Surgical Correction of Nostril Base and Nostril Sill Depression in Unilateral Secondary Cleft Lip Nose Deformity

Lee, Soo Hyang; Lee, Kyung Jin; Hwang, Eun A; Choi, Hyun Gon; Kim, Soon Heum; Shin, Dong Hyeok; Uhm, Ki Il

Abstract

PURPOSE
Most unilateral secondary cleft lip nose deformities have depressed nostril base and sill on the cleft side. To obtain a symmetric nose, correction of the recession on nostril is critical. The authors have worked out effective methods to elevate the nostril of the cleft side according to the extent of the depression.
METHODS
A total of 115 unilateral secondary cleft lip nose deformity patients with nostril depression were evaluated. Data were acquired from patients' charts and photography with special reference to the height difference of the nostrils between the cleft side and the non-cleft side. Patients were divided into three groups based on the difference and operated with various techniques :(1) mild degree(< 1mm) with graft,(2) moderate degree(1-3mm) with C-flap or suspension suture of septal cartilage(3) severe degree(> 3mm) with graft, C-flap and suspension suture. Follow-up period averaged 21.3 months.
RESULTS
Forty-six patients(40 percent) were in mild group, and forty-two(37 percent) were in moderate. In twenty-seven patients(23 percent), nostril recession was more than 3mm. The elevated nostril base and sill were maintained without height alteration during follow-up.
CONCLUSION
The symmetry of the nostril base, especially projection of nostril sill influences successful correction of unilateral cleft lip nose deformity. Our tolerable techniques can be applied to most deformities with nostril depression and can present a new guideline.