Evaluation of primary cleft nose repair: severity of the cleft versus final position of the nose.
BACKGROUND
Since 1957, when the concept of rotation-advancement repair was introduced by Millard, this technique has become the procedure of choice for unilateral cleft lip worldwide. More recently, modifications described by Noordhoof, Mohler, Skoog, and McComb started being jointly performed so that better results could be obtained. In this study, the nasal position was evaluated and related to the size of the cleft. The primary unilateral cleft lip repair was performed through a modified technique.


METHODS
Forty-five patients with unilateral cleft lip underwent primary surgical repair through this technique. To analyze aesthetic results, a severity classification of deformities and a scoring system for evaluation of the results were established based on nasal alar lateralization, dome position, alignment of bone segments, and deviation of the columella.


RESULTS
By means of the established system, 26.6% of mild forms, 13.4% of moderate forms, and 60% of severe forms were observed. Among aesthetic results, 17.8% were found to be good, and 82.2% were considered excellent. Among aspects considered negative, late deformity of the lower lateral cartilage prevailed.


CONCLUSIONS
Through the presented evaluation, the authors observed that there was no relation between severity of the cleft and final position of the nose. Among the 27 patients considered to have had severe forms of cleft deformity, 22 were classified as excellent results (81.5%). To obtain better results along time, technical refinements and the critical analysis of results must be performed on a routinely basis.
Tanikawa
Daniela Yukie Sakai
DY
Craniofacial Surgery Unit, Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
Alonso
Nivaldo
N
Rocha
Diógenes Laércio
DL
D002971:Cleft Lip / Q000145:classification / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009666:Nose / Q000002:abnormalities* / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome