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Facial Plast Surg 2020; 36(01): 102-111
DOI: 10.1055/s-0040-1701477
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Controversies in Cleft Rhinoplasty

Steven G. Hoshal
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology –Head and Neck Surgery, University of California Davis, Sacramento, California
,
Roberto N. Solis
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology –Head and Neck Surgery, University of California Davis, Sacramento, California
,
Travis T. Tollefson 
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology –Head and Neck Surgery, University of California Davis, Sacramento, California
› Author Affiliations Funding None.
Further Information

Publication History

Publication Date:
19 March 2020 (online)

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Abstract

Rhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip–palate are technically and intellectually challenging to master requiring a patient-tailored approach. The shape and structure of the nose are changed to improve both function and aesthetic appearance. In the primary setting, nasoalveolar molding is a form of presurgical infant orthopaedics used for preparation before the cleft lip and nose repair. Intermediate stages should be conservative to minimize scarring, while the definitive cleft rhinoplasty utilizes cartilage grafts from septum, ear, or rib to sculpt the nose. Hereinto, we will outline the controversies, the evidence supporting certain techniques, and our preferences.

Keywords

rhinoplasty - cleft lip - cleft nasal deformity - cartilage graft - definitive cleft rhinoplasty - intermediate cleft rhinoplasty - primary cleft rhinoplasty - nasoalveolar molding

Disclosures

None.


 

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