Evaluation of Elevated Nasal Clip Application in Unilateral Cleft Lip Nasal Deformity Correction

Background This study aims to characterize the long-term relapse patterns and evaluate the effectiveness of a novel elevated nasal clip in maintaining postoperative nasal symmetry in patients with unilateral cleft lip nasal deformity. Methods This study included a preliminary retrospective analysis to contextualize long-term relapse patterns, followed by a prospective randomized controlled trial, which constituted the principal component of the work. First, we conducted a preliminary retrospective analysis to contextualize long-term relapse patterns: we reviewed 2 independent cohorts of patients who underwent primary unilateral cleft lip repair and were followed up at 5 and 10 years postoperatively, respectively. Second, the main component of this study was a prospective randomized controlled trial designed to evaluate the efficacy of the elevated nasal clip, with postoperative follow-up at 6 and 12 months. Both parts employed standardized frontal and basal-view facial photographs and identical anthropometric parameters to quantitatively assess nasal symmetry. Results Long-term follow-up revealed progressive relapse in nasal morphology, particularly in deviation of the nasal tip and nostril height asymmetry by 10 years postoperatively. These findings provide a clinical context underscoring the importance of maintaining early nasal symmetry after cleft lip repair. On this basis, we designed a prospective randomized controlled study to rigorously evaluate the efficacy of an elevated nasal clip in patients with incomplete unilateral cleft lip. Compared with the traditional retainer group, the elevated nasal clip group demonstrated significantly better preservation of columella ratio, nostril height ratio, and nostril area ratio, supporting its clinical value as a targeted adjunct for early nasal symmetry maintenance. Conclusion Our study confirmed the progressive and multidimensional nature of long-term nasal symmetry relapse following primary cleft rhinoplasty, underscoring the need for early and effective interventions. Recognizing this long-term vulnerability underscores the need for effective early interventions. In this context, our prospective study demonstrates that the elevated nasal clip provides individually targeted improvement in columella and nostril symmetry, supporting its promise as a practical adjunct for postoperative nasal remodeling after unilateral cleft lip repair.