Browse > Article

Correction of Retracted Ala Using Spacer Graft in Secondary Cleft Lip and Nose Deformity  

Han, Kyu-Seok (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Choi, Hyun-Gon (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Shin, Dong-Hyeok (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Kim, Soon-Heum (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Hwang, Eun-A (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Uhm, Ki-Il (Department of Plastic and Reconstructive Surgery, School of Medicine, Konkuk University)
Publication Information
Archives of Plastic Surgery / v.38, no.4, 2011 , pp. 376-382 More about this Journal
Abstract
Purpose: In patients with unilateral cleft lip and nose deformity, alar retraction is commonly seen on the non-cleft side after cleft side is corrected. Spacer graft was used to drag down the inferior border of the alar cartilage of the non-cleft side so as to match the cleft side. By performing spacer graft and septal extension graft together, symmetry and cosmetic improvements were achieved. Methods: Seven unilateral cleft lip and nose deformity patients underwent surgery for alar retraction correction. The median age was 24 years (ranged from 15 to 34 years), and the median follow-up period was 7.4 months (ranged from 6 to 12 months). The perpendicular length from the longitudinal axis of the nostril to the alar rim, the nasolabial angle and the ala-labial angle were measured in the lateral view photo. The longest perpendicular length from the cephalic border of the alar rim to the parallel line of the alar base was measured in the frontal view photo. Results: Improvement in alar retraction was seen after the surgery. There were no specific complications during the follow-up and the symmetry of both nostrils was satisfactory. No increase in the nasolabial angle or exposure of the nostrils was seen after the tip projection via tip plasty. Conclusion: The fundamental factor in correcting alar retraction with secondary cleft lip and nose deformity is repositioning the alar rim with spacer graft, which seems to be more physiologic than other methods. The method combining spacer graft with septal extension graft will bring symmetry as well as more cosmetic improvement in correction of alar retraction with secondary cleft lip and nose deformity.
Keywords
Secondary cleft lip and nose deformity; Alar retraction; Spacer graft; Septal extension graft;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Kim HS, Roh SG: The alar extension graft for retracted ala. J Korean Soc Plast Reconstr Surg 36: 66, 2009
2 Koh KS, Kim EK: Management of unilateral cleft lip nose deformity with retracted ala of the noncleft side. Plast Reconstr Surg 118: 723, 2006   DOI   ScienceOn
3 Gunter JP, Rohrich RJ, Friedman RM: Importance of the alar-columellar relationship. In Dallas Rhinoplasty, ST. Louis Missouri, Quality Medical Publishing, Inc., 2007, p 401
4 Gunter JP, Hackney FL: Clinical assessment and facial analysis. In Dallas Rhinoplasty, ST. Louis Missouri, Quality Medical Publishing, Inc., 2007, p 105
5 Gruber RP, Kryger G, Chang D: The Intercartilaginous graft for actual and potential alar retraction. Plast Reconstr Surg 121: 288e, 2008   DOI   ScienceOn
6 Ko HW, Han SK, Lee BI, Kim WK: Effects of release of tip supporting fibrous tissues for short nose correction. J Korean Soc Plast Reconstr Surg 30: 275, 2003
7 Hobar PC, Adams WP, Mitchell CA: Lengthening the short nose. Clin Plast Surg 37: 327, 2010   DOI   ScienceOn
8 Byrd HS, Andochick S, Copit S, Walton KG: Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 100: 999, 1997   DOI   ScienceOn
9 Rohrich RJ, Raniere J Jr, Ha RY: The Alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 109: 2495, 2002   DOI   ScienceOn
10 Guyuron B: Alar rim deformities. Plast Reconstr Surg 107: 856, 2001   DOI   ScienceOn
11 Hirohi T, Yoshimura K: Surgical correction of retracted nostril rim with auricular composite grafts and anchoring suspension. Aesthetic Plast Surg 27: 418, 2003   DOI   ScienceOn