Longitudinal Anatomic Analysis of Primary Cleft Lip Rhinoplasty Outcomes

Abstract

Background:

The unilateral cleft lip deformity is associated with nasal deformities with secondary functional and aesthetic challenges.

Objectives:

Compare the change in nasal symmetry before and incrementally after primary endonasal cleft rhinoplasty concurrent with lip repair.

Methods:

This is a retrospective chart review of infants undergoing unilateral cleft lip repair. Data collection included demographics, surgical history, and pre- and postoperative alar and nostril photographs analyzed with Image J. Statistical analysis was done using linear and multivariable mixed effect models.

Results:

Twenty-two patients with a near even gender distribution (46% female) and primarily left-sided cleft lips underwent unilateral lip repair at a mean age of 3.9 months (median 3.0, range 2–12). Mean pre- and postoperative alar symmetry ratios were 0.099 (standard error [SE] 0.0019) and −0.0012 (SE 0.0179), with zero representing perfect symmetry and negative values indicating overcorrection. These values at 1, 2–4, 5–7, 8–12, 13–24, and 25+ months were 0.026, 0.050, 0.046, 0.052, 0.049, and 0.052 (SE range: 0.0015–0.0096), respectively, demonstrating stability of the alar symmetry 4 months postrepair.

Conclusions:

In this study, patients who underwent an overcorrective primary cleft rhinoplasty concurrent with lip repair had an initial regression of symmetry within the first 4 months postoperatively, followed by observed stabilization.