Our Summary

The research discusses the complexities of repairing nasal deformities associated with cleft lip conditions. Cleft lip is a condition where a person is born with a split or opening in the lip, which can also affect the shape of the nose. The paper emphasizes the importance of understanding the three-dimensional structure of the affected nose to choose the best surgical method for repair.

Before nose surgery, doctors should do an orthognathic surgery, which corrects conditions that affect the jaw and face. This step is essential to ensure the best outcome from the nose surgery.

The paper also lists the goals of secondary nose surgery, which is often required in such cases. These include relieving any blockage in the nose, creating balance and symmetry, defining the shape of the nose base and tip, and managing scarring.

The study particularly highlights the importance of septal reconstruction, which is a procedure to straighten the wall between the nostrils, in treating cleft nose deformities.

FAQs

  1. What is the connection between a cleft lip deformity and a nasal deformity?
  2. What are the goals of secondary rhinoplasty in patients with a cleft lip deformity?
  3. Why is septal reconstruction a key maneuver in cleft rhinoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft lip repair is to follow post-operative care instructions closely to ensure proper healing and optimal results. This may include avoiding certain foods or activities that could potentially cause harm to the surgical site, as well as keeping the area clean and protected. It is also important to attend follow-up appointments with the surgeon to monitor progress and address any concerns.

Suitable For

Patients with a cleft lip deformity are typically recommended for cleft lip repair surgery. These patients often have an associated nasal deformity that may require surgical intervention as well. The goals of cleft lip repair surgery include improving the appearance and function of the lip, creating symmetry, and improving overall facial aesthetics.

In some cases, patients may also require secondary rhinoplasty surgery to address nasal obstruction, asymmetry, scarring, and other issues related to the cleft deformity. Orthognathic surgery may also be recommended before nasal surgery to optimize the overall result.

It is important for surgeons to have a thorough understanding of the anatomy of the cleft nose in order to select the proper technique for repair. Septal reconstruction is a key maneuver in cleft rhinoplasty, and surgical techniques such as closed rhinoplasty and open rhinoplasty may be used to achieve the desired outcomes.

Overall, patients with cleft lip deformities may benefit from cleft lip repair surgery, secondary rhinoplasty, and other surgical interventions to improve both the appearance and function of the affected areas.

Timeline

Before cleft lip repair:

  • Patient is diagnosed with cleft lip deformity during prenatal ultrasound or shortly after birth
  • Patient undergoes evaluation by a multidisciplinary team including plastic surgeons, otolaryngologists, speech therapists, and orthodontists
  • Surgical planning and preparation is done, including discussion of the procedure, risks, and post-operative care
  • Patient may undergo presurgical orthodontic treatment to align the teeth and prepare for surgery

After cleft lip repair:

  • Surgery is performed to repair the cleft lip, typically between 3-6 months of age
  • Patient is monitored closely post-operatively for any complications or issues with healing
  • Follow-up appointments are scheduled to monitor growth and development of the repaired lip and to address any concerns
  • Patient may require additional surgeries, such as cleft rhinoplasty, as they grow and develop
  • Long-term follow-up is recommended to monitor for any issues with speech, hearing, dental development, and facial growth.

What to Ask Your Doctor

  1. What is the best timing for cleft lip repair surgery?
  2. What are the risks and potential complications of cleft lip repair surgery?
  3. What type of anesthesia will be used during the surgery?
  4. How long will the recovery process take, and what can I expect during the recovery period?
  5. Will there be visible scarring after the surgery, and if so, how can it be minimized?
  6. Will additional surgeries be needed in the future for further correction or improvement?
  7. What are the expected results of the cleft lip repair surgery in terms of function and appearance?
  8. Are there any specific post-operative care instructions or restrictions I should follow?
  9. What type of follow-up care will be needed after the surgery?
  10. Can you provide me with before and after photos of previous cleft lip repair surgeries you have performed?

Reference

Authors: Sykes JM, Tasman AJ, Suárez GA. Journal: Clin Plast Surg. 2016 Jan;43(1):223-35. doi: 10.1016/j.cps.2015.09.016. PMID: 26616710