Rhinoplasty and nasal function in patients with cleft lips.

The purpose of this study was to find out whether harvesting septal grafts and simultaneously doing a septoplasty improves nasal function in patients with clefts who are having a rhinoplasty to correct the external deformity. We studied 14 patients with a unilateral cleft (UCL(P)) and four with bilateral clefts (BCLP). Nasal airflow resistance was measured with active rhinomanometry preoperatively and postoperatively. In nine of the 14 with UCL(P) and in all those with BCLP nasal resistance was normal or near normal both preoperatively and postoperatively. In five with UCL(P) postoperative nasal resistance was highly increased on the cleft side and in three of these patients nasal resistance decreased significantly but still remained abnormal. Only one patient subjectively complained of poor nasal airflow but all sought improvement of their nasal appearance. Harvesting of the graft and simultaneous straightening of the nasal septum during a rhinoplasty in patients with clefts neither improved, nor had a deleterious effect on, nasal function.