Quantitative three-dimensional evaluation before and after rhinoplasty

Nineteen cases of unilateral cleft lip and nose were measured and evaluated before and after open rhinoplasty with the use of facial plaster models and a high-accuracy threedimensional digitizer (TRISTATION400CNC, Nikon, Tokyo). Surgery was performed from 1990 through 1994. The mean age of the subjects was 18.6 years.Three-dimensional wire-frame models were obtained from facial plaster models, and nasal landmarks were extracted automatically by an original program. The landmarks were evaluated and compared according to three operation techniques:(1) Flying bird group: A flying bird incision was made across the columella, and a tornado incision was made in the nostril. After cartilage reconstruction, complex tissue was transplanted into the nostril. Furthermore, Z-plasty was done across the white lip and the alar base of the affected side.(2) Col. base-graft group: An incision was made in the columella base and nostril rim. After cartilage reconstruction, ear cartilage was transplanted onto the nasal tip, alar, or both (3) Col. base-non-graft group: An incision was made in the columella base and nostril rim. The nasal cartilage was reconstructed without a graft.The nasal tips deviated about 5 mm to the normal side before operation and were corrected after operation in all groups. In the flying bird and col. base-graft groups, the nasal tips moved about 3 mm anteriorly. The difference in the distance between the columelia base and the alar base decreased markedly in the flying bird group. The columella base deviated about 3mm to the normal side before surgery and was corrected after surgery in all groups. In the Col. base-graft group, the columella base protruded inferiorly after operation. No remarkable change was observed in the alar dip in any group.The procedure used in the flying bird group was suggested to result in a better morphological outcome than the procedures used in the col. base with/without graft groups.