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Table 2 Nasal deformities associated with unilateral and bilateral clefts and our surgical solutions

From: Secondary correction of nasal deformities in cleft lip and palate patients: surgical technique and outcome evaluation

unilateral cleft bilateral cleft surgical solutions unilateral/bilateral
perpendicular plate deviates towards the cleft side shortened columella resection of the deviated bony septum/columellar skin gained by V-Y plasty
nasal spine deviates towards the non-cleft side lack of septal cartilage in the anterior columellar region not corrected/columella strut graft is used
bony pyramid deviates towards the non-cleft side downward rotation of the nasal tip bony pyramid replacement vis medial and lateral osteotomies/tip projection provided by the columella strut
lateral displacement of the alar base at the cleft side bifidity of the nasal tip lower lateral cartilage replacement/tip refinement with sutures and/or shield/tip grafting
downward displacement of the alar cartilage at the cleft side buckling of the lateral crura on both sides in both cases alar cartilage replacement and the two medial crural cartilages sutured together with the columella strut
asymmetry/bifidity of the dome area usually no severe septal deviation in both cases tip refinement with sutures and/or grafting
down position of the medial crus at the cleft side downward rotation of the alar cartilage in both cases tip projection provided by the columella strut