Novel Titanium Tip Support in Cleft Rhinoplasty

Patients with cleft lip and palate often present with severe nasal deformities that require complex surgical correction. Titanium miniplates can offer stable support to the nasal tip and septum, potentially improving both aesthetics and function. This study aimed to evaluate functional and aesthetic outcomes after rhinoplasty in patients with cleft who underwent nasal reconstruction with titanium miniplates. A retrospective cohort study was conducted at the Foundation for Rehabilitation of Craniofacial Deformities (FUNDEF), Lajeado-RS, Brazil, including patients with cleft lip and palate who underwent definitive rhinoplasty with titanium miniplates between 2000 and 2024. Functional outcomes were assessed using the NOSE-p questionnaire, while aesthetic satisfaction was evaluated using the Portuguese version of the Utrecht Questionnaire, which included a visual analog scale (VAS). Data were analyzed statistically using paired t tests and Wilcoxon tests. A total of 41 patients (53.7% female, mean age 30.3±10.1) were included; 58.5% received costal cartilage grafts and 41.5% septal cartilage grafts together with titanium miniplates for anterior nasal spine reconstruction. Postoperatively, mean NOSE-p scores improved significantly from 62.44±27.04 to 21.22±16.49 ( P <0.001). Visual analog scale scores measuring the aesthetic self-perception improved from a median of 3.0 ( Q25-Q75: 2.0-4.0 ) to 8.0 ( Q25-Q75: 7.0-10.0 ). The total Utrecht score decreased from 17.51±4.44 to 7.88±2.78 ( P <0.001), indicating enhanced patient-reported nasal appearance. Three patients experienced complications (7.3%). Titanium miniplate-assisted rhinoplasty appears to be an effective secondary cleft nasal reconstruction approach for nasal tip support, providing functional and aesthetic improvements with a rigid and stable framework.