Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Cleft Palate Craniofac J. 2021 Aug;58(8):974-983. doi: 10.1177/1055665620980228. Epub 2020 Dec 28.

Abstract

Objective: To compare cartilage grafting outcomes in intermediate versus definitive cleft rhinoplasty.

Design: A retrospective chart review was conducted. The χ2 and Fisher exact tests were used for statistical analyses. Results were considered statistically significant at P < .05.

Participants: All subjects who underwent revision cleft rhinoplasties between July 2011 and June 2019 were included. Subjects with syndromic conditions were excluded.

Results: A total of 46 subjects with a cleft nose deformity underwent 65 rhinoplasty procedures. The ages averaged 17 years (range 5-50) with 34 (73.9%) males and 12 (26.1%) females. In the intermediate group, 6 (28.6%) subjects required cartilage grafting as part of 6 cleft rhinoplasties, whereas 15 (71.4%) subjects underwent a total of 26 cleft rhinoplasties that did not require grafting. In the definitive group, 18 (76%) subjects required cartilage grafting over 21 cleft rhinoplasties, whereas 7 (24%) subjects underwent a total of 9 cleft rhinoplasties where cartilage grafting was not required. The difference between the number of subjects requiring cartilage grafting in the intermediate versus the definitive group was statistically significant (P = .007). Ear concha and nose were the most frequently used cartilage donor sites, with no observed complications.

Conclusions: Cartilage grafting was significantly more common in the definitive rhinoplasty group. Intermediate cleft rhinoplasty during the 5- to 13-year age period was effective, with a low-risk profile. In our experience, ear concha and nose were the preferred cartilage donor sites, with effective results and an excellent safety profile.

Keywords: cartilage grafting; cleft rhinoplasty.

MeSH terms

  • Adolescent
  • Adult
  • Cartilage / transplantation
  • Child
  • Child, Preschool
  • Cleft Lip* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose / surgery
  • Retrospective Studies
  • Rhinoplasty*
  • Young Adult