Use of The Open Approach for Repair of Secondary Cleft Lip-Nasal Deformities

Abstract

The anatomic characteristics of both the unilateral and bilateral cleft lip-nasal deformities at birth have been well described. The typical secondary cleft lip-nasal deformity is a product of the primary deformity and any past surgical attempts at correction. Secondary deformities usually involve abnormalities in all tissue layers and in all three planes., Correction of secondary cleft lip-nasal deformities involves precise diagnosis and treatment. The open approach provides maximal exposure for suture fixation of columellar struts, vertical division and reconstitution of the LLC, and accurate placement and suturing of nasal tip grafts. Careful use of these techniques improves nasal tip projection, definition and symmetry. Other methods such as alar base augmentation and alotomy with active placement of the alar rim aid in treatment of the nasal tip and alar base.