Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities

The treatment of patients with unilateral cleft lip has undergone significant development during the last decades. With better understanding of the anatomy of the unilateral cleft lip and nasal deformities, primary correction of the nasal deformity at the time of lip repair, critical evaluation of s...

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Main Authors: Mimis Cohen, David E. Morris, Aisha D. White, Pravin Patel
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2009-10-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699381
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author Mimis Cohen
David E. Morris
Aisha D. White
Pravin Patel
author_facet Mimis Cohen
David E. Morris
Aisha D. White
Pravin Patel
author_sort Mimis Cohen
collection DOAJ
description The treatment of patients with unilateral cleft lip has undergone significant development during the last decades. With better understanding of the anatomy of the unilateral cleft lip and nasal deformities, primary correction of the nasal deformity at the time of lip repair, critical evaluation of short and long-term results following various treatment protocols, and constant striving for perfection in both aesthetics and function, we have been able to design improved treatment strategies and more accurate surgical techniques so as to achieve overall superior and long-lasting results. In this review article, we present our protocols and experience for functional and aesthetic correction of secondary unilateral cleft lip nasal deformities and a retrospective review of 219 consecutive patients treated at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities. The protocols used in the treatment of 219 consecutive patients at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities were reviewed. In addition, analysis of the most recent 51 consecutive patients who underwent complete clinical and functional evaluation with rhinomanometry followed by correction of the cleft lip nasal deformity was performed. A variety of time-honoured techniques of rhinoplasty were applied in the correction of the residual deformities to achieve symmetry, aesthetic balance, and functional correction of the nose. Follow-up ranged from 5-11 years. Analysis of the data revealed that 39 patients (76.47%) had significant functional and aesthetic improvement; seven patients (13.07%) had significant aesthetic improvement but a modest functional improvement; and five patients (9.8%) required additional surgery to improve their appearance and had no functional improvement. Further analysis demonstrated that five out of seven patients in the second group had pharyngeal flaps in place that were primarily responsible for the airway obstruction. No attempt was made to revise the ports of these flaps because the speech was excellent. The surgical plan is based on the information gained from our extensive clinical evaluation and is tailored to the patient's specific functional and aesthetic needs.
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spelling doaj-art-721dfc7af8a942e199dd31f81ca747f42025-08-20T03:19:07ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2009-10-0142S91S10110.1055/s-0039-1699381Functional and aesthetic correction of secondary unilateral cleft lip nasal deformitiesMimis Cohen0David E. Morris1Aisha D. White2Pravin Patel3The Craniofacial Centre and the Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago, USAThe Craniofacial Centre and the Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago, USAThe Craniofacial Centre and the Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago, USAThe Craniofacial Centre and the Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago, USAThe treatment of patients with unilateral cleft lip has undergone significant development during the last decades. With better understanding of the anatomy of the unilateral cleft lip and nasal deformities, primary correction of the nasal deformity at the time of lip repair, critical evaluation of short and long-term results following various treatment protocols, and constant striving for perfection in both aesthetics and function, we have been able to design improved treatment strategies and more accurate surgical techniques so as to achieve overall superior and long-lasting results. In this review article, we present our protocols and experience for functional and aesthetic correction of secondary unilateral cleft lip nasal deformities and a retrospective review of 219 consecutive patients treated at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities. The protocols used in the treatment of 219 consecutive patients at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities were reviewed. In addition, analysis of the most recent 51 consecutive patients who underwent complete clinical and functional evaluation with rhinomanometry followed by correction of the cleft lip nasal deformity was performed. A variety of time-honoured techniques of rhinoplasty were applied in the correction of the residual deformities to achieve symmetry, aesthetic balance, and functional correction of the nose. Follow-up ranged from 5-11 years. Analysis of the data revealed that 39 patients (76.47%) had significant functional and aesthetic improvement; seven patients (13.07%) had significant aesthetic improvement but a modest functional improvement; and five patients (9.8%) required additional surgery to improve their appearance and had no functional improvement. Further analysis demonstrated that five out of seven patients in the second group had pharyngeal flaps in place that were primarily responsible for the airway obstruction. No attempt was made to revise the ports of these flaps because the speech was excellent. The surgical plan is based on the information gained from our extensive clinical evaluation and is tailored to the patient's specific functional and aesthetic needs.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699381cleft rhinoplastycleft nasal deformitysecondary cleft deformities
spellingShingle Mimis Cohen
David E. Morris
Aisha D. White
Pravin Patel
Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
Indian Journal of Plastic Surgery
cleft rhinoplasty
cleft nasal deformity
secondary cleft deformities
title Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
title_full Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
title_fullStr Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
title_full_unstemmed Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
title_short Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
title_sort functional and aesthetic correction of secondary unilateral cleft lip nasal deformities
topic cleft rhinoplasty
cleft nasal deformity
secondary cleft deformities
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699381
work_keys_str_mv AT mimiscohen functionalandaestheticcorrectionofsecondaryunilateralcleftlipnasaldeformities
AT davidemorris functionalandaestheticcorrectionofsecondaryunilateralcleftlipnasaldeformities
AT aishadwhite functionalandaestheticcorrectionofsecondaryunilateralcleftlipnasaldeformities
AT pravinpatel functionalandaestheticcorrectionofsecondaryunilateralcleftlipnasaldeformities