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Modified forked flap for controlling columella length in cleft lip open rhinoplasty.
J Craniomaxillofac Surg. 2008 Apr; 36(3):131-137.JC

Abstract

BACKGROUND & PURPOSE

Suturing the columellar flap after open rhinoplasty often reduces the tip projection gained, especially in patients with cleft lip deformity, in whom the columella is usually short and inelastic. A modification of the classical forked flap is proposed for controlling the tension created by the columellar suture.

PATIENTS

Five patients aged from 17 to 35 years underwent surgery in the previous 2 years using the described techniques.

METHODS

The columella incision followed the classic tepee shape, although the inverted V was extremely narrow and long, with its arms extending beyond the columellar rims, stopping at the base of the vestibule, then making acute angles and heading vertically towards the nostril tip, and continuing into the nostrils as normal marginal incisions. Consequently, a complete "W" was used, in which the lateral angles and arms lay in the nostrils, while the central inverted V was in the columella. The rhinoplasty was performed as planned and a triple "V-Y" suture was made.

RESULTS

The technique provided real lengthening of the columella or, at least, it closed the columellar incision without tension, thereby preserving the tip projection.

CONCLUSIONS

In open rhinoplasty on patients with cleft lip involvement a triple V-Y columellar suture preserves the surgically obtained columella length.

Authors+Show Affiliations

Department of Maxillofacial Surgery II (Head: Dr. F. Grecchi), Hospital Galeazzi RCCS - Milan, Italy. Electronic address: amb.carlino@tiscali.it.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18346903

Citation

Carlino, Franco. "Modified Forked Flap for Controlling Columella Length in Cleft Lip Open Rhinoplasty." Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, vol. 36, no. 3, 2008, pp. 131-137.
Carlino F. Modified forked flap for controlling columella length in cleft lip open rhinoplasty. J Craniomaxillofac Surg. 2008;36(3):131-137.
Carlino, F. (2008). Modified forked flap for controlling columella length in cleft lip open rhinoplasty. Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, 36(3), 131-137. https://doi.org/10.1016/j.jcms.2008.01.001
Carlino F. Modified Forked Flap for Controlling Columella Length in Cleft Lip Open Rhinoplasty. J Craniomaxillofac Surg. 2008;36(3):131-137. PubMed PMID: 18346903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified forked flap for controlling columella length in cleft lip open rhinoplasty. A1 - Carlino,Franco, Y1 - 2008/03/17/ PY - 2008/3/19/pubmed PY - 2008/8/1/medline PY - 2008/3/19/entrez SP - 131 EP - 137 JF - Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery JO - J Craniomaxillofac Surg VL - 36 IS - 3 N2 - BACKGROUND & PURPOSE: Suturing the columellar flap after open rhinoplasty often reduces the tip projection gained, especially in patients with cleft lip deformity, in whom the columella is usually short and inelastic. A modification of the classical forked flap is proposed for controlling the tension created by the columellar suture. PATIENTS: Five patients aged from 17 to 35 years underwent surgery in the previous 2 years using the described techniques. METHODS: The columella incision followed the classic tepee shape, although the inverted V was extremely narrow and long, with its arms extending beyond the columellar rims, stopping at the base of the vestibule, then making acute angles and heading vertically towards the nostril tip, and continuing into the nostrils as normal marginal incisions. Consequently, a complete "W" was used, in which the lateral angles and arms lay in the nostrils, while the central inverted V was in the columella. The rhinoplasty was performed as planned and a triple "V-Y" suture was made. RESULTS: The technique provided real lengthening of the columella or, at least, it closed the columellar incision without tension, thereby preserving the tip projection. CONCLUSIONS: In open rhinoplasty on patients with cleft lip involvement a triple V-Y columellar suture preserves the surgically obtained columella length. SN - 1010-5182 UR - https://www.unboundmedicine.com/medline/citation/18346903/Modified_forked_flap_for_controlling_columella_length_in_cleft_lip_open_rhinoplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1010-5182(08)00013-9 DB - PRIME DP - Unbound Medicine ER -