Primary Septal Cartilage Graft for Unilateral Cleft Rhinoplasty: 10-Year Follow-Up Results and the Effect on Septal Deviation.

[BACKGROUND] To enhance nasal symmetry, septal cartilage can be used as an alar rim graft on the cleft side during primary rhinoplasty. Short-term results have been favorable, but the long-term results are unclear. The authors compare nasal shape and septal deviation in patients with and without the graft at 10-year follow-up.

[METHODS] This study included 60 patients with unilateral complete cleft lip and palate; 23 patients received a septal cartilage rim graft, and 37 patients did not. Various bilateral measurements were taken, including nostril height, nostril width, the height of the medial one-fourth of the nostril, the nostril area, the nasal dome height, and the nostril axis. Ratios of these measurements were calculated and compared between patients with and without the graft. Asymmetry was categorized based on deviations from symmetry. Nasolabial angle and tip projection ratio assessed nasal growth, while septal deviation was measured using cephalometry.

[RESULTS] The one-fourth medial part of nostril height was higher in the graft group ( P = 0.031) than in the nongraft group. The consistency of the surgical results between the 2 groups was not statistically significant. The nasolabial angle and tip projection ratio were not significantly different between the groups. The graft group had a smaller deviated septal angle and length than the nongraft group ( P < 0.001).

[CONCLUSION] Using a septal cartilage graft during primary rhinoplasty was suggested by the study results to provide better support at the medial side of the alar rim and to result in a straighter nasal septum, improving long-term outcomes.