Nasal deformity in unilateral cleft lip.

The author presents his experience with the primary correction of nasal deformity in unilateral cleft lips in twenty five cases ranging in age from five months to 30 years. Emphasis is placed upon the important anatomical characteristics of the deformity, i.e. attenuation of the alar cartilage, displacement of the medial crus, thickening of the alar base as the result of deposition of fibrofatty tissue between the two separated layers of skin, accumulation of fibrofatty tissue between the two separated alar domes, drooping of the involved nostril and the presence of a well marked alar arch web. The technique described includes an adequate exposure through a bilateral gingivolabial sulcus incision connected by an intercartilaginous incision, release of the displaced alar base and columella, freeing of the alar cartilage from the opposite side and from overlying skin, repositioning of the alar cartilage and alar dome to a normal anatiomical position, and maintenance by a through and through mattress suture and a post-operative nasal pack. The immediate results have been satisfactory.