편측성 완전 구순구개열 환자에서 늑연골을 이용한 교정 비성형술

Corrective Rhinoplasty Using Rib Cartilage for Patients with Unilateral Complete Cleft Lip and Palate

Objective: The authors evaluated the surgical modality and efficacy of a rhinoplasty procedure which invloves structural component augmentation using a rib cartilage in patients with complete unilateral cleft lip and palate. Materials and Methods: The subjects included 10 patients with nonsyndromic cleft who had undergone open rhinoplasties by structural cartilage graft including columellar strut,alar contouring, tip graft, and dorsal augmentation using a rib cartilage. Clinical and photogrammetric analyses were performed with their medical records and peri-operativephotographs. In the photogrammetric facial analysis, measurements of alar width, columella height, the largest nostril diameter, and nasal projection were derived on the normal and cleft sides. The ratio of cleft side to normal side were calculated. Then we compared between preoperative ratios and post-operative ones. Values of p<0.05 were considered significant. Results: All patients were satisfied with the esthetic and functional improvement of the procedure. There were no major complications secondary to donor site morbidity or graft infection. In the photogrammetric analysis, the nasal projection was improved significantly. Conclusion: The cleft rhinoplasty by open structural augmentation using a rib cartilage could be a reliable approach for correction of the secondary nasal deformity in patients with a unilateral cleft.