Nostril suspension and lip adhesion improve nasal symmetry in patients with complete unilateral cleft lip and palate

Background: There is a difference between complete and incomplete cleft lip with regard to the nasal shape. Severe nasal deformity is found in almost all cases of complete cleft lip. This problem has been approached by preoperative nasoalveolar moulding, primary nasal correction and the use of a nostril retainer. We corrected the nasal deformity associated with complete cleft lip by using the combination of a nostril suspender and lip adhesion before cleft lip repair. The present article outlines this treatment strategy and assesses the effects of our treatment on nasal deformity. Methods: Fourteen patients with complete cleft lip and palate were assigned to two groups for retrospective analysis: group A comprised seven patients, who underwent cleft lip repair after a combination of nostril suspension and lip adhesion, while group B had seven patients, who received cleft lip repair alone. In group A, a nostril suspender was fabricated and fitted to each patient at the initial visit, while lip adhesion was done at 1 month of life. At 1 year postoperatively, four parameters (nostril symmetry, alar cartilage slump, alar base level and columellar tilt) were scored on a scale of 1-4 to compare nasal shape between the two groups. Results: With respect to nostril symmetry, alar cartilage slump and columellar tilt, group A showed less deformity compared with group B and the difference between the two groups was statistically significant. Conclusions: The use of a nostril suspender and lip adhesion can achieve dynamic correction of the nasal deformity associated with complete cleft lip. (C) 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.