Nasal Morphological Changes after Facial Maturation in Patients with Unilateral Cleft Lip Following Primary Overcorrected Rhinoplasty

Background: Although the Tajima overcorrection technique is used in primary rhinoplasty procedures at our institution, we have observed a recurring asymmetry problem in patients who undergo such procedures at around the age of approximately 1. Notably, this asymmetry appears to be minor and remains stable over time. The current study is a longitudinal analysis of outcomes following primary overcorrected rhinoplasty and provides insights into the long-term trajectory of nasal morphology after treatment. Methods: This retrospective study examined a cohort of 146 patients with a nonsyndromic unilateral cleft lip who underwent cheiloplasty with primary Tajima overcorrected rhinoplasty at the Chang Gung Memorial Hospital Craniofacial Center between 2002 and 2003. A longitudinal analysis of nostril morphology was conducted using a series of digital photographs taken at five time points: 1 (T1), 5 (T2), 10 (T3), 15 (T4), and 18 (T5) years of age. Symmetry was assessed using anthropometric measurements, including nostril height, nostril base height, nostril width, nasal width and columella angle. Results: Nostril asymmetry improved over time among both patients with a complete and incomplete unilateral cleft lip. Nostril height, nostril width, nasal width and columella angle significantly varied with time ( P < 0.01), whereas nostril base height remained stable. Conclusions: Achieving adequate cleft-side nasal height during primary procedures is crucial. The current results can provide valuable guidance for surgeons regarding the optimal timing for secondary rhinoplasty, particularly in cases where primary outcomes are suboptimal.