General anatomical structures of the unilateral CLN deformity have been well known. Various kinds of operation methods have been applied based on this knowledge. The degree of the unilateral CLN deformity varies depending on individual and type of cleft lip. Therefore, the correction parts and´ operation methods have to be modified depending on the cases.
Hypoplastic pyriform aperture is major external factor which causes the unilateral CLN deformity and, it also causes deformities of alar cartilage and nasal tip, and septal deviation, which has been well explained with the concept of ´Tilted Tripod´ by Hogan and Coverse in 1971. The correction of hypoplastic pyriform aperture which tilts nasal tripod gives satisfactory result of symmetric nasal tripod including its base.
For the correction of hypoplastic pyriform aperture, autogenous rib bone or iliac bone graft, autogenous cartilage graft, homologous cartilage graft and implant have been used, but scar deformity of doner site, and permanence of implant turned out to be problems. Authors used outer table of calvarial bone graft on 2 5 patients for the recovery of the collapsed pyriform aperture, of these, 14 patients were male and 1 were female. The youngest was 5 years of age, the eldest was 30 years, and 7 patients were under 16 years. We performed external rhinoplasty upon the symmetric pyri form. aperture corrected with calvarial bone graft and achieved satisfactory results, thus we represent our methods and cases with review of literatures.
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