Tags

Type your tag names separated by a space and hit enter

A new modified forked flap and a reverse V shaped flap for secondary correction of bilateral cleft lip nasal deformities.
Chin Med J (Engl) 2011; 124(23):3993-6CM

Abstract

BACKGROUND

The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients.

METHODS

A technique to correct this deformity is described. This consists of (1) a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, (2) a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, (3) inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, (4) open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, (5) reconstruction of the orbicularis orismuscle as required, and (6) the flaring nostril floor advancing medially and constructing the sill.

RESULTS

This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions.

CONCLUSIONS

This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.

Authors+Show Affiliations

Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22340330

Citation

Yan, Wei, et al. "A New Modified Forked Flap and a Reverse V Shaped Flap for Secondary Correction of Bilateral Cleft Lip Nasal Deformities." Chinese Medical Journal, vol. 124, no. 23, 2011, pp. 3993-6.
Yan W, Zhao ZM, Yin NB, et al. A new modified forked flap and a reverse V shaped flap for secondary correction of bilateral cleft lip nasal deformities. Chin Med J. 2011;124(23):3993-6.
Yan, W., Zhao, Z. M., Yin, N. B., Song, T., Li, H. D., Wu, D., ... Wang, X. G. (2011). A new modified forked flap and a reverse V shaped flap for secondary correction of bilateral cleft lip nasal deformities. Chinese Medical Journal, 124(23), pp. 3993-6.
Yan W, et al. A New Modified Forked Flap and a Reverse V Shaped Flap for Secondary Correction of Bilateral Cleft Lip Nasal Deformities. Chin Med J. 2011;124(23):3993-6. PubMed PMID: 22340330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new modified forked flap and a reverse V shaped flap for secondary correction of bilateral cleft lip nasal deformities. AU - Yan,Wei, AU - Zhao,Zhen-Min, AU - Yin,Ning-Bei, AU - Song,Tao, AU - Li,Hai-Dong, AU - Wu,Di, AU - Gao,Feng, AU - Wang,Xin-Gang, PY - 2012/2/21/entrez PY - 2012/2/22/pubmed PY - 2012/6/14/medline SP - 3993 EP - 6 JF - Chinese medical journal JO - Chin. Med. J. VL - 124 IS - 23 N2 - BACKGROUND: The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients. METHODS: A technique to correct this deformity is described. This consists of (1) a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, (2) a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, (3) inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, (4) open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, (5) reconstruction of the orbicularis orismuscle as required, and (6) the flaring nostril floor advancing medially and constructing the sill. RESULTS: This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions. CONCLUSIONS: This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/22340330/A_new_modified_forked_flap_and_a_reverse_V_shaped_flap_for_secondary_correction_of_bilateral_cleft_lip_nasal_deformities_ L2 - http://Insights.ovid.com/pubmed?pmid=22340330 DB - PRIME DP - Unbound Medicine ER -