Simultaneous Correction of Complex Secondary Deformities of Cleft Lip Using Autogenous Costal Cartilage Combined With Rib Grafts

摘要

Objective:Complex secondary deformities of cleft lip include nasal and labial deformities, alveolar cleft, oronasal fistula, and so on. In this report, the authors present a method to simultaneously repair the above complex deformities with autogenous costal cartilage and rib grafts.Methods:The surgical procedure of simultaneous correction includes filling the alveolar cleft with autologous rib;repairing the oronasal fistula with a local mucosal flap;correcting the nasal deformity with an autogenous costal cartilage graft; andrepairing the labial deformity with a local skin flap.Results:Satisfactory outcomes were achieved in all 22 patients. Fifteen patients were followed up for 6 to 24 months and exhibited good nasal shape, repaired alveolar cleft, improved labial shape, and closed oronasal fistula. Three patients presented with red nasal tips. One patient had local infection, which was cured by antibiotics.Conclusion:This method minimized the number of surgeries in adult patients with secondary deformities of cleft lip;reduced the injuries to the donor area by using rib instead of the iliac bone;expanded the application range of autogenous rib; andimproved the efficiency of autogenous cartilage grafts.As this method has led to positive outcomes, it has the potential to be widely used in clinical practice.