Primary Correction of Nasal Septal Deformity in Unilateral Clefts during Lip Repair—A Long-Term Study

Abstract

Objective The aim of this study was to assess the long-term effect of primary septal correction carried out during lip closure on the nasal septum. Materials, Subjects, and Methods Before primary septal correction was introduced, specimens from the septal cartilage and the anterior nasal spine of 10 deceased newborns and infants were analyzed with the aid of a light microscope to verify the presence of any growth zone. The study group comprised 91 children with unilateral clefts who had undergone primary lip repair with septal correction. The control group comprised 29 children with unilateral clefts operated on without primary septal correction. The appearance of the nasal septum was assessed on extraoral photographs in the second week of life and then 10 to 14 years postoperatively. Results Morphologic examination revealed fibrous connective tissue with no signs of growth between the cartilaginous septum and bone. At long-term examination, the study group was found to have a nasal septum that was straight in 75 (83%), moderately deviated in 14 (15%), and severely deviated in two (2%) patients, whereas in the control group, the septum was considered straight in four (14%) children, moderately deviated in 11 (38%), and severely deviated in 14 (48%). Conclusions Primary septal correction may be considered safe because no growth zone exists between the septal cartilage and the anterior nasal spine. Careful primary nasal septal correction improves nose shape in a way that allows normal growth.