Long-term comparison of four techniques for obtaining nasal symmetry in unilateral complete cleft lip patients: a single surgeon's experience.
BACKGROUND
This study was the result of a constant evaluation of surgical techniques and results to obtain excellence in primary cleft rhinoplasty.


METHODS
This was a retrospective study from 1992 to 2003 comparing the long-term outcomes of four techniques of nasal reconstruction. There were 76 patients divided into four groups: group I (n = 23 patients), primary rhinoplasty alone; group II (n = 16 patients), nasoalveolar molding alone; group III (n = 14 patients), nasoalveolar molding plus primary rhinoplasty; and group IV (n = 23 patients), nasoalveolar molding plus primary rhinoplasty plus overcorrection. The surgical results were analyzed using photographic records obtained at 5 years of age. A ratio of six measurements was obtained comparing the cleft and noncleft sides. A panel assessment was obtained to grade the appearance of the surgical results. All surgery was performed by the senior author (P.K.T.C.).


RESULTS
The results are given for groups I to IV, respectively. The nostril height ratio was 0.73, 0.77, 0.81, and 0.95. The nostril width ratio was 1.23, 1.36, 1.23, and 1.21. The one-fourth medial part of nostril height ratio was 0.70, 0.87, 0.92, and 1.00. The nasal sill height ratio was 0.75, 1.02, 1.07, and 1.07. The nostril area ratio was 0.86, 0.89, 0.95, and 1.08. The nostril height-to-width ratio was 0.58, 0.58, 0.71, and 0.92. Finally, group IV had the best panel assessment.


CONCLUSIONS
The results revealed that group IV had the best overall result. Overcorrection of 20 percent was necessary to maintain the nostril height. Further technical modifications are necessary to minimize widening of the nostril width.
Chang
Chun-Shin
CS
Taipei and Linkou, Taiwan; and Singapore From the Graduate Institute of Clinical Medical Sciences, Chang Gung University; the Department of Plastic and Reconstructive Surgery, the Department of Orthodontics and Craniofacial Dentistry, and the Craniofacial Center, Chang Gung Memorial Hospital; and the Department of Plastic and Reconstructive Surgery, Kandang Kerbau Women's and Children's Hospital.
Por
Yong Chen
YC
Liou
Eric Jein-Wein
EJ
Chang
Chee-Jen
CJ
Chen
Philip Kuo-Ting
PK
Noordhoff
M Samuel
MS
D000704:Analysis of Variance; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery; D009666:Nose / Q000033:anatomy & histology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome