title: Seven fundamental procedures for definitive correction of unilateral secondary cleft lip nasal deformity in soft tissue aspects.
abstract: OBJECTIVE
  It is accepted that patients who undergo appropriate primary repair for cleft lip will have secondary deformities. Because these deformities are caused by complex and diverse patterns, the deformities were categorized to provide a standardized treatment for each category.
  
  
  METHODS
  Pathologic characteristics of 1,170 patients were classified into 7 categories. Corrections were performed using 7 fundamental procedures corresponding to the surgical resolution of each deformity: 1) transposition of the caudal septum; 2) release of the septal-cartilaginous junction; 3) medial crus elevation; 4) lateral crus elevation; 5) release of the orbicularis oris muscle from the lip elevators; 6) anchoring of the orbicularis oris muscle to the anterior nasal spine; and 7) philtral column formation. A satisfaction survey was performed to evaluate the overall outcomes in 171 patients and an anthropometric analysis was performed in 38 patients.
  
  
  RESULTS
  Satisfactory scores obtained through postoperative follow-up were higher than preoperative scores, and there was no difference between postoperative scores obtained over the short and long term. All preoperative anthropometric measurements were different from the postoperative measurements, indicating that the fundamental procedure achieved effective outcomes.
  
  
  CONCLUSIONS
  These proposed 7 fundamental procedures can be used as guidelines that can always be applied for the correction of any secondary cleft lip nasal deformity to obtain ideal treatment outcomes.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yonsei University Health System, Severance Hospital, Seodaemun-gu, Seoul, Republic of Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.forename: Bong-Kyoon
authors.initials: BK
authors.lastname: Choi
authors.forename: Be-Young Yun
authors.initials: BY
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008046:Lip / Q000033:anatomy & histology / Q000601:surgery; D008297:Male; D009061:Mouth Mucosa / Q000601:surgery; D009295:Nasal Bone / Q000601:surgery; D055171:Nasal Cartilages / Q000033:anatomy & histology / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000033:anatomy & histology / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000145:classification / Q000601:surgery*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D040521:Subcutaneous Tissue / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult