Primary Cleft Rhinoplasty: Long-Term Outcomes of a Single Technique Used Over 2 Decades.

ABSTRACT

BACKGROUND: Primary cleft rhinoplasty has become widely accepted owing to evidence of improved outcomes and need for fewer revisions. Several techniques have been described, but few surgeons have reported long-term outcomes of repairs performed via a single method. The present study examines long-term outcomes of a single surgeon's experience over 22 years using the same primary cleft rhinoplasty technique. METHODS: All consecutive cases of primary cleft rhinoplasty performed by the senior author at the time of unilateral cleft lip repair from 1996 to 2018 were selected for retrospective review. Patients older than 3 years or lacking documented follow-up were excluded. The primary outcome was the need for secondary rhinoplasty at age 15 years or later. RESULTS: Fifty-six patients met inclusion criteria. Median follow-up time was 7.52 years (interquartile range, 1.38-14.82). Twelve patients required minor long-term lip revision. No school-aged patients required additional correction of the nasal deformity before beginning school. Fifteen patients had follow-up beyond 14 years of age, 5 of whom had undergone definitive rhinoplasties as adolescents (8.9% of cohort; 33.3% of patients with follow-up beyond 14 years). Of the remaining 10 patients older than 14 years at last follow-up, none were seeking additional rhinoplasty. CONCLUSIONS: This series represents one of the longest-running published experiences of primary cleft rhinoplasty. Using a technique that requires no nasal incisions, the senior author has had excellent long-term results, with no need for any elementary school age rhinoplasties and with the majority of patients with follow-up older than 14 years not requiring a rhinoplasty in adolescence.