The microsurgical approach in primary cleft rhinoplasty - an anthropometric analysis

Publication date: Available online 27 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Frizzi Bschorer, Daniel Schneider, Gerhard Schön, Max Heiland, Reinhard Bschorer
PurposeOral and maxillofacial surgeons use a variety of approaches to repair the nasal deformity of cleft lip patients, differing in both technique and timing. The aim of this longitudinal study was to analyze a new surgical technique to treat the nose deformity of cleft patients at four to six weeks of life using a microscope.Methods27 newborn cleft patients were treated by means of a primary repair of the nasal deformity using a microscope at four to six weeks of life. The procedure includes a columellar incision, alar cartilage plication sutures according to Daniel's and transcolumellar sutures. All patients were photographed at specific time points up to one year after the surgery. Established angles and distances were analyzed and compared to normal values of age-matched children by Farkas.1ResultsAll parameters improved through surgery and showed stable values at follow-up assessments. Almost ideal values concerning symmetry, as indicated by columellar deviation and nostril comparison, were obtained. Measurements of nasal morphology were similar to established norm values.ConclusionWe recommend the early treatment of the cleft nasal deformity involving microscopic surgery as it showed stable and symmetrical results at least up to one year after surgery. Clinical observations up to adolescence suggest no growth disturbance or deterioration of nasal shape.



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