Secondary rhinoplasty outcomes in unilateral cleft lip patients: A photogrammetric analysis

Jan Rustemeyer; Nouraldeen Mahmoud; Edita Ponelis; Susanne Sehhati Chafai Leuwer

doi:10.1016/j.jcms.2025.05.011

Secondary rhinoplasty outcomes in unilateral cleft lip patients: A photogrammetric analysis

J Craniomaxillofac Surg. 2025 May 16:S1010-5182(25)00176-3. doi: 10.1016/j.jcms.2025.05.011. Online ahead of print.

Authors

Jan Rustemeyer¹, Nouraldeen Mahmoud², Edita Ponelis², Susanne Sehhati Chafai Leuwer³

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany; Medizinisches Versorgungszentrum, Fachaertzezentrum Hanse, Bremen, Germany. Electronic address: janrustem@gmx.de.
² Department of Oral and Maxillofacial Surgery, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany.
³ Department of Oral and Maxillofacial Surgery, Klinikum Bremen-Mitte, Medical School of the University of Göttingen, Bremen, Germany; Medizinisches Versorgungszentrum, Fachaertzezentrum Hanse, Bremen, Germany.

PMID: 40461337
DOI: 10.1016/j.jcms.2025.05.011

Abstract

Secondary rhinoplasty (SRP) in patients with matured unilateral cleft lip and palate remains a surgical challenge due to nasal asymmetry, tip ptosis, and alar deformities. This study aimed to quantitatively assess morphological nasal changes using photogrammetric angular analysis and correlate them with patient-reported satisfaction. Thirty SRP patients were compared with 30 controls. Pre- and post-surgical profile and basal images were analysed using lateral and basal soft tissue angular measurements. Postoperative results showed significant improvements in nasal symmetry and tip projection, with normalization of several angles, notably interaxial and nostril axis angles. The mean satisfaction score was 3.93 on the 5-point Global Aesthetic Improvement Scale, with over 75 % of patients reporting marked improvement. Significant correlations were found between satisfaction scores and parameters related to nasal symmetry and tip projection. No differences in outcomes were noted between septal and costal cartilage grafts. Within the limitations of the study, the findings support SRP as an effective intervention for aesthetic improvement in cleft nasal deformities. Tailored surgical techniques, particularly using septal extension and alar support grafts, contributed to the positive outcomes observed.

Keywords: Nasal symmetry; Patient satisfaction; Photogrammetry; Secondary rhinoplasty; Septal extension graft; Unilateral cleft lip palate.