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Surgical Technique |

Secondary Rhinoplasty in Nasal Deformity Associated With the Unilateral Cleft Lip

Tom D. Wang, MD; Simon J. Madorsky, MD
Arch Facial Plast Surg. 1999;1(1):40-45. doi:10.1001/archfaci.1.1.40.
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The secondary nasal deformity of the unilateral cleft lip involves a retrodisplaced dome of the ipsilateral nasal tip, hooding of the alar rim, a secondary alar-columellar web, and other deficiencies. The sliding-flap cheilorhinoplasty effectively corrects these deformities using a laterally based chondrocutaneous flap. We modified this technique by using an open rhinoplasty approach with the laterally based chondrocutaneous sliding flap. Columellar struts and shield grafts were some of the techniques combined with this approach to produce optimal results. In a total of 7 patients, we performed both the original sliding-flap cheilorhinoplasty and the modified open rhinoplasty, which are described and discussed herein. The laterally based sliding-flap cheilorhinoplasty is an effective technique for correcting both the secondary nasal deformity and the lip scar associated with the unilateral cleft lip.

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Figure 1.

Sliding-flap cheilorhinoplasty. A, The original Vissarionov1 technique. B, The combined technique.

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Figure 2.

A and C, Preoperative views of a 6-year-old girl. B and D, Status 3\batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \({1}/{2}\) \end{document} years after repair with the original Vissarionov1 technique.

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Figure 3.

A, C, E, and G, Preoperative views of a 16-year-old girl. B, D, F, and H, Status 3 months after undergoing the combined technique with a shield, dorsal augmentation, a strut, and graft.

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Figure 4.

A, C, E, and G, Preoperative views of a 16-year-old boy. B, D, F, and H, Status 18 months after undergoing the combined technique with premaxillary augmentation, a shield, a strut, and graft.

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Figure 5.

A, The technique introduced by Gillies and Kilner.3 B, The technique introduced by Wilkie4 (reproduced with permission). C, The technique introduced by Converse5 (reproduced with permission).

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Figure 6.

The reverse-U technique (reproduced with permission from Tajima and Maruyama7).

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