Background and objectives: Alar base deformities is a common finding in a alveolar cleft patients. Due to distorted anatomy of the maxilla and lack of maxillary bone support in this area might induced not only tilted the tripod of the nose but also made the bony floor is depressed or missing. The aim of this article is to evaluate using of L shaped graft for bony floor of the alar base reconstruction in delayed closure of alveolar clefts.

Methods: This study was included 9 unilateral alveolar cleft patients (5 women, 4 men) with a average age 15 ± 6 years. written informed consent was obtained by all patients .Cone beam CT scan was taken before surgery to evaluate the exact size of the cleft. Via routine approach the nasal layer was closed then harvesting graft from anterior iliac crest was done. The cleft was filled with cancellous bone. finally before soft tissues closure, the L shaped cortico–cancellous graft was fixed with one or two screws.

Results: Off nine cases with unilateral alveolar cleft treated with this modified technique, eight cases were uneventful and in one case which we could not use NG tube, the wound dehiscence was occurred and needed a second operation. The mean size of the cleft was 11 mm (7–15 mm). The mean follow up was 12 months. Clinical out come was satisfactory in 8 cases .in one case no need to further rhinoplasty but in others although some improvement was achieved as a cosmetics points but further rhinoplasty was needed.

Conclusion: Using of L shaped graft in alveolar cleft could be improved the alar base area but long term follow up and further survey was needed.

Key words : L shaped graft; alar base; alveolar cleft

Conflict of interest: The authors have no conflict of interest.