Cleft lip and Nose Deformity

A cleft lip nose deformity is a structural abnormality of the nose that can occur in individuals with a cleft lip, either unilateral (one side) or bilateral (both sides). The severity of the deformity varies, but it often involves asymmetry, a flattened nasal tip, a shortened columella (the tissue that separates the nostrils), and a wider, flatter nostril on the cleft side. 

Here's a more detailed look:

Unilateral Cleft Lip Nasal Deformity: 

• Asymmetry:

The most prominent feature is the asymmetry of the nose, with the nasal tip deviating towards the non-cleft side. 

• Alar Cartilage:

The alar cartilage, which shapes the nostrils, is displaced and deformed on the cleft side. 

• Nasal Dome:

The nasal dome on the cleft side is flattened and lower than the non-cleft side. 

• Columella:

The columella is often shorter and deviates towards the non-cleft side. 

• Nostril Shape:

The nostril on the cleft side may be wider, flatter, and more oblique or slanted. 

• Alar Base:

The alar base (where the nostril meets the lip) is often wider on the cleft side. 

Bilateral Cleft Lip Nasal Deformity: 

• Broad, Flat Tip: Both sides of the nose are affected, leading to a broader, flatter nasal tip due to underdevelopment of the alar cartilages. 
• Short Columella: The columella is often short and retracted. 
• Maxillary Hypoplasia: In some cases, there may be an associated hypoplasia (underdevelopment) of the maxilla (upper jaw) on one or both sides. 

Causes:

• Incomplete Fusion: Cleft lip and palate, including the nasal deformity, result from incomplete fusion of the facial structures during early fetal development.
• Heredity: Genetic factors can play a role, but most cases are not inherited.
• Environmental Factors: Factors like smoking or alcohol use during pregnancy can also contribute. 

Treatment:

• Rhinoplasty:

Surgical procedures, often involving rhinoplasty techniques, are used to correct the nasal deformity, often at the time of primary lip repair. 

• Reconstruction:

Reconstruction may involve repositioning the alar cartilages, lengthening the columella, and reshaping the nostril.