Septal-Costal Cartilage Complex: A Novel Surgical Technique to Correct Septal Caudal Deviation in Unilateral Cleft Lip Nasal Deformity

The present study aimed to introduce a novel surgical technique of constructing a septal-costal cartilage complex to correct septal caudal deviation of patients with unilateral cleft lip nasal deformities (UCLND). The caudal end of the septal extension graft (SEG) was split based on preoperative 3D reconstruction of cranial CT to form 2 segments that straddle the septal cartilage and were firmly sutured to the anterior nasal spine. Subsequently, 2 thin septal extension grafts were inserted with SEG bilaterally to form a septal-costal cartilage complex. The study enrolled 40 patients with UCLND from January 2017 to December 2024 and collected clinical photos and the Nasal Obstruction Evaluation Scale (NOSE) scores preoperatively and postoperatively at 6 months to evaluate nasal morphology and function. Correction of septal caudal deviation were achieved in all patients. Postoperative nasal morphology, including nasofacial angle ( P< 0.001), nasal labial angle ( P =0.007), deviation angle of columella ( P <0.001), and the ratio of nostril (both P <0.001), showed significant improvements, and NOSE also showed significant differences ( P =0.035). The authors concluded that this surgical technique with the septal-costal cartilage complex provided a strong support structure and effectively corrected septal caudal deviation.