Orthopedics Research Today is a free monthly online journal that collates and summarizes the latest research about Orthopedics, including details on chronic injuries, muscoskeletal disorders, surgery, reconstruction.

Primary rhinoplasty in unilateral cleft patients: the "limited open" approach and other technical considerations.

Ahuja RB

Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India. rbahuja@vsnl.com

OBJECTIVE: To validate a method of primary anatomic alar repositioning using a "limited open rhinoplasty" approach, along with cleft lip repair, without presurgical orthopedics. METHODS: The cleft lip deformities were repaired using a modified Tennison technique, and primary muscle union and gingivoperiosteoplasty were achieved in all cases. The alar cartilages were visualized using an inverted "U" incision on the cleft side and a rim incision on the noncleft side, without joining the two with a transcolumellar incision. The domes of the cartilages were approximated by a single horizontal mattress suture. PATIENTS: Thirty-five patients were operated on by this technique between March 1999 and February 2004. The patients ranged in age from 4 to 36 months (mean, 6 months). The follow-up ranged from 4 months to 4.5 years (mean, 18 months). RESULTS: Overall, the results for nasal shape and symmetry have been extremely good. CONCLUSIONS: The technique used here provides an exposure just short of an "open" rhinoplasty without scarring the columella or nasal tip. Arch alignment and a symmetric and stable bony platform are generally achieved by 2 to 3 months after the surgery. In severe cases of complete clefts, we have observed an absolute increase in alar arch length as a result of tissue stretch.

Published 20 July 2006 in Cleft Palate Craniofac J, 43(4): 492-8.
Full-text of this article is available online (may require subscription).

© 2005-2008 Orthopedics Research Today. All Rights Reserved.