title: Secondary rhinoplasty in the bilateral cleft.
abstract: Secondary rhinoplasty in bilateral clefts is very complex due to its specific pathological anatomical characteristics. In this article, the general and specific characteristics of the nose of the bilateral clefts are described and careful preoperative assessment is emphasized. We discuss the timing of the operation considering growth inhibition and psychological aspects and a systematic rational surgical approach, dividing the operative procedure into: septal surgery, tip surgery, osseocartilaginous vault surgery, maxillary augmentation, and alar base reallocation. We report results of a retrospective study to evaluate the postoperative care with a custom-made vestibulum device to prevent stenosis of the vestibulum caused by scar tissue retraction in the postoperative period.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, The Netherlands.
authors.forename: Gilbert J
authors.initials: GJ
authors.lastname: Nolst Trenité
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002675:Child, Preschool; D002921:Cicatrix / Q000150:complications / Q000209:etiology; D002971:Cleft Lip / Q000150:complications*; D006801:Humans; D008437:Maxilla / Q000601:surgery; D015508:Nasal Obstruction / Q000209:etiology / Q000517:prevention & control; D009666:Nose / Q000002:abnormalities* / Q000254:growth & development / Q000473:pathology / Q000601:surgery; D011182:Postoperative Care; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D015607:Stents