Secondary open structural rhinoplasty with costal cartilage grafts.

Abstract

Background: Cleft lip and palate (CLP) represent one of the most prevalent congenital anomalies of the maxillofacial region, resulting in significant structural deformities that impact nasal function, facial aesthetics, and psychosocial well-being. These anomalies often lead to nasal obstruction and asymmetry. Surgical correction of the associated nasal deformities through rhinoplasty is essential to restore nasal airway function, achieve symmetrical nasal contour, and improve overall facial harmony. Autologous costal cartilage serves as an excellent grafting material due to its versatility, biocompatibility, and structural integrity, making it suitable for reconstructing various components of the nasal framework.

Case report: A retrospective, single-center, non-consecutive case series was conducted at our institution, involving eight patients diagnosed with cleft lip and palate (CLP) between 2019 and 2024. The cohort comprised four male and four female patients, of whom seven presented with unilateral CLP. The mean age at the time of surgery was 21 years. All patients were followed for a duration of 6 months postoperatively. Postoperative assessments demonstrated an increase in the tip projection ratio and a decrease in the alar width ratio, indicating improvement in nasal symmetry and projection.

Conclusion: Secondary structural rhinoplasty using autologous rib cartilage graft remains the definitive surgical approach for correcting nasal deformities in patients with cleft lip and palate (CLP). Despite its effectiveness, the procedure is technically demanding and requires meticulous planning and execution. A systematic and well-considered surgical strategy is essential to achieve optimal nasal tip definition and improved projection. Postoperative evaluations in our series demonstrated significant aesthetic improvements, including enhanced nasal tip projection and a reduction in alar base width, contributing to better nasal symmetry.