Cleft lip and cleft rhinoplasty complications

Overview

A cleft lip distorts the nostril, tip and base of the nose, and repairing it takes several operations from infancy through adolescence. Each operation can leave a new deformity. The authors review the range of secondary deformities that result from cleft lip and cleft rhinoplasty surgery and discuss how to manage them.

Sections of note

• Review article; no patient numbers, complication rates or outcomes appear in the abstract.
• Complications are attributed usually to errors in surgical planning and technique.
• The various secondary deformities after cleft lip and cleft rhinoplasty surgery are reviewed.
• Management options are discussed.
• The abstract does not list the specific deformities covered.

What it means for a patient

• A residual cleft nose deformity after earlier surgery is common and usually reflects the earlier operation rather than an unavoidable result of the cleft.
• Correction is possible but is more complex than a first-time rhinoplasty because of scar and altered anatomy.
• Expert review without data on how often each deformity occurs or how well each fix works.

Why this paper matters

Cleft rhinoplasty is among the hardest rhinoplasties, and its complications compound across a childhood of operations. This review, in a Facial Plastic Surgery complications issue, organizes them for surgeons who take on these patients. Outcome data by technique are not provided in the abstract.

Terms

• Cleft lip: a birth gap in the upper lip, often with a cleft of the palate, that pulls the nose out of shape.
• Cleft rhinoplasty: nasal surgery to correct the deformity caused by a cleft lip.
• Secondary deformity: a shape problem left after or caused by a previous operation.
• Alar base: the point where the nostril meets the cheek, often displaced in cleft noses.
• Nasal sill: the floor of the nostril opening.
• Surgical planning: deciding the steps, timing and sequence of operations before surgery.