Primary Septal Cartilage Graft for Unilateral Cleft Rhinoplasty: 10-Year Follow-Up Results and the Effect on Septal Deviation

Ueno K, Fukui M, Yao CF, Chen PK, Lu TC.

What this paper says

Ten years after primary cleft-lip nose repair in 60 children, those who received a septal cartilage rim graft on the cleft side had a higher inner nostril rim and a straighter septum than those who did not.

Overview

In infants with a unilateral cleft lip and palate, a small septal cartilage graft can be placed under the cleft-side nostril rim at the primary repair to improve symmetry. Short-term results were known; this study from Chang Gung's craniofacial centre compares 23 grafted and 37 non-grafted patients at 10 years, using nostril measurements, nasolabial angle, tip projection ratio and cephalometric septal deviation.

Sections of note

60 patients with unilateral complete cleft lip and palate; 23 grafted, 37 not.
The medial one-quarter of nostril height was higher in the graft group (P = 0.031).
Overall symmetry consistency did not differ significantly between groups.
Nasolabial angle and tip projection ratio, used as nasal growth measures, did not differ.
The graft group had a smaller septal deviation angle and length (P < 0.001).

What it means for a patient

Taking a small piece of septal cartilage in infancy did not impair nasal growth over 10 years in this study.
The graft gave a modest symmetry benefit at the inner nostril and was associated with a straighter septum.
Overall nose symmetry at 10 years was similar with or without the graft.

Why this paper matters

Ten-year follow-up data on cleft rhinoplasty techniques are rare, and growth disturbance is the main concern with early septal surgery. Limits: retrospective, unequal groups, and the graft decision was not randomised.

Terms

Cleft lip nasal deformity: the flattened, asymmetric nostril and tip that accompany a cleft lip.
Primary rhinoplasty (cleft): nasal correction done at the time of the infant lip repair.
Alar rim graft: cartilage placed along the nostril edge to support and shape it.
Cephalometry: standardised skull X-ray measurement.
Nasolabial angle: the angle between the upper lip and the columella.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“To enhance nasal symmetry, septal cartilage can be used as an alar rim graft on the cleft side during primary rhinoplasty. Short-term results have been favorable, but the long-term results are unclear. The authors compare nasal shape and septal deviation in patients with and without the graft at 10-year follow-up.…”

Excerpt; the full abstract is on PubMed.