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Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap: an anatomic approach.
Plast Reconstr Surg. 1998 Oct; 102(5):1350-7; discussion 1358-9.PR

Abstract

Adult incomplete cleft lip nose deformity is not uncommon in India. Poverty, ignorance, and parental neglect account for its late presentation. Besides the classical features of cleft lip nose deformity, the constant findings observed in this patient population have been a widened and depressed nasal sill. This is attributable to the sparse, hypoplastic, and abnormally orientated orbicularis oris muscle in the region of the sill. Failure to restore the nasal sill symmetry by suitably augmenting the sill frequently leads to unsatisfactory and asymmetric results. However, in the literature, satisfactory restoration of the nasal sill has not been given the importance it deserves while performing cleft lip rhinoplasty. We present a method of augmenting the depressed nasal sill in cases of adult incomplete nose deformity using a superiorly based orbicularis oris muscle flap, which is harvested from the soft tissues between the apex of the cleft and the nostril sill. Following de-epithelialization of the overlying skin, the exposed muscle is raised as a superiorly based flap after dissecting it from the underlying mucosa. It is folded, turned over, and tucked into the nasal sill base and anchored to the anterior nasal spine to give the desired augmentation. Satisfactory results have been obtained in 18 cases of nasal deformity associated with incomplete cleft lip. In our opinion, this technique offers a simple and effective method of augmenting the depressed sill by utilizing locally available tissues and without the need for procuring autologous tissue from distant sites.

Authors+Show Affiliations

Post Graduate Department of Plastic and Reconstructive Surgery at King George's Medical College, Lucknow, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9773989

Citation

Agarwal, R, et al. "Nasal Sill Augmentation in Adult Incomplete Cleft Lip Nose Deformity Using Superiorly Based Turn Over Orbicularis Oris Muscle Flap: an Anatomic Approach." Plastic and Reconstructive Surgery, vol. 102, no. 5, 1998, pp. 1350-7; discussion 1358-9.
Agarwal R, Bhatnagar SK, Pandey SD, et al. Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap: an anatomic approach. Plast Reconstr Surg. 1998;102(5):1350-7; discussion 1358-9.
Agarwal, R., Bhatnagar, S. K., Pandey, S. D., Singh, A. K., & Chandra, R. (1998). Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap: an anatomic approach. Plastic and Reconstructive Surgery, 102(5), 1350-7; discussion 1358-9.
Agarwal R, et al. Nasal Sill Augmentation in Adult Incomplete Cleft Lip Nose Deformity Using Superiorly Based Turn Over Orbicularis Oris Muscle Flap: an Anatomic Approach. Plast Reconstr Surg. 1998;102(5):1350-7; discussion 1358-9. PubMed PMID: 9773989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap: an anatomic approach. AU - Agarwal,R, AU - Bhatnagar,S K, AU - Pandey,S D, AU - Singh,A K, AU - Chandra,R, PY - 1998/10/17/pubmed PY - 1998/10/17/medline PY - 1998/10/17/entrez SP - 1350-7; discussion 1358-9 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 102 IS - 5 N2 - Adult incomplete cleft lip nose deformity is not uncommon in India. Poverty, ignorance, and parental neglect account for its late presentation. Besides the classical features of cleft lip nose deformity, the constant findings observed in this patient population have been a widened and depressed nasal sill. This is attributable to the sparse, hypoplastic, and abnormally orientated orbicularis oris muscle in the region of the sill. Failure to restore the nasal sill symmetry by suitably augmenting the sill frequently leads to unsatisfactory and asymmetric results. However, in the literature, satisfactory restoration of the nasal sill has not been given the importance it deserves while performing cleft lip rhinoplasty. We present a method of augmenting the depressed nasal sill in cases of adult incomplete nose deformity using a superiorly based orbicularis oris muscle flap, which is harvested from the soft tissues between the apex of the cleft and the nostril sill. Following de-epithelialization of the overlying skin, the exposed muscle is raised as a superiorly based flap after dissecting it from the underlying mucosa. It is folded, turned over, and tucked into the nasal sill base and anchored to the anterior nasal spine to give the desired augmentation. Satisfactory results have been obtained in 18 cases of nasal deformity associated with incomplete cleft lip. In our opinion, this technique offers a simple and effective method of augmenting the depressed sill by utilizing locally available tissues and without the need for procuring autologous tissue from distant sites. SN - 0032-1052 UR - https://www.unboundmedicine.com/medline/citation/9773989/Nasal_sill_augmentation_in_adult_incomplete_cleft_lip_nose_deformity_using_superiorly_based_turn_over_orbicularis_oris_muscle_flap:_an_anatomic_approach_ L2 - https://Insights.ovid.com/pubmed?pmid=9773989 DB - PRIME DP - Unbound Medicine ER -