Subcutaneous Nasolabial Flap for Eliminating Depressed Nasal Floor in Adult Cleft Rhinoplasty: Technical Note

Overview

In people born with a cleft lip, the floor of the nostril on the cleft side is often depressed, and that dip extends into the nostril opening. Existing solutions require extra skin incisions beyond those used in a standard open rhinoplasty. The authors describe a flap of tissue from the nasolabial area, moved beneath the skin, to build up the floor.

Sections of note

• The problem addressed is a depressed nasal floor extending into the nostril in cleft patients.
• The stated drawback of existing methods is the need for skin incisions beyond the routine open rhinoplasty incisions.
• A subcutaneous nasolabial flap supplies the bulk under the depressed floor.
• The flap is covered by advancing the ala and by a triangular flap from the medial nasal floor.
• The paper is labelled a technical note, describing the method rather than reporting a series.
• No patient numbers, follow-up duration, complication rates or outcome measures are given in the abstract.

What it means for a patient

• The approach is for adults having secondary cleft rhinoplasty who still have a sunken nostril floor.
• Its stated advantage is avoiding additional visible incisions, since it works through cuts already being made.
• It fills the depression with the patient's own tissue rather than a graft or implant.
• With no reported cases, follow-up or complications in the abstract, nothing can be said about how well or how reliably it works.

Why this paper matters

The nostril floor is a small area but a persistent giveaway of a repaired cleft, and correcting it late in adulthood is difficult because scarred tissue resists being moved. Reusing existing access is the practical contribution here. Whether the added bulk persists over years is not reported.

Terms

• Cleft rhinoplasty: nasal surgery in a person born with a cleft lip or palate.
• Nasal floor: the base of the nostril, forming the roof of the mouth's front edge.
• Nasolabial: the region between the side of the nose and the corner of the mouth.
• Subcutaneous flap: a piece of tissue moved beneath the skin while keeping its blood supply.
• Ala: the outer wing of the nostril.
• Technical note: a short paper describing a surgical method rather than reporting results.