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Primary rhinoplasty by open approach with repair of bilateral complete cleft lip.
J Craniofac Surg. 2009 Sep; 20 Suppl 2:1715-8.JC

Abstract

Nasal deformities inherent to a cleft are challenging. A controversy existed regarding the best time to correct these nasal problems. Now, there is a consensus that these nasal deformities are better to be dealt with along with repair of cleft lip.Primary cheilorhinoplasty involves proper reconstruction of clefted musculoaponeurotic complex by placing the muscles in their proper anatomic-physiologic orientation through careful identification, dissection, and mobilization of paranasal and labial musculature. In short, cleft repair is a muscle repair that enhances the establishment of a normal nasolabial complex. Delicate dissection and accurate repositioning of the lower alar cartilages during a primary lip repair will definitely help to establish a normal nasal shape. The nasal tissues must be supported with accurately placed sutures either by an open or a closed approach. The author prefers the open approach as published by Trott and Mohan (Br J Plast Surg 1993;46:215-222) with modifications because it has the added advantage for the identification and proper repositioning of the lower alar cartilages by accurately placed sutures under direct vision and the incisions of this procedure can be carried out through hidden rim incisions without any residual scars even in the colored population who were offered with this technique. Silicone nostril retainers, if available, during the immediate postoperative period will definitely promote the proper contours and the patency of the nostrils.Since 1994, the author has been performing this technique for patients with complete unilateral and bilateral cleft lip, which were presented separately. Patients with incomplete cleft lip were not included in this study because the nasal deformities were minimal, although the technique can be adopted for the correction of incomplete cleft lip nasal deformity also. Till December 2007, a total of 142 children with complete bilateral cleft lip with gross nasal deformities have been operated on and followed up.

Authors+Show Affiliations

Plastic Surgery Service in Oman, Muscat, Sultanate of Oman. Cthomas@omantel.net.om

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19816337

Citation

Thomas, Chona. "Primary Rhinoplasty By Open Approach With Repair of Bilateral Complete Cleft Lip." The Journal of Craniofacial Surgery, vol. 20 Suppl 2, 2009, pp. 1715-8.
Thomas C. Primary rhinoplasty by open approach with repair of bilateral complete cleft lip. J Craniofac Surg. 2009;20 Suppl 2:1715-8.
Thomas, C. (2009). Primary rhinoplasty by open approach with repair of bilateral complete cleft lip. The Journal of Craniofacial Surgery, 20 Suppl 2, 1715-8. https://doi.org/10.1097/SCS.0b013e3181b3ef2c
Thomas C. Primary Rhinoplasty By Open Approach With Repair of Bilateral Complete Cleft Lip. J Craniofac Surg. 2009;20 Suppl 2:1715-8. PubMed PMID: 19816337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary rhinoplasty by open approach with repair of bilateral complete cleft lip. A1 - Thomas,Chona, PY - 2009/10/10/entrez PY - 2009/12/25/pubmed PY - 2010/5/5/medline SP - 1715 EP - 8 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 Suppl 2 N2 - Nasal deformities inherent to a cleft are challenging. A controversy existed regarding the best time to correct these nasal problems. Now, there is a consensus that these nasal deformities are better to be dealt with along with repair of cleft lip.Primary cheilorhinoplasty involves proper reconstruction of clefted musculoaponeurotic complex by placing the muscles in their proper anatomic-physiologic orientation through careful identification, dissection, and mobilization of paranasal and labial musculature. In short, cleft repair is a muscle repair that enhances the establishment of a normal nasolabial complex. Delicate dissection and accurate repositioning of the lower alar cartilages during a primary lip repair will definitely help to establish a normal nasal shape. The nasal tissues must be supported with accurately placed sutures either by an open or a closed approach. The author prefers the open approach as published by Trott and Mohan (Br J Plast Surg 1993;46:215-222) with modifications because it has the added advantage for the identification and proper repositioning of the lower alar cartilages by accurately placed sutures under direct vision and the incisions of this procedure can be carried out through hidden rim incisions without any residual scars even in the colored population who were offered with this technique. Silicone nostril retainers, if available, during the immediate postoperative period will definitely promote the proper contours and the patency of the nostrils.Since 1994, the author has been performing this technique for patients with complete unilateral and bilateral cleft lip, which were presented separately. Patients with incomplete cleft lip were not included in this study because the nasal deformities were minimal, although the technique can be adopted for the correction of incomplete cleft lip nasal deformity also. Till December 2007, a total of 142 children with complete bilateral cleft lip with gross nasal deformities have been operated on and followed up. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19816337/Primary_rhinoplasty_by_open_approach_with_repair_of_bilateral_complete_cleft_lip_ DB - PRIME DP - Unbound Medicine ER -
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