<< Back to the abstract archive
Secondary Cleft Rhinoplasty: A single surgeon's experience
Dr. Ananth Murthy
Dr. Patrick Lamb
Summa Health
2020-02-14
Presenter: Dr. Patrick Lamb
Affidavit:
50% of the concept and 100% of the research and writing is the residents work
Director Name: Douglas S Wagner MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
This is a 10 year retrospective review of 30 consecutive patients who underwent secondary cleft rhinoplasty performed by a single surgeon. 20 (66.6%) were female, 22 (73.3%) were left sided and 26 (86.6%) were complete clefts who underwent surgery at a mean age of 16.2 years. Subjective ratings utilizing the unilateral cleft lip surgical outcomes evaluation (UCL SOE) which rates 4 components (nose, cupid's bow, lateral lip, and free vermillion) with a score of 0-2. Multiple anthropometric measurements (Nostril height ratio, width ratio, medial ¼ height ratio, sill ratio, nostril area ratio, columellar angle, tip projection ratio, and nasolabial angle) were taken utilizing a free NIH program, ImageJ. Standardized photographs were compared pre and post operatively (21 had complete records). The techniques utilized, history of previous rhinoplasty (13.3%), and additional concomitant procedures were recorded. There was 1 (3.3%) patient with complication of retained nasal stent requiring removal in clinic and late onset erythema secondary to suture irritation resolved with oral antibiotics. There were no hematomas or infections. Subjective pre-operative ratings were stratified into pre-op nasal ratings of 0-.6, .7-1.3, and 1.4-2 and objective measurements were compared pre and post operatively. Poor subjective ratings did correlate with a higher degree of asymmetry in the objective measurements. Recommended revision cases had poor pre-operative and predictably poor post-operative subjective ratings as well as increased asymmetry on objective measurements. Nostril medial ¼ height, nasal sill height, and nostril area ratios tend to correlate with subjective UCL SOE rating scores.
