Morphological analysis of the lip and nose following cleft lip repair with simultaneous partial primary rhinoplasty: A prospective study over 4 years

IntroductionFacial clefts involve complex abnormalities. The therapy is elaborate, and a critical evaluation of therapeutic outcome is required. Our study analyzed the lip and nose deformities associated with unilateral clefts in a prospective longitudinal study.Material and methodsA total of 33 patients with a cleft lip or cleft lip and alveolus (UCL) and 46 with a cleft lip and palate (UCLP) were treated using a similar concept. Standardized photographs were taken preoperatively (age 0.4–0.52 years) and again aged 4.04–4.59 years. Anthropometric analyses were performed and compared with age-matched normal values.ResultsNostril width (UCL = 1.01, UCLP = 1.03) and nostril floor width (UCL = 1.02, UCLP = 1.04) were almost symmetric. Nasal tip angles were normalized by surgery. Upper labial height improved, but remained slightly reduced (−4% to −6%). Upper vermillion length was increased (15–17%), and vermillion width was reduced (−12% to −13%) postoperatively. A significantly flatter nostril axis inclination persisted, especially on the affected side (UCL: 37.5°; UCLP: 38.5°), when compared with normal values (53.8°).ConclusionMost cleft irregularities were almost eliminated by therapy; however, the outcome is still not satisfactory for some parameters. The rehabilitation of patients with clefts remains a considerable surgical challenge. Facial anthropometric assessment must play an important role in order to detect and overcome therapeutic shortcomings.