A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series

Aim and background: The cleft lip nasal deformity (CLND) is characterized by numerous complex and interdependent deformities involving the soft tissues and skeleton of the nose. The underlying anatomic deformities mostly require replacement of the deficient framework with some form of cartilage graf...

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Bibliographic Details
Main Authors: Ankit Aggarwal, Raja Tiwari, R Manju, Komal Gupta, Maneesh Singhal
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2025-06-01
Series:Journal of Postgraduate Medicine, Education and Research
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Online Access:https://www.jpmer.com/doi/JPMER/pdf/10.5005/jp-journals-10028-1743
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Summary:Aim and background: The cleft lip nasal deformity (CLND) is characterized by numerous complex and interdependent deformities involving the soft tissues and skeleton of the nose. The underlying anatomic deformities mostly require replacement of the deficient framework with some form of cartilage grafts. With a wide array of cartilage grafts available, it becomes difficult for even the most experienced surgeon to choose the right graft for a particular patient. The primary objective of this study was to compare the properties of different cartilage grafts available for correction of secondary CLND. Methods: We present a series of 10 patients with cleft nose (all unilateral cleft) with various deformities. These patients underwent surgery between January 2018 and January 2019. Results: The follow-up period ranged from 12 to 18 months (mean: 14.7 months). Costal cartilage (<i>n</i> = 5) provided excellent long-term stability and versatility but was associated with high donor-site morbidity. Conchal cartilage (<i>n</i> = 2) offered good contouring for alar onlay grafts but showed moderate stability. Septal cartilage (<i>n</i> = 2) demonstrated minimal donor site morbidity and was ideal for smaller corrections, but limited availability constrained its use. One patient received a combination of costal and conchal cartilage, achieving excellent esthetic outcomes. Conclusion: A tailor-made approach to each deformity should be followed, where a suitable cartilage graft should be selected depending on the desired reconstructive goal. Clinical significance: These findings guide surgeons in choosing appropriate grafts based on factors such as stability, contouring ability, donor-site morbidity, and long-term results, ultimately improving surgical planning and patient satisfaction in managing CLND.
ISSN:2277-8969
2278-0262