Septal Reposition During Intermediate Cleft Rhinoplasty: A Second Chance for Correcting Caudal Septal Deviation.

Abstract

We investigated postoperative nasal morphology changes in patients undergoing secondary correction of cleft lip nose with septal repositioning and alar cartilage suspension during preschool age. We performed a retrospective review on 77 patients who underwent secondary correction of cleft lip nose. The patients were aged 5‒6 years and underwent intermediate rhinoplasty by alar cartilage suspension, with or without septal repositioning. They were divided into two groups based on time: septal repositioning (Sep. 2015-Nov.2017) and control (Nov. 2009-Aug. 2015) groups. We performed a photogrammetric comparison by assessing the postoperative nasal morphology changes using linear and angular parameters. The cleft-to-non-cleft side ratio of each parameter was measured for the nostril width and height, nostril area, and caudal septal deviation angle. Among the 77 patients, 43 were selected as the septal repositioning group and 34 as the control. The evaluation timing was 5.32 ± 0.45-year-old for the preoperative period (T0), 6.57 ± 0.5-year-old for short-term (T1), and 9.28 ± 0.65-year-old for long-term follow-up (T2). The septal repositioning group showed significantly improved nostril width ratio and caudal septal deviation angle in the T1 and T2 periods. The septal repositioning significantly decreased the nostril area ratio in the T1 and T2 periods due to decreased cleft side and increased non-cleft side nostril area. The secondary correction of cleft lip nose with septal repositioning during preschool age offers a second chance to correct nasal appearance by balancing the nostril symmetry and correcting the caudal septal deviation.