耳介軟骨を用いた就学期の唇裂鼻修正術の経験

概要

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Many operative techniques for correction of residual unilateral cleft lip nasal deformity have been reported. The authors have used the cartilage suspension technique by the external approach for patients school age. The majority of patients are operated on between the ages of 5 and 7 years based on the need for a “tidy appearance” by first grade. Regardless of the technique used by the authors, the incidence of poor correction and/or recurrence appeared to be high. A bulbous nose was very common after puberty. Wide dissection of the lower nose and excessive plication of the lower lateral cartilage were the main reasons for this unfavourable result.<BR>The authors describe our present technique for correcting residual unilateral cleft lip nasal deformity at school age. This procedure involves: 1. an open method to expose and correct lower lateral cartilage deformity. 2 The lower lateral cartilage on the cleft side is elevated and matched to the cartilage on the noncleft side by advancing it superiorly and cephalad. 3. Augmentation of the nasal tip and perialar sulcus is performed with a free conchal cartilage graft. This technique has been more rewarding than the other techniques we have attempted.