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Facial Plast Surg 2020; 36(01): 102-111
DOI: 10.1055/s-0040-1701477
DOI: 10.1055/s-0040-1701477
Original Article
Controversies in Cleft Rhinoplasty
Funding None.
Further Information
Publication History
Publication Date:
19 March 2020 (online)
Abstract
Rhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip–palate are technically and intellectually challenging to master requiring a patient-tailored approach. The shape and structure of the nose are changed to improve both function and aesthetic appearance. In the primary setting, nasoalveolar molding is a form of presurgical infant orthopaedics used for preparation before the cleft lip and nose repair. Intermediate stages should be conservative to minimize scarring, while the definitive cleft rhinoplasty utilizes cartilage grafts from septum, ear, or rib to sculpt the nose. Hereinto, we will outline the controversies, the evidence supporting certain techniques, and our preferences.
Keywords
rhinoplasty - cleft lip - cleft nasal deformity - cartilage graft - definitive cleft rhinoplasty - intermediate cleft rhinoplasty - primary cleft rhinoplasty - nasoalveolar moldingDisclosures
None.
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References
- 1 Stark HL, Fries CA, Mercer NS. Translational techniques from cleft to cosmetic rhinoplasty. Arch Plast Surg 2019
- 2 Cuzalina A, Jung C. Rhinoplasty for the cleft lip and palate patient. Oral Maxillofac Surg Clin North Am 2016; 28 (02) 189-202
- 3 Murray JC. Gene/environment causes of cleft lip and/or palate. Clin Genet 2002; 61 (04) 248-256
- 4 Wyszynski DF, Beaty TH, Maestri NE. Genetics of nonsyndromic oral clefts revisited. Cleft Palate Craniofac J 1996; 33 (05) 406-417
- 5 Tollefson TT, Shaye D, Durbin-Johnson B, Mehdezadeh O, Mahomva L, Chidzonga M. Cleft lip-cleft palate in Zimbabwe: estimating the distribution of the surgical burden of disease using geographic information systems. Laryngoscope 2015; 125 (Suppl. 01) S1-S14
- 6 Cho BC, Baik BS. Correction of cleft lip nasal deformity in Orientals using a refined reverse-U incision and V-Y plasty. Br J Plast Surg 2001; 54 (07) 588-596
- 7 Hsieh TY, Dedhia R, Del Toro D, Tollefson TT. Cleft septorhinoplasty: form and function. Facial Plast Surg Clin North Am 2017; 25 (02) 223-238
- 8 McNEIL CK. Orthodontic procedures in the treatment of congenital cleft palate. Dent Rec (London) 1950; 70 (05) 126-132
- 9 Latham RA. Orthopedic advancement of the cleft maxillary segment: a preliminary report. Cleft Palate J 1980; 17 (03) 227-233
- 10 Grayson BH, Cutting C, Wood R. Preoperative columella lengthening in bilateral cleft lip and palate. Plast Reconstr Surg 1993; 92 (07) 1422-1423
- 11 Grayson BH, Cutting CB. Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants born with unilateral and bilateral clefts. Cleft Palate Craniofac J 2001; 38 (03) 193-198
- 12 Sitzman TJ, Girotto JA, Marcus JR. Current surgical practices in cleft care: unilateral cleft lip repair. Plast Reconstr Surg 2008; 121 (05) 261e-270e
- 13 Tan SP, Greene AK, Mulliken JB. Current surgical management of bilateral cleft lip in North America. Plast Reconstr Surg 2012; 129 (06) 1347-1355
- 14 Ahmed MK, Bui AH, Barnett R, Rousso JJ. Quantitative evaluation of nasolabial alterations following nasoalveolar molding (NAM) therapy in patients with unilateral cleft lip. Facial Plast Surg 2019; 35 (01) 73-77
- 15 Matsuo K, Hirose T, Tomono T. , et al. Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Plast Reconstr Surg 1984; 73 (01) 38-51
- 16 Singh GD, Moxham BJ, Langley MS, Waddington RJ, Embery G. Changes in the composition of glycosaminoglycans during normal palatogenesis in the rat. Arch Oral Biol 1994; 39 (05) 401-407
- 17 Shetty V, Vyas HJ, Sharma SM, Sailer HF. A comparison of results using nasoalveolar moulding in cleft infants treated within 1 month of life versus those treated after this period: development of a new protocol. Int J Oral Maxillofac Surg 2012; 41 (01) 28-36
- 18 Levy-Bercowski D, Abreu A, DeLeon E. , et al. Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J 2009; 46 (05) 521-528
- 19 Maillard S, Retrouvey JM, Ahmed MK, Taub PJ. Correlation between nasoalveolar molding and surgical, aesthetic, functional and socioeconomic outcomes following primary repair surgery: a systematic review. J Oral Maxillofac Res 2017; 8 (03) e2
- 20 Abbott MM, Meara JG. Nasoalveolar molding in cleft care: is it efficacious?. Plast Reconstr Surg 2012; 130 (03) 659-666
- 21 van der Heijden P, Dijkstra PU, Stellingsma C, van der Laan BF, Korsten-Meijer AG, Goorhuis-Brouwer SM. Limited evidence for the effect of presurgical nasoalveolar molding in unilateral cleft on nasal symmetry: a call for unified research. Plast Reconstr Surg 2013; 131 (01) 62e-71e
- 22 Rubin MS, Clouston SAP, Esenlik E, Shetye PR, Flores RL, Grayson BH. Midface growth in patients with unilateral cleft lip and palate treated with a nasoalveolar molding protocol. J Craniofac Surg 2019; 30 (06) 1640-1643
- 23 Liou EJ, Subramanian M, Chen PK, Huang CS. The progressive changes of nasal symmetry and growth after nasoalveolar molding: a three-year follow-up study. Plast Reconstr Surg 2004; 114 (04) 858-864
- 24 Pai BC, Ko EW, Huang CS, Liou EJ. Symmetry of the nose after presurgical nasoalveolar molding in infants with unilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J 2005; 42 (06) 658-663
- 25 Chang CS, Por YC, Liou EJ, Chang CJ, Chen PK, Noordhoff MS. Long-term comparison of four techniques for obtaining nasal symmetry in unilateral complete cleft lip patients: a single surgeon's experience. Plast Reconstr Surg 2010; 126 (04) 1276-1284
- 26 Patel PA, Rubin MS, Clouston S. , et al. Comparative study of early secondary nasal revisions and costs in patients with clefts treated with and without nasoalveolar molding. J Craniofac Surg 2015; 26 (04) 1229-1233
- 27 Matsuo K, Hirose T, Otagiri T, Norose N. Repair of cleft lip with nonsurgical correction of nasal deformity in the early neonatal period. Plast Reconstr Surg 1989; 83 (01) 25-31
- 28 Brussé CA, Van der Werff JF, Stevens HP. , et al. Symmetry and morbidity assessment of unilateral complete cleft lip nose corrected with or without primary nasal correction. Cleft Palate Craniofac J 1999; 36 (04) 361-366
- 29 Anderl H. Unilateral cleft lip nose. Plast Reconstr Surg 1987; 79 (04) 661-662
- 30 Haddock NT, McRae MH, Cutting CB. Long-term effect of primary cleft rhinoplasty on secondary cleft rhinoplasty in patients with unilateral cleft lip-cleft palate. Plast Reconstr Surg 2012; 129 (03) 740-748
- 31 Sarnat BG, Wexler MR. Growth of the face and jaws after resection of the septal cartilage in the rabbit. Am J Anat 1966; 118 (03) 755-767
- 32 McComb HK, Coghlan BA. Primary repair of the unilateral cleft lip nose: completion of a longitudinal study. Cleft Palate Craniofac J 1996; 33 (01) 23-30 , discussion 30–31
- 33 Volpicelli EJ, Pfaff MJ, Hakimi K, Bradley JP, Solem RC, Lee JC. Age-related differences in psychosocial function of children with craniofacial anomalies. Plast Reconstr Surg 2017; 140 (04) 776-784
- 34 Ayeroff JR, Volpicelli EJ, Mandelbaum RS. , et al. Component restoration in the unilateral intermediate cleft tip rhinoplasty: technique and long-term outcomes. Plast Reconstr Surg 2019; 143 (03) 572e-580e
- 35 Wang TD. Secondary rhinoplasty in unilateral cleft nasal deformity. Clin Plast Surg 2010; 37 (02) 383-387
- 36 Cutting CB. Secondary cleft lip nasal reconstruction: state of the art. Cleft Palate Craniofac J 2000; 37 (06) 538-541
- 37 Pawar SS, Wang TD. Secondary cleft rhinoplasty. JAMA Facial Plast Surg 2014; 16 (01) 58-63
- 38 Shih CW, Sykes JM. Correction of the cleft-lip nasal deformity. Facial Plast Surg 2002; 18 (04) 253-262
- 39 Tajima S, Maruyama M. Reverse-U incision for secondary repair of cleft lip nose. Plast Reconstr Surg 1977; 60 (02) 256-261
- 40 Bhuskute AA, Tollefson TT. Cleft lip repair, nasoalveolar molding, and primary cleft rhinoplasty. Facial Plast Surg Clin North Am 2016; 24 (04) 453-466
- 41 Skoog T. A method of hump reduction in rhinoplasty. A technique for preservation of the nasal roof. Arch Otolaryngol 1966; 83: 283-287
- 42 Greives MR, Camison L, Losee JE. Evidence-based medicine: unilateral cleft lip and nose repair. Plast Reconstr Surg 2014; 134 (06) 1372-1380
- 43 Yeow VK, Chen PK, Chen YR, Noordhoff SM. The use of nasal splints in the primary management of unilateral cleft nasal deformity. Plast Reconstr Surg 1999; 103: 1347-1354
- 44 Lu X, Chen G. Primary septal cartilage graft for the unilateral cleft rhinoplasty. Plast Reconstr Surg 2017; 140: 832e-835e
- 45 Lopez MA, Shah AR, Westine JG, O'Grady K, Toriumi DM. Analysis of the physical properties of costal cartilage in a porcine model. Arch Facial Plast Surg 2007; 9 (01) 35-39
- 46 Read-Fuller AM, Yates DM, Radwan A, Schrodt AM, Finn RA. The use of allogeneic cartilage for grafting in functional and reconstructive rhinoplasty. J Oral Maxillofac Surg 2018; 76 (07) 1560.e1-1560.e7