Effect of Autogenous Auricular Cartilage Composite Skin Graft for Bilateral Cleft Lip Nose Deformity Repair

Objective: Bilateral cleft lip nose deformity often involves nasal alar retraction. The use of autogenous auricular cartilage for correction further aggravated nasal alar retraction caused by nasal lining defects after the operation. A novel graft was developed to address bilateral cleft lip nose deformity. This graft effectively addresses the lining defect and avoids nasal alar retraction following surgical intervention. Methods: Seventeen patients (7 males and 10 females) with bilateral cleft lip nose deformity were treated at the authors' institution. All patients underwent repair with an auricular cartilage-composite skin graft. The surgical effect was evaluated from 4 aspects: nasal flange position, postoperative appearance satisfaction, nasal aesthetic subunit index, and three-dimensional difference. Results: Postoperatively, 17 patients with bilateral cleft lip nose deformity were followed up from 3 months to 1 year, none of them had any obvious inward collapse or recession of the nasal margin ( P > 0.05), and all of them showed satisfactory results. The satisfaction rate was above 90% ( P < 0.01). The nasal tip angle and nasolabial angle were significantly smaller postoperatively than those preoperatively ( P < 0.01). The nostril height and nasal columellar height were greater postoperatively than those preoperatively ( P < 0.01). A comparison of the three-dimensional spatial differences revealed that the appearance of the nasal deformity was noticeably better after surgery ( P < 0.01). Conclusions: Auricular cartilage-composite skin graft repair is highly effective for enhancing nasal support, correcting nasal tip shape, effectively resolving nasal flange recession, and preventing nasal flange retraction in the postoperative period. Level of Evidence: Level IV.