Repositioning of the lower lateral cartilage in primary cleft nasoplasty: utilization of a modified Tajima technique.

Repositioning the lower lateral cartilages during primary cleft nose repair often requires external bolsters to place suspension sutures. We describe a series of primary unilateral cleft nasal repairs using a modified Tajima technique. The cleft-side lower lateral cartilage is suspended to the contralateral upper lateral cartilage using a buried polydioxanone suture passed through a reverse-U incision with a hollow needle. A modified Tajima nasal repair was performed on 13 unilateral cleft patients. The average age was 6.6 months, and average follow-up was 9 months. All 13 patients demonstrated adequate repositioning of the lower lateral cartilage and improved tip symmetry. No postoperative infections, complications, or extruded sutures were observed. This modification to Tajima's technique allows suture placement without bolsters. We anticipate that long-term results will be maintained as well, if not better than other series, as placing a buried polydioxanone stitch avoids the need for suture removal. Continued monitoring will confirm this.