Rhinoplasty in adolescent cleft patients

Abstract

It is universally accepted that correction of cleft lip nose deformity remains a formidable challenge. Despite early correction of cleft lip nose deformity, one is often faced with an adolescent patient who has an acceptable upper lip but has a deformed nose. Usually, these patients come from underdeveloped countries to the United States for correction of nasal deformities. The nose forms a prominent part of the face. Ironically, a masterly executed cleft lip repair directs the beholders’ eyes from the deformed lip to the deformed nose. Real progress has been made in the treatment of cleft lip and palate in the last four decades. Preoperative dental orthopedics and appliances have progressed to produce a near normal maxillary dental arch. In the bilateral cleft lip and palate, positioning of a protruding premaxilla in the dental arch results in superior cleft lip repair. Many techniques have been designed to correct cleft nose deformity; however, the technical improvements in cleft nose repair have lagged behind the progress in cleft lip and palate repair. More and more cleft surgeons are beginning the correction of cleft nose at the time of cleft lip repair; however, several of the patients still require correction of cleft lip nose deformity later in life.