Component Restoration in the Unilateral Intermediate Cleft Lip Rhinoplasty: Our Experience and Technique Modification

Background: During a critical stage of children psycho-social development, tip asymmetries are addressed with an intermediate cleft lip rhinoplasty. The idea of individual restoration of each anatomical component is the foundation upon which the authors explain and assess the long-term results of that method for patients with unilateral cleft lip. Methods: Modified component restoration technique was used in all the study patients. The outcomes were compared to age-matched unilateral cleft lip control individuals (n = 20) in this prospective comparative study. As control patients, a different set of individuals with unilateral cleft lip who did not have an intermediate rhinoplasty was examined. Age-matched control patient photos were included at every interval in the study group. Preoperatively (time 0), immediately postoperatively (time 1), 3-6 months postoperatively (time 2), and more than a year postoperatively (time 3), if available, were the four time periods at which standardized basal view images were evaluated.Results: Preoperative (time 0) baseline comparison between the study and the control groups showed significant differences regarding the nostril dimensions at the cleft side (P value 0.027) and alar symmetry (P value 0.000) denoting more severe deformity in the study group. At time 1, the study showed significant improvement regarding the alar symmetry (P value 0.000), and nasal tip protrusion (P value 0.004). At time 2, the study added significant improvement regarding the nostril dimensions at the cleft side (P value 0.049) that may reflect the importance of follow-up and using the nostril silicon retainer. At all times no significant changes regarding the nostril measures at non-cleft side were noticed.Conclusion: Alar symmetry, nostril diameters at the cleft side, and nasal tip protrusion are all improved by the modified component restoration approach used in the unilateral intermediate cleft lip rhinoplasty.