[Nostril retainers in the primary cleft rhinoplasty].
BACKGROUND
The nasal cleft cartilage tends to depression after primary rhinoplasty. Nasal stents are probe to be useful in the management of these patients in order to maintain the new morphology.


OBJECTIVE
The purpose of this paper is to present our experience with the use of postoperative nasal splinting in the management of cleft lip nasal deformity.


METHODS
A nostril retainer was placed in 18 cleft patients (4 bilateral, 14 unilateral) during primary repair of the cleft lip nasal deformity from 2001 to 2004. The nasal morphology in the postoperative period was compared with that of 10 control patients who were operated on without nasal stenting in a previous period. Nostril retainers were left in place after the rhinoplasty using 4/0 poliglecaprone absorbable. Those sutures fixed the stent in place during three weeks after surgery. Results. Average follow-up was 18.5 months. Retention of the splint was 3.5 months mean time (range 4 weeks to 6 months). The methods employed for retention were multiple based upon parental preferences. Photogrammetric analysis showed relevant asymmetry of the nostrils in 10% of the splinted group as compared with 48% for controls (p<0.001).


CONCLUSIONS
The use of nasal stents has been found effective postoperatively after cleft primary rhinoplasty, avoiding relapse of the nasal reconstruction and drop of the nasal ala. Retainers also allows airway patent and avoid surgical adhesions due to nasal secretions and scarring. Parental collaboration is needed.
Méndezl
R
R
Servicio de Cirugía Pediátrica, 2 Hospital Materno Infantil Teresa Herrera, Complejo Hospitalario Universitario Juan Canalejo, A Coruña. roberto.mendez.gallart@sergas.es
López-Cedrún
J L
JL
Tellado
M G
MG
Somoza
I
I
Liras
J
J
Sánchez-Abuín
A
A
Pais
E
E
Vela
D
D
D000015:Abnormalities, Multiple / Q000601:surgery*; D002971:Cleft Lip / Q000601:surgery*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D009666:Nose / Q000002:abnormalities* / Q000601:surgery*; D012225:Rhinoplasty / Q000295:instrumentation; D015607:Stents