0
Review |

Secondary Cleft Rhinoplasty

Sachin S. Pawar, MD1; Tom D. Wang, MD2
[+] Author Affiliations
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee
2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland
JAMA Facial Plast Surg. 2014;16(1):58-63. doi:10.1001/jamafacial.2013.1562.
Text Size: A A A
Published online

The cleft nasal deformity seen in patients with unilateral and bilateral cleft lip presents a formidable challenge for the facial plastic surgeon. The underlying anatomic deformities combined with scarring from previous procedures make secondary cleft rhinoplasty a difficult procedure for even the most experienced surgeons. Numerous techniques for secondary cleft rhinoplasty have been described in the literature over the past several decades, yet the lack of wide adoption of any given technique highlights the great variability seen with this problem. Regardless, the fundamental goals of achieving nasal symmetry with definition of the nasal base and tip, correction of nasal airway obstruction, and repair of nasal scarring or webbing have driven the progressive evolution of techniques developed to correct various aspects of the cleft nasal deformity. Despite the number of techniques that have been published, very few studies have looked specifically at outcomes in secondary cleft rhinoplasty, and further work is needed in this area. In this article, we will review anatomy of the cleft nasal deformity, repair strategies and timing, surgical techniques for both unilateral and bilateral cleft nasal deformity, and outcomes for secondary cleft rhinoplasty.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Place holder to copy figure label and caption
Figure 1.
Secondary Unilateral Cleft Lip Nasal Deformity

A, Anteroposterior view; B, basal view.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Secondary Bilateral Cleft Lip Nasal Deformity

A, Anteroposterior view; B, basal view.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.
Sliding Cheilorhinoplasty

A, The original Vissarionov technique. B, Modified combined technique. Left, outline of lip scar, chondrocutaneous flap, alar-web incision, and transcolumellar incision. Middle, laterally based chondrocutaneous flap elevated, along with external rhinoplasty exposure. Right, chondrocutaneous flap advanced superior-laterally, secured with columellar strut and nasal tip graft. Reproduced with permission from Wang and Madorsky.28

Graphic Jump Location

Tables

References

Correspondence

CME


You need to register in order to view this quiz.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();