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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