Converse : Chapter 47 Secondary Deformities of Cleft Lip , Cleft Lip and Nose , and Cleft Palate

The diversity of secondary deformities following repair of the cleft lip and nose is striking. The deformities reflect the wide variety of surgical techniques used to repair the cleft lip and the cleft lip nose. Secondary deformities of the repaired cleft lip and nose result from several distinct but related components: congenitally abnormal tissues; surgically modified tissues; the innate tendency of tissue to reflect its phenotype; the absence of diverse tissue elements such as ectoderm and mesoderm; and the effects of growth and development. Whereas primary repair of the cleft lip has become increasingly successful, repair of the cleft lip nose has continued to be a difficult problem. The three-dimensional nature of the abnormality and the presence of a mixed tissue matrix are responsible for the difficulty in finding an empirical solution to the nasal deformity.