title: Cleft lip nose correction combining open rhinoplasty with the Dibbel technique.
abstract: Cleft lip nose rhinoplasty is a challenging procedure because of the different presentation and severity of the deformity. Due to this presentation type, there is still no standard procedure correcting all the components of the deformity although a number of techniques have been published in literature. In this study, the effectiveness of the combination of open rhinoplasty and the Dibbel technique with nasal sill augmentation was evaluated. We hereby report our experience with 7 patients who had unilateral cleft lip nose deformity with slumped lower lateral cartilage and underprojected and deformed dome, operated on between September 2010 and April 2013 by 1 surgeon. The mean age of the patients at the time of surgery was 24.5 years (18-38 years) and the patients were followed up for an average of 18.5 months (6-31 months). All patients were operated on with open rhinoplasty and Dibbel technique combination with nasal sill augmentation. Frontal, lateral, oblique, and basilar photographs were obtained preoperatively and postoperatively for each patient. Nasal projection, columella height, nasolabial angle, nasal sill symmetry, and base width were measured on the photographs for comparison of preoperative and postoperative results. All patients' medial and lateral cantus distances were used for photographic standardization. The results demonstrated that there was a statistically significant increase in nasal projection (2.13 ± 0.28 mm preoperatively versus 2.31 ± 0.08 mm postoperatively; P = 0.018), columella height (1.07 ± 0.25 mm preoperatively versus 1.21 ± 0.18 mm postoperatively; P = 0.028), nostril apex height (1.11 ± 0.15 mm preoperatively versus 1.22 ± 0.11 mm postoperatively, P < 0.028), nasolabial angle (77.71 ± 8.74 mm preoperatively versus 91.33 ± 6.49 mm postoperatively; P < 0.05), and nasal sill symmetry (0.42 ± 0.15 mm preoperatively versus 0.27 ± 0.07 mm postoperatively; P < 0.05), and a significant decrease of alar width (2.35 ± 0.44 mm versus 2.16 ± 0.32 mm postoperatively; P = 0.018) on the affected side in response to surgery. The results of this study demonstrated that the Dibbel technique and open rhinoplasty combination with nasal sill augmentation is an effective and safe method for the correction of cleft lip nose deformity in respect to nasal symmetry.
authors.affiliation: *Plastic, Reconstructive and Aesthetic Surgery Department †Statistic Department, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Ayse Ozlem
authors.initials: AO
authors.lastname: Gundeslioglu
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Altuntas
authors.forename: Irfan
authors.initials: I
authors.lastname: Inan
authors.forename: Fatma
authors.initials: F
authors.lastname: Bilgen
authors.forename: Lorenc
authors.initials: L
authors.lastname: Jasharllari
authors.forename: Adnan
authors.initials: A
authors.lastname: Karaibrahimoglu
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D009666:Nose / Q000002:abnormalities* / Q000601:surgery; D009668:Nose Diseases / Q000601:surgery*; D011184:Postoperative Period; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome