Improvement of Nasal Airway Morphology and Ventilation in Patients With Cleft Lip Nasal Deformity by Repositioning of Lower Lateral Cartilage.

Abstract

Objective: This study introduces a modified surgical approach to improve the nasal morphology and ventilation function of cleft lip patients by repositioning the lower lateral cartilage.

Methods: This study concluded 28 patients with unilateral cleft lip nasal deformity. All patients underwent modified rhinoplasty by repositioning lower lateral cartilages between October 2022 and April 2024. Preoperative and postoperative nasal airway morphology and ventilation were measured objectively. Nasal airway morphological characteristics were obtained using an acoustic rhinometer, including nasal volume (NV 0-2 , NV 2-7 , NV 7-11 , distance from nostril 0-2 cm, 2-7 cm, 7-11 cm), internal nasal valve area (INVa), and external nasal valve area (ENVa). The anterior rhinomanometry was used to evaluate nasal resistance, including unilateral effective resistances during inspiration (Reffin), expiration (Reffex), and the entire breath (ReffT), as well as unilateral vertex resistance during inspiration (VRin) and expiration (VRex).

Results: The average age of the patients was 16.6 years old, ranging from 12 to 25 years old. The mean follow-up period was 9.8 months, ranging from 6 to 17 months. There was a significant increase in the postoperative ENVa and NV 0-2 on the cleft side compared with preoperative data, whereas there was no significant change in the INVa. All ventilatory resistances on the cleft side were significantly reduced compared with the preoperative resistances.

Conclusion: This modified technique relies on the anatomic repositioning of the lower lateral cartilages to improve nasal morphology and ventilation in cleft lip patients, which achieved remarkable effect.