Three Dimensional Rhinoplasty and Nasal Airway Improvement in Cleft-Nose Deformity

Abstract

Septorhinoplasty is particularly challenging among revision surgeries for cleft sequelae. The challenge of cleft septorhinoplasty is mainly due to the complex anatomy of nose, deformity of each of its components and the difficulty and lack of clarity in surgical management. From 2014 to 2017, 26 patients with cleft lip nose deformity were operated by the same cleft team. The study was conducted to assess the improvement in nasal airway and appearance following secondary rhinoplasty with extracorporeal septoplasty. Post operatively each patient was evaluated using the standard modified rhinoplasty outcome evaluation questionnaire, a validated instrument that aids in stratifying patients according to their subjective response. All patients reported great relief of nasal obstruction and improved breathing. More than 80% of our patients were satisfied with improved aesthetics and reported better self-confidence. Secondary cleft rhinoplasty with extracorporeal septoplasty surgery significantly improves the cosmesis and nasal airway opening, subsequently giving them improved self-confidence.

Keywords: Cleft rhinoplasty; Congenital cleft deformity; Extracorporeal septoplasty; Functional nasal airway; Rhinoplasty outcome evaluation.

Fig. 1

Comparison of pre-op and post-op total mean scores based on rhinoplasty outcome evaluation (ROE) questionnaire results. Similar comparison for unilateral and bilateral subgroups is also shown

Fig. 2

Comparison of difference in scores for individual questions of rhinoplasty outcome evaluation (ROE) questionnaire. Difference in score = post-op score − pre-op score (x axis—questions, y axis—mean scores of each question)

Fig. 3

Photographs showing the surgical results of two representative patients