Symmetry and morbidity assessment of unilateral complete cleft lip nose corrected with or without primary nasal correction

Objective: Unilateral complete cleft lip patients treated with or without a primary nasal correction at the time of cleft lip repair were compared to evaluate the relevance of early surgical correction of the nose by using tw o assessments: nasal symmetry and morbidity, Design, Setting, Patients: The no nasal correction group (NNC, n = 19) was operated by surgeon A using the Millard technique. The primary nasal correc tion group (PNC, n = 9) was operated by surgeon B combining the modified Mi llard technique with a columellar lift and alar mobilization. Symmetry was assessed on two sets of standardized photographs at 9 years of age using a computer-assisted analysis. Both cleft groups were compared with normal con trols (NC, n = 20). The computer method included area and angular measureme nts. Morbidity was assessed by the number of procedures on the vermilion, t he lip, and/ or nose for revisional surgery up to the age of 9 (NNC, n = 26 ; PNC, n = 12). Results: No significant differences in symmetry were found between the NNC and PNC groups regarding the area and angular measurements. With regard to the area measurements, both cleft groups produced a significant asymmetry w hen compared to the NC group. Concerning the angular measurements, however, the NNC group differed significantly from the NC group, whereas such a dif ference could not be noted between the PNC group and NC group. With respect to morbidity, no revisional procedures were performed in the PNC group. Th e number of revisional procedures in the NNC group was 16 in 10 patients. Conclusion: Results are presented that favor, up to the age of 9 years, a p rimary nasal correction at the time of cleft lip repair.