Background and objectives: In the treatment of cleft lip and palate (CLP), it is ideal for the patients to get best results after all the treatments have been completed. We have been performing one stage repair of cleft lip and palate including primary cleft rhinoplasty. However, it is difficult to get symmetric shape of nose, so we tend to perform nose repair as the last surgery in their adulthood. Most of the cases are treated with septal cartilage graft and some of the cases, of which the bearing property is not strong enough, are treated with costal cartilage. The objectives of this paper are to report the operative technique of integrated repair of nasal tip and columella of cleft lip/plalate using costal cartilage graft and discuss its indication and treatment results.
Methods: Between April 2009 and September 2012, a total 73 cases are treated with this method. As for the grafted costal cartilage, VI or VII costal cartilage was used in most of the cases. When VII costal cartilage is enough in quantity, we select VII cartilage for the graft. The linear part of harvested cartilage was used for dorsum of the nose and the rest was used for columella as both of the parts were sutured up like the letter L. The cartilage was inserted from the reverse U incision in the nasal cavity.
Results: We have had good treatment outcomes in all the cases. However, one case developed local infection and another case required reoperation due to the warp of the cartilage.
Conclusions: This method bears high degree of satisfaction esthetically and is indicated for the cases where development of septal cartilage is poor and the cases in which the robust bearing property of nasal tip is required.
Key words : cleft lip and palate; nose repair; costal cartilage