Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

A Novel Cleft Rhinoplasty Procedure Combining an Open Rhinoplasty with the Dibbell and Tajima Techniques: A 10-Year Review

Flores, Roberto L., M.D.; Sailon, Alexander M., B.A.; Cutting, Court B., M.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 2041-2047
doi: 10.1097/PRS.0b013e3181bcf100
PEDIATRIC/CRANIOFACIAL: ORIGINAL ARTICLES
Buy
SDC

Background: The authors assessed the safety and efficacy of a novel cleft rhinoplasty procedure that combines an open rhinoplasty with the Dibbell and Tajima techniques.

Methods: A single-surgeon, 10-year, retrospective review was conducted of all unilateral cleft lip rhinoplasties (n = 157). Nonsyndromic patients undergoing a combined open incision/Dibbell/Tajima procedure and who had follow-up of greater than 8 months were included. Thirty-five patients were identified. Standardized patient photographs were studied in 18 patients who had both preoperative and 1-year postoperative photographs. Farkas normal values were applied to the medial canthal distance; from this value, metric measurements of changes in alar base width, columellar height, and nostril apex height were derived.

Results: There were no complications secondary to skin envelope ischemia or cartilage graft infection. The revision rate was 11 percent for alar base position, 3 percent for depressed lower lateral cartilage, and 3 percent for nostril apex overhang. After the procedure, there was a statistically significant decrease in alar base width (19.9 mm versus 18.2 mm; p < 0.01) and an increase in columellar height (8.37 mm versus 9.59 mm; p = 0.02) and nostril apex height (4.70 mm versus 5.44 mm; p = 0.02) on the affected side. The differences in alar base width, columellar height, and nostril apex height between the affected and nonaffected sides all decreased significantly postoperatively.

Conclusions: The combined open rhinoplasty/Dibbell/Tajima procedure is safe, has a low revision rate, and is associated with a statistically significant decrease in alar base width, an increase in columellar height and nostril apex height, and a greater symmetry of nasal form.

Indianapolis, Ind.; and New York, N.Y.

From the Division of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center, and the Institute of Reconstructive Plastic Surgery, New York University Medical Center.

Received for publication October 31, 2008; accepted February 9, 2009.

Presented at Plastic Surgery 2008, the 77th Annual Meeting of the American Society of Plastic Surgeons, in Chicago, Illinois, October 31 through November 5, 2008.

Disclosure:The authors have no financial interests to declare.

Supplemental digital content is available for this article. A direct URL citation appears in the printed text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal’s Web site (www.PRSJournal.com).

Court B. Cutting, M.D., Institute of Reconstructive Plastic Surgery, New York University Medical Center, TH-169, 560 First Avenue, New York, N.Y. 10016, court.cutting@med.nyu.edu

©2009American Society of Plastic Surgeons