Columellar strut graft in unilateral cleft nasal deformity: Anthropometry and clinical outcomes

Introduction: The cleft nasal deformity is a three-dimensional asymmetry involving all layers of the nose. Columellar strut graft is an important method to provide support to the skeletal framework in an attempt to retain structural support and balance. Aims: The purpose of our study is to describe the surgical outcomes following the use of columellar strut graft when it is used in secondary cleft rhinoplasty. The study was designed to identify the changes in tip projection (Tip Proj), tip rotation (Tip Rot), and other anthropometric measurements postoperatively. Materials and Methods: A prospective study was conducted among patients presenting with secondary cleft nasal deformity and operated utilizing a columellar strut graft. The parameters considered were columellar height (CH), columellar width, Tip Proj, Tip Rot, nasofrontal angle, nasofacial angle, and nasolabial angle. All the measurements were analyzed statistically. Results: During the study, results could be evaluated for 25 patients. The Tip Proj increased in 84% of patients, and the magnitude of difference between pre- and post-operative follow-up at 9 months was found to be statistically significant (P = 0.009). The CH increased in 20 patients (80%). The Tip Rot increased in 20 patients (80%). The postoperative changes were consistently maintained at different follow-up intervals. Conclusions: Columellar strut is necessary in improving the Tip Proj, correcting the tilted tripod and lower lateral cartilage deformities. It also functions as a central scaffold on which the tip structures can be unified.