Long-Term Outcome of Secondary Cleft Rhinoplasty in Patients with Secondary Nasal Deformity: Optimal Indications for Tajima Technique

Overview

The Chinese authors grouped non-syndromic patients with secondary unilateral cleft nasal deformity treated with the Tajima reverse-U incision by age (4-13 years n = 56; 13-18 n = 22; over 18 n = 18) and severity (mild 7, moderate 22, severe 67), and followed them for five years with FACE-Q and nasal symmetry measurements.

Sections of note

• 96 patients completed FACE-Q for nose and nostril.
• Nostril satisfaction: 79.72 before, 85.95 at 1 week, 82.61 at 5 years.
• Five symmetry parameters changed significantly at 1 week; the correction was maintained at 5 years in the 4-13 age group.
• Mild deformities held improvement in sill height ratio; moderate deformities held four parameters.
• Level of Evidence IV.

What it means for a patient

• For a child with a mild or moderate cleft nose asymmetry, the Tajima procedure before adolescence gave lasting improvement in this series.
• Severe deformities and older patients did not show the same maintained benefit, implying they may need a different or more structural operation.
• Satisfaction rose modestly and stayed above baseline at five years.

Why this paper matters

It gives five-year, age- and severity-stratified data on a widely used cleft technique, which helps decide who should get it. Limits: retrospective, uneven group sizes, single centre.

Terms

• Tajima reverse-U incision: a rim incision that allows the cleft-side tip cartilage to be lifted and sutured into symmetry.
• Secondary cleft nasal deformity: residual asymmetry after the original cleft repair.
• FACE-Q: a validated patient-reported outcome questionnaire.
• Nasal sill: the floor of the nostril opening.
• Non-syndromic: a cleft not part of a wider genetic syndrome.