A total of 45 patients with
cleft lip nasal
deformities were operated on between September 1997 and December 1999. We reviewed 35 of them. Out of these, 31 patients had unilateral
cleft lip nasal
deformities and four patients had bilateral
cleft lip nasal
deformities. The age range of the patients was from 3 years to 56 years. A reverse-U incision with V-Y plasty was used in 20 patients with mild to moderate unilateral
cleft lip nasal
deformities. An open
rhinoplasty incision combined with the reverse-U incision and V-Y plasty was used in 11 patients with severe unilateral
cleft lip nasal
deformities. A bilateral reverse-U incision and a trans-columellar incision were used in the four patients with bilateral
cleft lip nasal
deformities. After advancement of the mucochondrial flap, alar transfixion
sutures were used to ensure firm contact between the nasal skin and the redraped reverse-U flap. A composite graft for columellar lengthening was used in six cases of severe unilateral
cleft lip nasal
deformity and the four cases of bilateral
cleft lip nasal
deformity. Ancillary procedures included correction of a lateral displacement of the alar base, lip
scar revision, a cartilage graft for tip augmentation, iliac
bone grafting for correction of hypoplasia of the maxilla or for an alveolar cleft and corrective
rhinoplasty. A self-made nasal retainer was applied for 6 months in all patients to maintain the corrected contour of the nostril. The follow-up period ranged from 11 months to 26 months, with an average of 18 months. The final results were evaluated based on the degree of symmetry of the nostrils, the redraping of the alar-columellar web and the exposure of the nostrils. Good results were obtained in 29 patients where alar-columellar web
deformities were either absent or minimal and a satisfactory symmetry of the nostrils was achieved. Four patients had fair results and two patients had poor results. In conclusion, we suggest that the reverse-U incision with V-Y plasty is a useful method for achieving symmetry of the nostrils in
cleft lip nasal
deformities in Orientals. In addition, this technique provides ample advancement and repositioning of the mucochondrial flap and simultaneous correction of the nasal vestibular web.