Cleft nose deformity or cleft lip nasal deformity happens due to cleft lip and palate. A cleft lip and palate happens when there is a hole or split in the lip or the roof of the mouth, large enough to connect the top lip and nose. To correct a cleft nose deformity, patients can undergo cleft lip nasal surgery or nasal reconstruction. If you are looking to have your child undergo cleft nose deformity surgery, get your advice from a reputable ENT surgeon in Sydney. They are very experienced in nasal surgery and uses the latest in techniques and technologies.

Cleft nasal reconstruction is one of the most challenging surgeries for any cleft surgeon or any surgeon, for that matter. Not only it’s a complex and delicate procedure, but surgeons usually have to wait for the nose to develop fully. Continuous nasal surgery may be required even in the adolescent and teen years if not done correctly. However, the initial simultaneous repair of the cleft lip and nasal deformity performed as a newborn is probably the most significant operation a child with a cleft will need.

In relation to cleft lip and palate, there are two types of cleft nose deformity. They are as follows.

Types of Cleft Nose Deformity

Unilateral Cleft Nasal Deformity

The unilateral cleft lip nasal deformity is when one side of the nose, the cleft side, arises to an oblique and minor displacement while the noncleft side is considered normal. It results in a less defined nasal tip and projection as it collapses the arch forms that define the nose. On the cleft side, the medial crus is shorter, and the lateral crus is taller, giving a less defined and widened dome. Both nostril, cleft and noncleft, has deviated nasal septum. The oblique nostril side, in most cases, blocks the nasal airway on the cleft side. Hence, making it hard for the patient to breathe.

Bilateral Cleft Nasal Deformity

The bilateral cleft lip nasal deformity is when the columella is not long enough or nonexistent due to decreased soft tissue and skin between the nasal tip and upper lip. The degree of columellar shortening severity may vary. Anyhow, nasal obstruction due to a wide septum may still occur. Hence, a blocked airway equals to breathing problem.

Cleft Lip Nasal Deformity Treatments

Cleft lip nasal surgery is break up into primary, intermediate, and secondary repairs. It was believed that early manipulation of the nasal cartilage interferes with growth, but that is not the case anymore. Multiple studies have disproved this idea. Because of these studies, the primary cleft rhinoplasty can proceed along with the initial lip repair. Early interventions enable surgeons an early restoration of nasal shape, allowing patients to benefit from a more potential symmetric nasal growth. Note that surgery performed at an early age can cause scar tissue and may consequently affect future surgeries.

Cleft Rhinoplasty (Cleft Lip Nasal Surgery)

Primary Rhinoplasty

Primary rhinoplasty is the nasal surgery done at the same time as the first cleft lip repair. Both the cleft lip and cleft nose are connected and should address together when it comes to repair and reconstruction. The purpose of primary rhinoplasty for both the unilateral deformity and bilateral deformity is to provide better shape, symmetry, and nasal tip projection by clearing, tunneling, and realigning the lower lateral cartilages. Also, in unilateral deformities, the deviated nasal septum is realigned to allow a more symmetric growth. While in bilateral cleft nasal deformity, primary rhinoplasty is usually limited to repositioning the alar bases and reconstructing the nasal muscular ring. Nasal tip surgery for bilateral patients is reserve for the intermediate stage.

You can read more about primary rhinoplasty here.

Intermediate Rhinoplasty

Intermediate rhinoplasty is usually performed between 4 and 6 years of age, preferably before the cleft patient enters school. This timing allows the surgeon to perform any minor lip improvements and revisions such necessary, as well as achieve more normal nasal tip symmetry. The purpose of surgery is to correct the deformed position of the cleft-side lower lateral cartilage so that later nasal growth will not worsen the cleft lip nasal deformity. This process produces a more symmetrical appearance of the nose after surgery and also allows easier correcting of any nasal asymmetries after facial growth is complete.

Secondary Rhinoplasty

Secondary rhinoplasty is commonly the last step procedure that results in a change in facial features. Patients who underwent primary and intermediate rhinoplasty can proceed to this procedure. Typically they are the ages around 14 to 16 years old in female cleft patients and 16 to 18 years old in male cleft patients. This procedure leads to both a subjective and statistically vital physical improvement of facial appearance.

Takeaway Thoughts

The cleft nose or nasal deformity is a common problem that has both consistent and reliable findings, as well as distinctive nuances. The irregular thin tissue and skeletal base can further be complicated by the long-term effects of anatomic growth and surgical scarring. The purposes of primary cleft rhinoplasty are to rebuild symmetry and realign the nasal structures such that further growth will not worsen deformities. Intermediate rhinoplasty, although not always mandatory, can be done before school age to help achieve better symmetry and help mitigate future growth malformations. Secondary rhinoplasty is best performed after the nasal has developed fully and proceeded through an open technique to visualize the nasal structure fully. Cleft nasal deformity is a complicated problem that requires several cleft nasal surgeries. It is important that your child can get regular appointments with an expert to detect any health issues early enough.