Comprehensive rhinoplasty technique to correct the bilateral cleft lip nasal deformity using conchal composite grafts.
BACKGROUND
Anatomical abnormalities and heterogeneous tissue deficiencies of the bilateral cleft lip nasal deformity challenges the cranio-maxillofacial plastic surgeon to create a functional, yet aesthetically pleasing nose. The authors propose a comprehensive rhinoplasty technique to correct the bilateral cleft lip nasal deformity using composite conchal grafts.


METHODS
Five children with bilateral cleft lip nasal deformities had nasal reconstruction using conchal composite grafts, averaging 5 years in age at time of surgery. Patient follow-up averaged 21 months.


METHODS
An open tip rhinoplasty was performed using a 'V' shaped columellar incision. The conchal composite graft was obtained from the lateral aspect of the ear and was used to reconstruct the lateral alar mucosal defects. Conchal cartilage was used as a columellar strut. The columellar skin was closed in a 'V-Y' fashion, giving greater columellar length.


RESULTS
Visual inspection confirmed that the cleft lip nasal deformity was improved in all patients. There were no postoperative complications. All patients had complete composite graft take with minimal donor site morbidity and deformity.


CONCLUSIONS
This comprehensive rhinoplasty technique improves the abnormalities found in bilateral cleft lip nasal deformity by using the successful aspects of other methods and introducing the composite conchal graft.
Division of Plastic and Reconstructive Surgery, Oregon Health & Sciences University, Portland, OR, USA. ozakiw@scoms.com
Wayne
W
Ozaki
Richard A K
RA
Chaffoo
Kim-Chi
KC
Vu
Bernard L
BL
Markowitz
D002356:Cartilage / Q000637:transplantation; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications*; D004431:Ear, External / Q000637:transplantation*; D006801:Humans; D009666:Nose / Q000002:abnormalities*; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods