title: Secondary correction of nasal deformities in cleft lip and palate patients: surgical technique and outcome evaluation.
abstract: BACKGROUND
  Nasal deformity associated with cleft lip and palate is a highly challenging reconstructive problem in rhinoplasty. In the literature, several operative solutions and evaluation methods have been described, however these do not offer a standard procedure for the surgeon. Our aim was to standardize our surgical technique-as much as the uniqueness of each case allowed it-based on the most frequent deformities we had faced; and to evaluate our results via a postoperative patient satisfaction questionnaire. Between 2012 and 2014 12 consecutive patients with combined cleft lip and palate deformities underwent secondary nasal and septal correction surgery with the same method by the same surgeon. The indications of surgery were, on one hand, difficult nasal breathing and altered nasal function (tendency for chronic rhinosinusitis) and on the other hand the aesthetic look of the nose. No exclusion criteria were stated. In our follow-up study we evaluated our results by using a modified Rhinoplasty Outcome Evaluation (ROE) questionnaire: patients answered the same four questions pre- and postoperatively. Data were statistically analyzed by t-test.
  
  
  RESULTS
  Based on the questionnaire, all patients experienced improvement of nasal breathing function, improved appearance of the nose and less stigmatization from the society. According to the t-test, all scores of the four questions improved significantly in the postoperative 4-6 months, compared with the preoperative scores.
  
  
  CONCLUSIONS
  In our opinion with our standardized surgical steps satisfactory aesthetic and functional results can be achieved. We think the modified ROE questionnaire is an adequate and simple method for the evaluation of our surgical results.
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Szeged, Tisza L. krt. 111, 6725, Szeged, Hungary. vassgabor@hotmail.com.
authors.forename: Gabor
authors.initials: G
authors.lastname: Vass
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Korányi fasor 6, 6720, Szeged, Hungary. drmohosgabor@yahoo.com.
authors.forename: Gabor
authors.initials: G
authors.lastname: Mohos
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Szeged, Tisza L. krt. 111, 6725, Szeged, Hungary.
authors.forename: Zsofia
authors.initials: Z
authors.lastname: Bere
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Szeged, Tisza L. krt. 111, 6725, Szeged, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Ivan
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Korányi fasor 6, 6720, Szeged, Hungary.
authors.forename: Janos
authors.initials: J
authors.lastname: Varga
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Szeged, Kálvária sgt. 57, 6725, Szeged, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Piffko
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Szeged, Tisza L. krt. 111, 6725, Szeged, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Rovo
mesh_terms: D000293:Adolescent; D000328:Adult; D002971:Cleft Lip / Q000175:diagnosis / Q000601:surgery*; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000002:abnormalities / Q000601:surgery; D009666:Nose / Q000002:abnormalities / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cleft lip and palate; Rhinoplasty outcome evaluation questionnaire; Secondary rhinoplasty; Standard surgical technique