The complexity of this type of deformity of the nose requires significant surgical ability to correct
The development of the lips, gum and palate plays a decisive role in the normal development of the nose internally and externally. Any impairment of this development, as is found in a cleft lip, gum and palate, therefore inevitably leads to changes in the shape of the nose. The term ‘cleft nose’ is used for the typical changes in the internal and external nose where a cleft lip, gum and palate are present.
The primary surgical treatment for a cleft lip, gum and palate usually takes place over several stages during early childhood. A nose correction, described as a cleft nose correction in this situation, usually only takes place as a secondary procedure when the nose has stopped growing in length, which is usually at the age of 16 or 17. By this time any orthopaedic or surgical procedures required on the jaw should have been completed.
The basic pathology of a cleft nose is complex. On the healthy side there may be a crooked nose with varying degrees of prominence, accompanied by complex, deep distortion of the nasal septum on the side of the cleft. The tip of the nose appears asymmetrical, as do the nostrils and the bottom of the wings of the nose. To correct a cleft nose surgically, cartilage grafts from the ear or the rib area are often required. As there is a high risk of the reconstructed nasal septum becoming deformed again, a cmplex extracorporeal correction of the septum or the use of the Kassel L-Beam should be considered in every case. In many cases this is the only to achieve an acceptable and realistic result.