Resorbable Plates in Secondary Cleft Nasal Reconstruction

Abstract

Objective:

The authors report on the use and complications of alloplastic resorbable plates and compare their use to autologous cartilage grafts in secondary cleft nasal reconstruction.

Design:

Institutional review board (IRB)–approved retrospective chart review.

Setting:

Texas Cleft-Craniofacial Center at the McGovern Medical School at the University of Texas Health Sciences Center at Houston.

Patients:

Patients with unilateral or bilateral cleft lip nasal deformity who have undergone secondary correction of their nasal deformity with at least 1-year follow-up.

Interventions:

During their reconstruction, some patients had cartilage grafts used for support, whereas others were reconstructed using resorbable plates.

Main Outcome Measure(s):

Complications (exposure, infection, malposition, hematoma/seroma) and rates of tertiary revisions.

Results:

197 patients underwent secondary cleft nasal reconstruction, with 30 patients in the resorbable plate group and 32 in the cartilage graft group. Age at surgery was 8.5±4.1 years with resorbable plates and 11.0±4.8 years with cartilage graft (P = .03). Infection rate in the resorbable plate group and cartilage graft group were 0% and 3.25% (P = 1). Extrusion occurred in 3 of the absorbable plate group and 2 patients with cartilage graft (P = .67). Additional surgery was recorded in 43.3% of the resorbable plate group versus 53.1% of the cartilage graft group (P = .459).

Conclusion:

The data provide evidence that the use of alloplastic resorbable plate in the pediatric population is a safe alternative to autologous septal cartilage in secondary cleft nasal reconstruction. There is no statistical difference in short-term complications or the incidence of additional nasal surgery.