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Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair

  • Lee, Yoon Seok (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Shin, Dong Hyeok (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Choi, Hyun Gon (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Jee Nam (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Lee, Myung Chul (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Soon Heum (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Kim, Cheol Keun (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Jo, Dong In (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Uhm, Ki Il (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine)
  • Received : 2015.06.01
  • Accepted : 2015.09.01
  • Published : 2015.11.15

Abstract

Background Various techniques for lengthening short columellae have been used for bilateral cleft nose repair. However, previous methods have not yielded satisfactory results. We performed a full-thickness skin graft to lengthen short columellae during secondary cleft nose repair in adult patients. Methods Ten bilateral cleft lip and nose patients underwent secondary cheiloplasty with open rhinoplasty between July 2008 and August 2014. The patients underwent a full-thickness skin graft on the medial crura to elongate the columella. The average age of the patients at the time of surgery was 22.2 years. Nasal profiles were evaluated before and after the operation using the photogrammetric method. Results The nasal profiles were improved in all patients, and all skin grafts were well taken, with the exception of one patient. Columellar height, nostril height, and columella-lip angle increased, and nasal width decreased significantly. The ratios of columellar height to nasal height, columellar height to nasal width, and nasal height to nasal width increased to a statistically significant extent. Conclusions Columella lengthening with a full-thickness skin graft is a simple and effective method for the repair of severely short columellae in bilateral cleft nose patients. We had satisfactory outcomes, with good color matching and aesthetically pleasing contours.

Keywords

References

  1. McIndoe SA, Rees TD. Synchronous repair of secondary deformities in cleft lip and nose. Plast Reconstr Surg Transplant Bull 1959;24:150-62. https://doi.org/10.1097/00006534-195908000-00002
  2. Cronin TD. Lengthening columella by use of skin from nasal floor and alae. Plast Reconstr Surg Transplant Bull 1958; 21:417-26.
  3. Millard DR. Bilateral cleft lip and a primary forked flap: a preliminary report. Plast Reconstr Surg 1967;39:59-65. https://doi.org/10.1097/00006534-196701000-00006
  4. Cheon YW, Park BY. Long-term evaluation of elongating columella using conchal composite graft in bilateral secondary cleft lip and nose deformity. Plast Reconstr Surg 2010; 126:543-53. https://doi.org/10.1097/PRS.0b013e3181e0969a
  5. Lindsay WK, Farkas LG. The use of anthropometry in assessing the cleft-lip nose. Plast Reconstr Surg 1972;49:286-93. https://doi.org/10.1097/00006534-197203000-00008
  6. Masuoka H, Kawai K, Morimoto N, et al. Conchal cartilage graft for correction of bilateral cleft lip nasal deformities during childhood. Plast Reconstr Surg Glob Open 2014;2:e104. https://doi.org/10.1097/GOX.0000000000000051
  7. Sheen JH, Sheen AP. Aesthetic rhinoplasty. St. Louis: Mosby; 1987.

Cited by

  1. Primary Repair of Bilateral Cleft Lip Deformity and Absent Prolabium With a Full-Thickness Skin Graft vol.32, pp.6, 2015, https://doi.org/10.1097/scs.0000000000007829
  2. Change in nostril ratio after cleft rhinoplasty: correction of nostril stenosis with full-thickness skin graft vol.22, pp.2, 2015, https://doi.org/10.7181/acfs.2021.00010