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A new modified forked flap with subcutaneous pedicles for adult cases of bilateral cleft lip nasal deformity: from normalization to aesthetic improvement.
J Craniofac Surg 2008; 19(5):1374-80JC

Abstract

In adult cases of bilateral cleft lip nasal deformity, an esthetically satisfying result can not be obtained only by manipulation inside the nose with the nasal tip pointing upward. The nasal tip should be made in a more anterior direction for nasal esthetic improvement. Additional tissue beyond the nose is needed, and the forked flap is a useful method in such cases. However, the blood circulation of long and narrow flaps containing the scar, especially after open rhinoplasty, is unstable. We have developed a new long and narrow forked flap that has a more stable blood circulation. The forked flap was made using two subcutaneous pedicles attached to the periphery of the each flap. We applied this flap to five adult cases of bilateral cleft lip nasal deformity. Four of the cases had the scar associated with the flying bird incision, and one case required no treatment after the primary repair. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the profile was esthetically improved. In the final stage of correction for adult cases of bilateral cleft lip nasal deformity, this method, making maximum use of the tissue containing the scar in not only the white lip but also the vermilion, is very effective. It is very important to obtain nasal esthetic improvement for the adult patient with bilateral cleft lip nasal deformity.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18812866

Citation

Rikimaru, Hideaki, et al. "A New Modified Forked Flap With Subcutaneous Pedicles for Adult Cases of Bilateral Cleft Lip Nasal Deformity: From Normalization to Aesthetic Improvement." The Journal of Craniofacial Surgery, vol. 19, no. 5, 2008, pp. 1374-80.
Rikimaru H, Kiyokawa K, Koga N, et al. A new modified forked flap with subcutaneous pedicles for adult cases of bilateral cleft lip nasal deformity: from normalization to aesthetic improvement. J Craniofac Surg. 2008;19(5):1374-80.
Rikimaru, H., Kiyokawa, K., Koga, N., Takahashi, N., Morinaga, K., & Ino, K. (2008). A new modified forked flap with subcutaneous pedicles for adult cases of bilateral cleft lip nasal deformity: from normalization to aesthetic improvement. The Journal of Craniofacial Surgery, 19(5), pp. 1374-80. doi:10.1097/SCS.0b013e3180f6117d.
Rikimaru H, et al. A New Modified Forked Flap With Subcutaneous Pedicles for Adult Cases of Bilateral Cleft Lip Nasal Deformity: From Normalization to Aesthetic Improvement. J Craniofac Surg. 2008;19(5):1374-80. PubMed PMID: 18812866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new modified forked flap with subcutaneous pedicles for adult cases of bilateral cleft lip nasal deformity: from normalization to aesthetic improvement. AU - Rikimaru,Hideaki, AU - Kiyokawa,Kensuke, AU - Koga,Noriyuki, AU - Takahashi,Nagahiro, AU - Morinaga,Keigo, AU - Ino,Kou, PY - 2008/9/25/pubmed PY - 2009/1/17/medline PY - 2008/9/25/entrez SP - 1374 EP - 80 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 19 IS - 5 N2 - In adult cases of bilateral cleft lip nasal deformity, an esthetically satisfying result can not be obtained only by manipulation inside the nose with the nasal tip pointing upward. The nasal tip should be made in a more anterior direction for nasal esthetic improvement. Additional tissue beyond the nose is needed, and the forked flap is a useful method in such cases. However, the blood circulation of long and narrow flaps containing the scar, especially after open rhinoplasty, is unstable. We have developed a new long and narrow forked flap that has a more stable blood circulation. The forked flap was made using two subcutaneous pedicles attached to the periphery of the each flap. We applied this flap to five adult cases of bilateral cleft lip nasal deformity. Four of the cases had the scar associated with the flying bird incision, and one case required no treatment after the primary repair. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the profile was esthetically improved. In the final stage of correction for adult cases of bilateral cleft lip nasal deformity, this method, making maximum use of the tissue containing the scar in not only the white lip but also the vermilion, is very effective. It is very important to obtain nasal esthetic improvement for the adult patient with bilateral cleft lip nasal deformity. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/18812866/A_new_modified_forked_flap_with_subcutaneous_pedicles_for_adult_cases_of_bilateral_cleft_lip_nasal_deformity:_from_normalization_to_aesthetic_improvement_ L2 - http://Insights.ovid.com/pubmed?pmid=18812866 DB - PRIME DP - Unbound Medicine ER -