Resorbable Plates in Secondary Cleft Nasal Reconstruction.

OBJECTIVE

The authors report on the use and complications of alloplastic resorbable plates and compare their use to autologous cartilage grafts in secondary cleft nasal reconstruction.

DESIGN

Institutional review board (IRB)-approved retrospective chart review.

SETTING

Texas Cleft-Craniofacial Center at the McGovern Medical School at the University of Texas Health Sciences Center at Houston.

PATIENTS: Patients with unilateral or bilateral cleft lip nasal deformity who have undergone secondary correction of their nasal deformity with at least 1-year follow-up.

INTERVENTIONS: During their reconstruction, some patients had cartilage grafts used for support, whereas others were reconstructed using resorbable plates.

MAIN OUTCOME MEASURE(S): Complications (exposure, infection, malposition, hematoma/seroma) and rates of tertiary revisions.

RESULTS

197 patients underwent secondary cleft nasal reconstruction, with 30 patients in the resorbable plate group and 32 in the cartilage graft group. Age at surgery was 8.5±4.1 years with resorbable plates and 11.0±4.8 years with cartilage graft ( P = .03). Infection rate in the resorbable plate group and cartilage graft group were 0% and 3.25% ( P = 1). Extrusion occurred in 3 of the absorbable plate group and 2 patients with cartilage graft ( P = .67). Additional surgery was recorded in 43.3% of the resorbable plate group versus 53.1% of the cartilage graft group ( P = .459).

CONCLUSION

The data provide evidence that the use of alloplastic resorbable plate in the pediatric population is a safe alternative to autologous septal cartilage in secondary cleft nasal reconstruction. There is no statistical difference in short-term complications or the incidence of additional nasal surgery.