Long-Term Outcome of Nasal Base Tripod in Patients With Unilateral Cleft: A 3-Dimensional Relationship Among Columellar and Alar Bases

Background Primary rhinoplasty is gaining popularity in cleft care. However, for a comprehensive reconstruction of 3-dimensional nasal morphology, an emphasis on lip muscle repair is essential to achieve nasal symmetry. Surgeons aiming to improve outcomes need to extend their understanding of the interrelationships among the alar bases, columellar base, and the underlying skeletal structure in primary condition and up to skeletal maturity. Methods This study analyzed imaging data from 192 skeletally matured patients, dividing them into unilateral complete, incomplete, and noncleft groups. Both cone-beam computed tomography and 3D photographs were utilized to investigate the 3-dimensional relationships among bilateral alare and subnasale, including underlying structures (soft-tissue thickness and skeletal asymmetry). Statistical comparisons were performed. Through stepwise multiple linear regression analysis, the study identified significant interrelationships among the nasal bases. Results The data revealed that despite the asymmetry in the underlying skeletal foundation, the current surgical methods have been successful in reconstructing the alar bases in a 3-dimensional aspect. However, columellar base deviation was observed when compared to the noncleft patients. The regression analysis revealed a notable correlation between the depression of the cleft-side alar base and columellar base deviation. Conclusions This study provides an insight for evaluating the cleft lip repair. Correcting the anteroposterior depression on cleft side alar base, in addition to adequate muscle reconstruction, could possibly reduce the columellar base deviation.