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    Cleft Lip Nose Correction Combining Open Rhinoplasty With the Dibbel Technique
    (Lippincott Williams & Wilkins, 2015) Gundeslioglu, Ayse Ozlem; Altuntas, Zeynep; Inan, Irfan; Bilgen, Fatma; Jasharllari, Lorenc; Karaibrahimoglu, Adnan
    Cleft lip nose rhinoplasty is a challenging procedure because of the different presentation and severity of the deformity. Due to this presentation type, there is still no standard procedure correcting all the components of the deformity although a number of techniques have been published in literature. In this study, the effectiveness of the combination of open rhinoplasty and the Dibbel technique with nasal sill augmentation was evaluated. We hereby report our experience with 7 patients who had unilateral cleft lip nose deformity with slumped lower lateral cartilage and underprojected and deformed dome, operated on between September 2010 and April 2013 by 1 surgeon. The mean age of the patients at the time of surgery was 24.5 years (18-38 years) and the patients were followed up for an average of 18.5 months (6-31 months). All patients were operated on with open rhinoplasty and Dibbel technique combination with nasal sill augmentation. Frontal, lateral, oblique, and basilar photographs were obtained preoperatively and postoperatively for each patient. Nasal projection, columella height, nasolabial angle, nasal sill symmetry, and base width were measured on the photographs for comparison of preoperative and postoperative results. All patients' medial and lateral cantus distances were used for photographic standardization. The results demonstrated that there was a statistically significant increase in nasal projection (2.13 +/- 0.28mm preoperatively versus 2.31 +/- 0.08mm postoperatively; P = 0.018), columella height (1.07 +/- 0.25mm preoperatively versus 1.21 +/- 0.18mm postoperatively; P = 0.028), nostril apex height (1.11 +/- 0.15mm preoperatively versus 1.22 +/- 0.11mm postoperatively, P< 0.028), nasolabial angle (77.71 +/- 8.74mm preoperatively versus 91.33 +/- 6.49mm postoperatively; P< 0.05), and nasal sill symmetry (0.42 +/- 0.15mm preoperatively versus 0.27 +/- 0.07mm postoperatively; P< 0.05), and a significant decrease of alar width (2.35 +/- 0.44mm versus 2.16 +/- 0.32mm postoperatively; P = 0.018) on the affected side in response to surgery. The results of this study demonstrated that the Dibbel technique and open rhinoplasty combination with nasal sill augmentation is an effective and safe method for the correction of cleft lip nose deformity in respect to nasal symmetry.