Deformity
of nose occurs in varying degrees along with cleft lips.
Although the lip gets corrected early on in life, the
nose deformity persists as a stigma and it causes mental
trauma to the affected.
The
correction of such deformities is challenging and the
results are rewarding. Nose function as well as appearance
gets major improvement by surgery. The days are gone
when such surgeries were done in surgical camps. More
and more patients are seeking better care and attention.
Restoration of near normal appearance should be the
goal. The surgical options are many and varied. The
results depend on judicious selection of technique keeping
in mind the nature of deformity. Results are permanent.
COMPONENTS
OF CLEFT LIP NOSE DEFORMITY.
The
striking features of a cleft lip nose deformity are:
-
1.
The deviation of nasal tip.
2.
Flattening and buckling of the outer wall of nostril.
3.
Widening of the nostril on the affected side.
These
are a few other deformities which go along with these
like deviation of the septum, bulbous tip, excess skin
inside the nostril, and low nasal bridge. The severity
of the deformities varies between different individuals.
TIMING
OF NOSE CORRECTION
The
nose deformity /should be addressed at the time of cleft
lip closure. This is primary nose correction and gives
good results. If the nose was not corrected early in
childhood, the best time would to do so would be after
completion of facial growth i.e. 14 – 16 years.
METHOD
OF CORRECTION
The
surgical plan depends on the deformity and patients
expectations. The bony and cartilage framework can be
altered to create an aesthetically appealing nose. Skin
excess can be trimmed or readjusted.
Implants
may be employed in selected cases to improve the profile.
The scar on the lip can be improved upon at the same
time. In some cases, the upper lip needs to be plumped
up. This is also done in the same sitting permanently
using the patients own tissue.
The
surgery is done as a day care procedure and under general
anesthesia.
RECOVERY
TIME
The
nose may be packed with gel foam for two days. Tapes
over the nose come off in 4 days. Swelling over the
nose takes a while to go off. Most of it resolves in
2-3 weeks.
Length
of stay: Outpatient (home same day).
Before
Surgery Avoid taking aspirin, Advil,
Motrin, or other aspirin-containing products for
two weeks If you are a smoker, stop smoking to
aid in healing.
Discomfort:
Mild to moderate. Anticipate 2-5 days of prescription
pain medication.
Final
result: Will be seen after the scars
have matured, which will be about six months.
Improves over 14 days.
