A MODEL FOR THE CLEFT-LIP NASAL DEFORMITY

The underlying pathology of the cleft lip nasal deformity has yet to b e fully realized, and cleft lip rhinoplasty continues to challenge the reconstructive surgeon. A new model is proposed, which is composed of elements that represent known anatomical structures of the nose. Thes e structures are considered elemental to the mechanism of the primary cleft lip nasal deformity. The lobule is reduced to four arches. Five points on the skull provide foundations for these arches, which react interdependently to extrinsic forces and positional change. When certa in changes are imposed on the model, predictable alterations in the co nfiguration of the model imitate the observed deformities in the spect rum of the cleft lip nasal deformity, unilateral and bilateral, mild t hrough severe. The model is described with illustrations, anatomic dis section, physical models, and selected clinical cases. A better unders tanding of the mechanisms of the cleft nasal deformities can be obtain ed through analysis of the model.