• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.406-415
• /
• 2010

Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.

• Korean Journal of Cleft Lip And Palate
• /
• v.2 no.1_2
• /
• pp.23-28
• /
• 1999

The author presents Bardach' s technique for the residual unilateral cleft lip nasal deformity, The key to a successful and stable correction of the nasal deformity is to lengthen the columella on the cleft side and to mobilize alar cartilage from its surrounding tissue, creating a symmetric shape and length, The major advantages of the technique are lengthening of the cleft columella and creation of a symmetric and well-projected nasal tip.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.4
• /
• pp.348-355
• /
• 2006

Tennison was the first to recognize and to preserve the Cupid's bow by lowering the peak in the margin of the cleft. Randall had modified the Tennison's repair based on accurate measurements. Bardach's technique evolved from the basic concept of triangular flap cleft lip repair described by Tennison-Randall method. Precise measurements are used to define the dimensions of the equilateral triangular flap, which is created on the cleft side and is inserted into an equilateral triangular defect on the noncleft side. Two symmetrical vertical distances on either side of the cleft are thus formed. It is essential that the incisions in the skin correspond precisely with those on the muscles and mucosa, and that all layers are sutured with the use of the triangular flap, thus preventing vertical scar contracture. This procedure produces a symmetric, balance lip with a well-defined Cupid's bow, a symmetric vermilion, and a properly aligned orbicularis oris muscle. We had treated three patients with unilateral incomplete cleft lip by using Bardach's triangular flap method. The operation scars could be reduced comparing to Millard method because Bardach's method did not use the columella base and the alar base incision. And the flap design was more simple and accurate comparing to Tennison-Randall method. On the other hand, the postoperative scars on the philtrum pointed as a disadvantage of triangular flap method were cosmetically acceptable because the three patients had incomplete cleft lip. We have experienced that Bardach's triangular flap is a recommendable technique for the repair of unilateral incomplete cleft lip.

• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.75-79
• /
• 2021

Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach's two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.