xRead - Treatment of Cleft Lip and Cleft Palate (May 2025)

adequate repositioning of

cartilage and improved tip symmetry

Surgical technique described is largely successful in achieving

overall symmetry of the upper lip and nostril regions

Most symmetry scores improved with surgery. Problem area was nostril axis inclination

gives long-term symmetric alar

and nostril height compared to non-overcorrected noses

Study validates the rationale for overcorrection of nasal configuration during primary repair

Cleft severity is an important factor contributing to

aesthetics results; the greater the severity, the worse the results

Adolescent growth spurt did not alter overall nasal symmetry and growth is unaffected

Rhinoplasty with primary cleft lip repair helps to promote more symmetrical and natural nasal

growth and better appearance at an early age

Period Details of Procedure Assessment Technique Outcome Conclusion to 2 years Goteborg/McComb rhinoplasty Photographic evaluation by 5 plastic surgeons stitches

Early results demonstrate

Primary nasal overcorrection

All exhibited adequate cartilage repositioning and improvement in nasal symmetry. Also slight overcorrection of the defect

with normal values more on cleft side, but also on unaffected side healthy and corrected sides (less than 10%)

terms of nostril and ala height Nostril asymmetry could almost be eliminated. Nostril axis inclination-flatter compared

Overcorrection with Tajima incision showed statistically significant better results in

deformity at 9-month follow-up

Aesthetic results of all cases were optimal or satisfactory

rhinoplasty and normal children No recurrence of drooping of nostril rims. Nasal tips

reasonably symmetrical. No nostril flare

More symmetry of nostril and nasal dome projection than without rhinoplasty. No significant

difference in anthropometric measurements between children with primary

Minimal difference between

Significant relapse in nasal

anthropometric—nasal tip

projection, columellar length, nasal width

Reviewed to assess nasal symmetry and overall aesthetics Photography and

Measurements with digital caliper. Assessment of 5 anatomical parameters—one for nose (nose sill width)

Indirect 2-D photogrammetry—5 parameters for nose.

Comparison between cleft and noncleft side and also normal population

Photo evaluation of 6 parameters for the nose

anthropometric measurements of 2 components—nostril

height and nostril floor width

Photographs and computer-based measurement analysis—4 parameters

Intraoperative direct

rhinoplasty (undermining skin from lower lateral. cartilage þ Tajima sutures)

Alar rim incision on cleft side, dissection and Tajima suture. Septoplasty done

technique with primary cleft side

– 79 8months 4 years Primary rhinoplasty with Tennison-Randall (no description on rhinoplasty)

overcorrection with

Tajima incision on cleft side

from rim to nasion.

Sutures to lift alar cartilage

Hadassah University Medical Center, Israel 2003-2008 23 3months 1 year Kernahan and Bauer

Kim et al. (2004) Dong-a University Hospital, Korea 1992-2001 217 3months 78months average

Follow-Up

1975-1993 10 18 years Undermining of nasal skin

3months 9 months Tajima incision, transalar

13 6.6 months 9 months Tajima with rim incision on

AgeDuring

Intervention

26 3-12 months 6 months

cleft)

38 (all complete) 3-4 months 12 months Closed dissection versus

Number of Patients

July 2008 to October 2013

Table 3. Closed Rhinoplasty Case Series. Study Study Location Study Period Spencer and Buzzo (2017) Professor Heriberto Bezerra Pediatric Hospital, Brazil

2009-2013 29 (all complete

University of Pittsburgh Medical Center and Children’s Mercy

Hospital, Kansas City

Tuebingen,

Germany

Hospital, Taiwan

Hospital and United Christian Hospital, Kowloon, Hong Kong

Princess Margaret Hospital for

Children, Perth

Rottgers and Jiang (2010)

Margulis et al. (2014)

Coghlan (1996)

Kluba et al. (2015) University Hospital

Lonic et al. (2016) Chang Gung Memorial

Tang et al. (2016) Queen Elizabeth

McComb and

79

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