RHINOPLASTY IN THE CLEFT-LIP PATIENT

Several important factors to consider in the surgical repair of the cl eft lip nose are described: the importance of an adequate lip closure technique to ensure symmetry can prevent a more conspicuous deformity of the nose during growth, the consequences of secondary rhinoplasty i n the growing nose in which the surgeon has to weigh the possible grow th inhibition due to scar tissue against the possible functional and e sthetic improvement, a systematic surgical approach in which the opera tive procedure is divided into different steps, and the use of autogen ous graft material. In the evaluation of 52 cleft lip patients (5 bila teral clefts, 47 complete unilateral clefts) who had undergone a secon dary rhinoplasty, two specific postoperative problems were encountered : slight to moderate recurrence of the caudal septal deviation (in uni lateral clefts) and restenosis of the nasal vestibule at the cleft sid e. Adjustment of the surgical technique and the use of a custom-made v estibulum device diminished these sequellae considerably.