Vestibular Marginal Skin Excision Technique for Minor Secondary Unilateral Cleft Nose Deformity.

Background: Unilateral cleft lip secondary nasal deformities are common and require surgical correction frequently. The nasal dome on the cleft side is depressed, and the nasal ala is in an extended and flattened position compared with the noncleft side. In addition, the nasal septum is deviated into the cleft nostril. Intermediate cleft rhinoplasty is frequently performed during preschool age to address nasal deformities in cleft patients before the most critical period of psychosocial development. The purpose of this study is to describe an innovative method involving a minimal incision and tip dissection for secondary nasal repair in patients with unilateral cleft lip.

Methods: This is a prospective cohort study. Since 2019, a single surgeon has operated on 25 consecutive unilateral cleft lip and palate patients with minor secondary nasal deformities. The method involves vestibular marginal skin excision and nasal tip dissection to reshape the affected nostril, improving symmetry. The outcomes were evaluated through anthropometric measurements of the repaired nose during at least 3 years of follow-up.

Results: A single surgeon has operated on 25 unilateral cleft lip and palate patients with minor secondary nasal deformities using the proposed technique. Total nostril symmetry was achieved in 84% of cases during follow-up at the time of alveolar bone graft.

Conclusions: Proposed secondary cleft rhinoplasty is a good approach to improve nostril appearance in patients with minor secondary unilateral nasal deformities. However, longer follow-up time and comparative studies are required to evaluate its efficacy.