Comparing definitive unilateral cleft rhinoplasty with and without diced-cartilage alar-base augmentation: A retrospective cohort study

Current Treatment Progress of Unilateral Cleft Lip Nasal Deformities

INTRODUCTION

Secondary nasal deformity following unilateral cleft lip is a common facial congenital malformation. Due to its complex treatment, there is currently no unified treatment plan in clinical practice. Dysplasia of cartilage, dislocation of muscles, and dysplasia of maxilla are the main causes of secondary nasal deformities of unilateral cleft lip. This article provides a comprehensive summary of the perioperative period and treatment process of unilateral cleft lip nasal deformities, aiming to find better clinical treatment guidance for patients with unilateral cleft lip and nasal deformity.

METHODS

A review of numerous previous studies on unilateral cleft lip nasal deformity, particularly within the last five years, was conducted to gather information on treatment strategies and perioperative care for unilateral cleft lip rhinoplasty.

CONCLUSION

Currently, there is still no unified final surgical method for the correction and treatment of unilateral cleft lip nasal deformity. In terms of surgical timing, simultaneous primary rhinoplasty and lip repair are gradually being recognized internationally, while intermediate rhinoplasty can be considered when it affects the patients social and psychological life. Patients with severe initial nasal deformity require multiple revisions. Secondary rhinoplasty remains the ideal treatment for final correction of secondary nasal deformities in unilateral cleft lip.

LEVEL OF EVIDENCE V

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Comprehensive repair of the alveolar cleft using cortical and cancellous bone layers: A retrospective study

To retrospectively review the clinical effect of comprehensive treatment of alveolar cleft (CTAC) using the mandible as the bone source. Patients with alveolar clefts who met the inclusion criteria were subjected to a CTAC protocol that included the following: (1) preoperative orthodontic treatment for creating good soft-tissue conditions; (2) 'area-like grafting' with subperiosteal osteogenic chin bone instead of cartilaginous osteogenic iliac bone; (3) simulation of normal bone anatomy via a sandwich-like bone graft consisting of 'cortical bone + cancellous bone + cortical bone'; and (4) strong internal fixation to ensure initial bone block stability. At 6 months postoperatively, the titanium plate was removed and cone-beam computed tomography was performed to evaluate the surgical results. A total of 54 patients underwent treatment with the CTAC protocol. The average age at the initial operation was 10.3 ± 2.1 years, and the average hospital stay was 2.8 ± 0.6 days. At 6 months postoperatively, 49 patients (90.7%) showed good clinical results. The transplanted bone block formed a 'cortical bone + cancellous bone + cortical bone' structure similar to that of the normal jawbone. A mature bone bridge formed, and the impacted permanent teeth continued to erupt and enter the bone graft area. CTAC is a comprehensive restorative solution for alveolar cleft repair that integrates multiple concepts, including orthodontics, embryology, anatomy, and improvements to surgical methods. The method is easy to perform, causes little surgical trauma, and shows a stable success rate, and is thus worth promoting.