International Journal of Head and Neck Surgery

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VOLUME 11 , ISSUE 2 ( April-June, 2020 ) > List of Articles

REVIEW ARTICLE

Secondary Rhinoplasty on Patients with Cleft Lip and Palate: A Review

Vijayaranghan Sathyabama, Muthusubramanian Veerabahu

Keywords : Cleft lip and palate, Columella lengthening, Rhinoplasty, Secondary rhinoplasty, Steal technique, Strut graft,Augmentation grafts

Citation Information : Sathyabama V, Veerabahu M. Secondary Rhinoplasty on Patients with Cleft Lip and Palate: A Review. Int J Head Neck Surg 2020; 11 (2):26-31.

DOI: 10.5005/jp-journals-10001-1386

License: CC BY-NC 4.0

Published Online: 00-06-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: The cleft lip and palate patients undergo a series of surgical procedures from the time of their birth, wherein the primary cleft lip correction procedure is carried out. The last in the series is rhinoplasty after the maxillary skeletal base has been set right in its dynamics with the mandibular base. The degree of deformity lies in the type of cleft and its accompanying features. The timing of correction at the primary lip closure stage, allowing a repositioning of the lateral nares, the detailed examination of the nose at the time of presentation ascertains the degree of augmentation necessary. Background: The first mention of rhinoplasty dates back to the dates of Shusruta and his disciples who managed to reconstruct parts of the nose and ear, which were sliced as a part of criminal punishment. The Roman encyclopedist published the techniques of reconstruction, followed by the Europeans. By the 11th century, the Arabs converted Shushruta\'s book into Sanskrit, and this spread to the Western atmosphere. Evidence for a free flap graft and a forehead graft that were adopted and published by Doctors Cruzo and Findlay in 1794 are the first steps to the modern rhinoplasty techniques. Review results: The correction of the nose at the primary surgery of the cleft lip was widely accepted to reduce the gross deformities that would manifest if the small corrections were not made appropriately the first time. The caudal resection of septae was identified as the reason for the growth deformities that happened secondarily. The secondary rhinoplasty was to be performed as a final procedure after the growth phase when all other surgical procedures were done and dealt with leaving an L-shaped strut of the septae at the dorsal, and the caudal end was advocated for a stable result of the septum without any buckling and further deformity. Conclusion: The key to performing a near-perfect procedure lies in the clinical assessment at the time of presurgical presentation.


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