Correction of unilateral cleft lip nasal deformity in preschool and school-aged children with refined reverse-U incision and V-Y plasty: long-term follow-up results.

BACKGROUND: A total of 47 preschool and school-aged patients with cleft lip nasal deformities underwent surgery between September of 1996 and December of 2003. The age of the patients ranged from 4 to 10 years.

METHODS: A reverse-U incision and V-Y plasty were used in 40 patients with mild to moderate unilateral cleft lip deformities. An open rhinoplasty incision combined with a reverse-U incision and V-Y plasty was used in seven patients with severe unilateral cleft lip nasal deformities. The follow-up period ranged from 6 months to 9 years, with an average of 4 years.

RESULTS: The final results were evaluated on the basis of the degree of symmetry of both nostrils. The length of the longitudinal axis of the nostril and width at the midcolumella level were measured with calipers. Excellent results were obtained in 28 patients in whom alar-columella web deformities were absent or minimal, and a satisfactory symmetry of the nostrils was obtained. Thirteen patients showed good results, four patients showed fair results, and two patients showed poor results. Postoperative nostril symmetry was maintained within 1 to 2 years of follow-up. However, there was a mild change of the corrected alar-columella web 4 to 5 years after the operation.

CONCLUSIONS: These results suggest that the reverse-U incision and V-Y plasty are useful methods for creating symmetry of the nostrils in cases of cleft lip nasal deformities. In addition, they are recommended for a slight overcorrection of the cleft lip nasal deformity in preschool and school-aged children.