The Effects of Secondary Cleft Procedures on Alar Base Position and Nostril Morphology in Patients with Unilateral Clefts.

Objective:  To compare effects of secondary cleft procedures on alar base position and nostril morphology. Design:  Retrospective review. Setting:  Multidisciplinary cleft clinic at tertiary center. Patients, Participants:  Seventy consecutive patients with unilateral clefts were grouped according to secondary procedure. Interventions:  Alveolar bone graft versus total lip takedown with anatomic muscle repair versus single-stage total lip with cleft septorhinoplasty (nose-lip) versus rhinoplasty alone. Main Outcome Measures:  Anthropometric measurements were recorded from pre- and postoperative photographs. Ratios of cleft to noncleft side were compared within and across groups pre- and postoperatively using parametric and nonparametric tests. Results:  Within the bone graft group, no differences were seen postoperatively in alar base position in long-term follow-up. The total lip group demonstrated greater symmetry at the alar base (P < .001), increased vertical lip dimension (P < .001), and decreased no...