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Long-Term Evaluation of Elongating Columella Using Conchal Composite Graft in Bilateral Secondary Cleft Lip and Nose Deformity

Title
Long-Term Evaluation of Elongating Columella Using Conchal Composite Graft in Bilateral Secondary Cleft Lip and Nose Deformity
Authors
Cheon, Young WooPark, Beyoung Yun
Ewha Authors
전영우
Issue Date
2010
Journal Title
PLASTIC AND RECONSTRUCTIVE SURGERY
ISSN
0032-1052JCR Link
Citation
vol. 126, no. 2, pp. 543 - 553
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Indexed
SCI; SCIE; SCOPUS WOS
Abstract
Background: A short columella is one of the most severe problems in bilateral cleft hp and nose deformity. In particular, with tissue insufficiency or scar contracture on the upper lip, it is very hard to achieve a good nasal profile with conventional methods. Methods: One hundred thirty-seven patients with a short columella were operated on front February of 1987 to December of 2008 The average age at operation was 7.3 years. The conchal cartilage was harvested. The preauricular or postauricular skin-subcutaneous fat composite tissue was harvested Through a transcolumellar incision, the conchal cartilage was inset and the defect was covered with skin-fat composite tissue The serial nasal profiles were evaluated before and after surgery. Also, the postoperative nasal profiles were compared with normal profiles The postoperative color difference with surrounding skin was measured by the L*a*b* photographic analysis method. Results: The mean height and width of skin-subcutaneous fat composite tissue were 9.81 and 22.14 mm, respectively. The preoperative and postoperative measuring for columella height was 5.1 +/- 1.1 mm and 14.2 +/- 1.5 mm. The columella-lip angle was 120 30 +/- 12.97 preoperatively degrees and 98.76 +/- 10.98 degrees postoperatively, whereas the angle of columellar-alar triangle was 111.56 +/- 11 39 degrees and 97 91 +/- 11.49 degrees, respectively None of the postoperative profiles were different. from those of normal Korean people of the same age except in die 0- to 6-year-old group (p < 0 05). The color match was best with preauricular composite tissue. Complications included total necrosis in three cases and partial necrosis in 12 cases that were treated conservatively. Conclusion: Elongating columella using a composite graft can be a satisfying alternative, especially for a severe short columella with upper lip tissue deficiency. (Plast. Reconstr. Surg 126: 543, 2010.)
DOI
10.1097/PRS.0b013e3181e0969a
Appears in Collections:
의과대학 > 의학과 > Journal papers
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