EARLY CORRECTION OF THE NOSE IN UNILATERAL CLEFT-LIP PATIENTS USING AN OPEN METHOD - A 10-YEAR REVIEW

Purpose: To review a 10-year follow-up of cases with rhinoplasty for a cleft lip-associated nose deformity done during the preschool years. Materials and Methods. Sixteen patients from 16 to 19 years of age wer e evaluated with two indices: the nasal index and the lobule portion o f the columella index. Results: Several years after surgery the result s appeared to be reasonably satisfactory. However, as the patients app roached their adolescent growth spurt at 15 years of age, undesirable features became obvious, Each patient showed a strikingly bulbous nose , The nasal index of male patients ranged from 68.8% to 82.7% (mean, 7 5.4%) and that of female patients ranged from 72.7% to 85.0% (mean, 79 .2%). The mean value of the nasal index in the Japanese male and femal e is 58.5% +/- 1.5% and 59.0% +/- 1.0%, respectively. The lobule porti on index of male patients ranged from 57.1% to 72.0% (mean, 65.1%) and that of female patients ranged from 62.5% to 82.0% (mean, 74.2%). The lobule portion of the columella constitutes 33% of the total columell ar length on average. Conclusions: A possible cause of the undesirable deformities is use of an open surgical method. A second possible caus e is mobilization and suspension of the alar cartilages. These undesir able features may occur only in Oriental noses.