title: Evaluation of primary cleft nose repair: severity of the cleft versus final position of the nose.
abstract: 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.
authors.affiliation: Craniofacial Surgery Unit, Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Daniela Yukie Sakai
authors.initials: DY
authors.lastname: Tanikawa
authors.forename: Nivaldo
authors.initials: N
authors.lastname: Alonso
authors.forename: Diógenes Laércio
authors.initials: DL
authors.lastname: Rocha
mesh_terms: 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