Controversies in Cleft Rhinoplasty

Author:

Hoshal Steven G.1,Solis Roberto N.1,Tollefson Travis T.1ORCID

Affiliation:

1. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology –Head and Neck Surgery, University of California Davis, Sacramento, California

Abstract

AbstractRhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip–palate are technically and intellectually challenging to master requiring a patient-tailored approach. The shape and structure of the nose are changed to improve both function and aesthetic appearance. In the primary setting, nasoalveolar molding is a form of presurgical infant orthopaedics used for preparation before the cleft lip and nose repair. Intermediate stages should be conservative to minimize scarring, while the definitive cleft rhinoplasty utilizes cartilage grafts from septum, ear, or rib to sculpt the nose. Hereinto, we will outline the controversies, the evidence supporting certain techniques, and our preferences.

Publisher

Georg Thieme Verlag KG

Subject

Surgery

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