A novel cleft rhinoplasty procedure combining an open rhinoplasty with the Dibbell and Tajima techniques: a 10-year review.
BACKGROUND
The authors assessed the safety and efficacy of a novel cleft rhinoplasty procedure that combines an open rhinoplasty with the Dibbell and Tajima techniques.


METHODS
A single-surgeon, 10-year, retrospective review was conducted of all unilateral cleft lip rhinoplasties (n = 157). Nonsyndromic patients undergoing a combined open incision/Dibbell/Tajima procedure and who had follow-up of greater than 8 months were included. Thirty-five patients were identified. Standardized patient photographs were studied in 18 patients who had both preoperative and 1-year postoperative photographs. Farkas normal values were applied to the medial canthal distance; from this value, metric measurements of changes in alar base width, columellar height, and nostril apex height were derived.


RESULTS
There were no complications secondary to skin envelope ischemia or cartilage graft infection. The revision rate was 11 percent for alar base position, 3 percent for depressed lower lateral cartilage, and 3 percent for nostril apex overhang. After the procedure, there was a statistically significant decrease in alar base width (19.9 mm versus 18.2 mm; p < 0.01) and an increase in columellar height (8.37 mm versus 9.59 mm; p = 0.02) and nostril apex height (4.70 mm versus 5.44 mm; p = 0.02) on the affected side. The differences in alar base width, columellar height, and nostril apex height between the affected and nonaffected sides all decreased significantly postoperatively.


CONCLUSIONS
The combined open rhinoplasty/Dibbell/Tajima procedure is safe, has a low revision rate, and is associated with a statistically significant decrease in alar base width, an increase in columellar height and nostril apex height, and a greater symmetry of nasal form.
Flores
Roberto L
RL
Indianapolis, Ind.; and New York, N.Y. From the Division of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center, and the Institute of Reconstructive Plastic Surgery, New York University Medical Center.
Sailon
Alexander M
AM
Cutting
Court B
CB
D000293:Adolescent; D000328:Adult; D002971:Cleft Lip / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery*; D009666:Nose / Q000002:abnormalities / Q000601:surgery*; D015588:Observer Variation; D010781:Photography; D011336:Probability; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult