. This paper presents postoperative results of primary nasal correction in unilateral cleft lip patients treated at our centre with open or closed rhinoplasty technique (60 patients). We used Millard's rotation advancement for all patients. Either closed or open rhinoplasty was used for nasal correction. Photographic evaluations in frontal, lateral and basal views were carried out preoperatively, and postoperatively at 1st week, 3rd month and 6th month. The nasal correction achieved by closed methods is as good as by open technique. However, a larger study with a longer follow-up is probably required to comment on the superiority of one method over the other. It can be concluded that satisfactory results can be achieved by primary correction of the nose in these patients.