Correction of Nostril Asymmetry in Asians Secondary Unilateral Cleft Lip Nasal Deformity Based on Novel Nostril Ring Concept.

[BACKGROUND] Asymmetry of the bilateral nostrils is one of the most common deformities associated with secondary unilateral cleft lip nasal deformity. In this study, we introduce a novel concept of the "nostril ring" and propose a series of corrective strategies based on the anatomical characteristics of the nostril ring and the factors influencing its morphology.

[METHODS] A retrospective review was conducted of 114 patients who underwent secondary cleft rhinoplasty between January 2021 and January 2024. Surgical techniques included correction of columellar deviation, adjustment of alar skin, reconstruction of the lower lateral cartilage, and among other procedures. Surgical outcomes were assessed by comparing preoperative and postoperative nostril parameters. The aesthetic outcomes of the patients were assessed by surgeons using the visual analog scale (VAS), and patient was self-assessed using the rhinoplasty outcome evaluation (ROE) scale. Additionally, the Nasal Obstruction Symptom Evaluation (NOSE) scale was utilized to assess improvements in nasal obstruction symptoms.

[RESULTS] In the postoperative group, the nostril width and nasal floor height were significantly reduced (P < 0.05). The nostril height, nostril area, and symmetry showed significant increases following surgery (P < 0.05), along with significant improvements in VAS and ROE scores (P < 0.05). There were no statistically significant differences between the preoperative and postoperative NOSE scores. No significant complications were observed during the follow-up period.

[CONCLUSION] By analyzing the anatomical characteristics of the nostril ring and identifying the key factors influencing its structure, we have successfully utilized a combination of techniques to correct nostril asymmetry in patients with unilateral cleft lip nasal deformities.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the table of contents or the online instructions to Authors www.springer.com/00266 .