Diced Cartilage Graft for Correction of Alar Base Asymmetry in Post Unilateral Cleft-Lip Nose Deformity.

Abstract

Background: Cleft lip is one of the most common birth defects. Unilateral cleft-lip nose deformity is often complicated by maxillary bone hypoplasia that involves the pyriform aperture.

Aim: To evaluate the outcome of using diced cartilage graft to correct asymmetry in the alar base postunilateral cleft lip nasal deformity through the analysis of preoperative and postoperative 3D CT volume rendering images, clinical assessments, and photogrammetry.

Patients and methods: This was a case series clinical trial conducted between April 2021 and April 2024 on 40 patients with post cleft-lip nose alar base asymmetry (treated by injection of diced cartilage for alar base asymmetry in addition to rhinoplasty). The patients were evaluated preoperatively and postoperatively using 3D CT volume rendering images processed using specialized programs (RadiAnt DICOM Viewer), clinical assessments, and photogrammetry.

Results: Forty unilateral cleft lip patients were included. There was a statistically highly significant difference between preoperative and postoperative evaluations among the studied patients regarding nostril height, alar base position, vertical lip length, nasal base inclination angle, and alar base width. In all, 10% of patients were unsatisfied, 82.5% were satisfied, and 7.5% were very satisfied. In all, 12.5% of patients had alar base asymmetry, 5% of patients had nostril asymmetry, and 82.5% of patients did not complain of asymmetry. Five percent of patients had a poor functional assessment, while 95% had a good functional assessment.

Conclusion: The use of diced cartilage showed excellent surgical outcomes in correcting alar base asymmetry in postunilateral cleft-lip nose deformity patients. The study demonstrated a statistically significant difference between preoperative and postoperative evaluations among the studied patients regarding nostril height, alar base position, vertical lip length, nasal base inclination angle, and alar base width, with a high score of patient satisfaction.

Level of evidence: Level II, therapeutic study.