Long-Term Outcome of Secondary Cleft Rhinoplasty in Patients with Secondary Nasal Deformity: Optimal Indications for Tajima Technique.

Background: The authors investigated the timing of and indications for the Tajima reverse-U incision for correcting secondary unilateral cleft nasal deformities.

Methods: Nonsyndromic patients with secondary cleft lip and nasal deformity who received Tajima reverse-U incision rhinoplasty were grouped by age (4 to 13 years, n = 56; 13 to 18 years, n = 22; older than 18 years, n = 18) and severity of deformity (mild deformity, n = 7; moderate deformity = 22; severity deformity = 67) during 5-year follow-up. FACE-Q assessment and nasal symmetry measurements were used in this study.

Results: Ninety-six patients completed the FACE-Q assessment for the nose and nostril. The results showed higher satisfaction with nostril appearance 1 week after surgery (85.95 ± 13.01) compared with before surgery (79.72 ± 11.89), maintained at the 5-year follow-up (82.61 ± 14.06). Significant differences were observed in 5 nasal parameters (nasal height ratio, one-fourth media part of nostril height ratio, nasal sill height ratio, columellar angle, and inner nostril height-to-width ratio [cleft]) at 1 week postoperatively, and the corrected outcome of the Tajima technique was maintained 5 years after surgery in the 4- to 13-year age group. The same statistically significant changes were found in nasal sill height ratio in the mild deformity group and nostril width ratio, one-fourth media part of nostril height ratio, columellar angle, and inner nostril height-to-width ratio (cleft) in the moderate deformity group.

Conclusion: The Tajima procedure was beneficial for preadolescent children and children with mild to moderate unilateral cleft nasal deformities.

Clinical question/level of evidence: Therapeutic, IV.