The use of nasal splints in the primary management of unilateral cleft nasal deformity

Primary surgical correction of the cleft lip nasal deformity is routinely p erformed at the Craniofacial Center at Chang Gung Memorial Hospital. Over t ime, however, there is a tendency for the lower lateral cartilage to retain its memory and, subsequently, recreate the preoperative nasal deformity. T herefore, it is current practice to use a nostril retainer for a period of at least 6 months to maintain the corrected position of the nose. The aim o f this study was to qualitatively assess the benefit of postoperative nasal splinting in the primary management of unilateral cleft nasal deformity. Data from two groups of 30 patients with complete unilateral cleft lips eac h were retrospectively collected and analyzed. The first group sewed as a c ontrol (no nasal splints), and the second group used the nasal retainer com pliantly for at least 6 months postoperatively. All patients had their prim ary lip repair at 3 months of age. A photographic evaluation of the results when the patients were between 5 and 8 years of age was conducted. The par ameters used to assess the nasal outcome were nostril symmetry, alar cartil age slump, alar base level, and columella tilt. The first scores were based on residual nasal deformity, and the second set were based on overall appe arance. It was found that the mean scores of residual nasal deformity for all four parameters in patients who used the nasal stent were statistically better t han the scores of patients who did not (p values ranged from 0.0001 to 0.00 5). The overall appearance scores for the four parameters in the patients w ho used the nasal stent after surgery were also statistically better than t he scores for those who did not (p Values ranged from 0.0001 to 0.01). The results show that postoperative nasal splinting in the primary manageme nt of the unilateral cleft nasal deformity serves to preserve and maintain the corrected position of the nose after primary lip and nasal correction, resulting in a significantly improved aesthetic result. Therefore, it is re commended that all patients undergoing primary correction of complete unila teral cleft deformity use the nasal retainer postoperatively for a period o f at least 6 months.