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6th Internet World Congress for Biomedical Sciences

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CLEFT LIP: A TREATMENT FOR THE SHORT NOSE

BLANCO RUEDA JOSE ANTONIO(1), Miguel Garcia(2), Marta Izquierdo(3), Fe Garcia(4), Luis Redondo(5), REDONDO LUIS (6), Alberto Verrier(7)
(1)(2)(3)(4)(5)(6)(7)HOSPITAL DEL RIO HORTEGA - VALLADOLID. Spain

[ABSTRACT] [INTRODUCTION] [MATERIAL & METHODS] [RESULTS] [IMAGES] [IMAGES-2] [DISCUSSION] [CONCLUSIONS] [BIBLIOGRAPHY] [Discussion Board]
ABSTRACT Previous: MANDIBULAR PATOLOGY AND RECONSTRUCTION PLATES MATERIAL & METHODS
[Oral & Maxilofacial Surgery]
Next: Analysis Of The Results Of Surgical Treatment For Squamous Cell Carcinoma Of Mobile Tongue And Base Of Tongue		 [Plastic Surgery]
Next: Maximising skin care with the use of advanced skin penetration techniques

INTRODUCTION Top Page

The reconstruction of the nasal arquitecture create one of the most demands over surgical treatment of the residual cleft lip, overcoat towards the final of the adolescense. Different authors, as Cronin, Millard, Talman, Dibbnell, Nishimura y Ortiz Monasterio have developed thecniques to resolve this morphological anomaly. The treatment of the nasal malformation in patients with bilateral cleft palate and lip is better to concluded it in a second surgical time because of vascular risk. fig.1

MATERIAL & METHODS Top Page

We present a technique that associates a labial rotation flap with a free grooved costal graft like treatment, in a single step, for the defect of residual short columella in patient with unilateral cleft lip.

We show two cases of bilateral cleft lip treated with this surgical technique.

We show two 19 year-old patients with sequels of the harelip, nasal deformity and wide base. The absense of nasal projection is due to the existence of a short columella together with the retracted alar cartilages and the flattened dome, what causes an enlarged and fallen nasal tip.

RESULTS Top Page

Two sliding flaps with nasolabial rotation were created through an T-incision in the middle of the columella.

We shaped a free grooved costal graft that was supported on the anterior nasal spine. Sometimes it can be associated a Sheen or Peck graft.

The rotation of nasolabial tissue will model the final columella making an narroness of the distance between alar cartilages. fig.2, fig. 3, fig. 4,fig. 5,fig. 6,fig. 7,fig. 8

DISCUSSION Top Page

The short nose syndrome constitutes a surgical challenge between the sequels of the cleft lip. The possible causes of this anomaly are defects of the osteocartilaginous arquitecture, scars or fibrosis of the inferior nasal third by surgery. A great part of these surgical thecniques make wide approachs to the nasal pyramid that not solvent the aesthetic problem definitively.

CONCLUSIONS Top Page

This surgical thecnique helps to define the nasolabial angle and obtains a lenghtening of the columellas and symmetry of the narinas compatible with the normality. At the end, the functional and aesthetic results are satisfactory.

BIBLIOGRAPHY Top Page

  1. Chen PK, Yeow VK, Noordhoff MS, Chen YR Augmentation of the nasal floor with Surgicel in primary lip repair: a prospective study showing no efficacy. Ann Plast Surg 1999 Feb;42(2):149-53
  2. Cutting C, Grayson B, Brecht L, Santiago P, Wood R, Kwon S.: Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg 1998 Mar;101(3):630-9
  3. Eskeland G, Borchgrevink H, Abyholm FE .: Columella lengthening in bilateral cleft lip patients. Experience with the forked flap procedure. Scand J Plast Reconstr Surg 1979;13(3):429-36
  4. Meyer R, Poulenas I.: Surgery for secondary deformity of the nose and cleft lip. Med Hyg (Geneve) 1977 Mar 9;35(1231):817-22
  5. Mulliken JB.: Correction of the bilateral cleft lip nasal deformity: evolution of a surgical concept. Cleft Palate Craniofac J 1992 Nov;29(6):540-5
  6. Nakajima T. Early and one stage repair of bilateral cleft lip and nose. Keio J Med 1998 Dec;47(4):212-8
  7. Anastassov GE, Joos U, Zollner B.: Evaluation of the results of delayed rhinoplasty in cleft lip and palate patients. Functional and aesthetic implications and factors that affect successful nasal repair. Br J Oral Maxillofac Surg 1998 Dec;36(6):416-24
  8. Wu K, Xu J, Lin Y.: The apron mucosal flap of the lower lip for the repair of the secondary deformities of the cleft lip Chung Hua Cheng Hsing Shao Shang Wai Ko Tsa Chih 1996 May;12(3):203-206.
  9. Yoshimura Y, Nakajima T, Nakanishi Y, Yoneda K.: Secondary correction of bilateral cleft lip deformity with simultaneous Abbe flap and nasal repair. J Craniomaxillofac Surg 1998 Feb;26(1):17-21

Discussion Board
Discussion Board

Any Comment to this presentation?

[ABSTRACT] [INTRODUCTION] [MATERIAL & METHODS] [RESULTS] [IMAGES] [IMAGES-2] [DISCUSSION] [CONCLUSIONS] [BIBLIOGRAPHY] [Discussion Board]
ABSTRACT Previous: MANDIBULAR PATOLOGY AND RECONSTRUCTION PLATES MATERIAL & METHODS
[Oral & Maxilofacial Surgery]
Next: Analysis Of The Results Of Surgical Treatment For Squamous Cell Carcinoma Of Mobile Tongue And Base Of Tongue		 [Plastic Surgery]
Next: Maximising skin care with the use of advanced skin penetration techniques
BLANCO RUEDA JOSE ANTONIO, Miguel Garcia, Marta Izquierdo, Fe Garcia, Luis Redondo, REDONDO LUIS , Alberto Verrier
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Last update: 18/01/00