[Epithesis of nasal deformity after prosthesis of unilateral complete harelip with design of nasal subunits].

OBJECTIVE

To discuss the operative method and therapeutic effect of correcting nasal deformity after prosthesis of unilateral complete harelip with design of nasal subunits.

METHODS

From January 2006 to December 2008, 18 patients with nasal deformity after prosthesis of unilateral complete harelip were treated. There were 7 males and 11 females aged 6-26 years old. The deformity located on the left side in 11 cases and the right side in 7 cases with major manifestations of deviation and crispation towards normal side of nasal columella, applanation and collapse of nasal ala, lenity and dissymmetry of nostrils, malposition of basement of nasal ala. Time between harelip prosthesis and secondary epithesis was 4-21 years (average 8 years). During epithesis, nasal columella were extended, collapse nasal alar cartilages were liberated and fixed in symmetrical positions, injured upper lip was extended with nasolabial flap or to "tongue-like" flap on nasal base. Eleven cases were implanted L-type silicone prosthesis to hump nose.

RESULTS

For 1 case suffered postoperative rejection, the implant of L-type silicone prosthesis was taken out promptly, and reimplant of prosthesis was performed 6 months later without postoperative rejection. The incision of the other patients all healed by first intention without any postoperative complications. The effect of epithesis was good with such manifestations as the eminence of injured nasal ala, normal radian, and symmetrical nostrils. All patients were followed up for 3 months-2 years (average 8 months). The incision was hidden with well-maintained appearance and no obvious scar.

CONCLUSION

Based on feature of nasal subunits and formation causes of deformity, individual-orientated epithesis design of nasal ala margin, nasal columella basement incisions, reset and fix nasal alar cartilages and tissues values can provide the patients suffering the secondary nasal deformity with satisfied appearance.