Is a Nostril Retainer necessary?

Is a Nostril retainer necessary for a post operative cleft surgery?

What would be the need for a nostril retainer for post operative cleft surgery? Well, there were some of the questions when I first encountered the nostril retainer. When I started the journey onto making this product, there were a lot of surgeons on both sides of the fence. Some said that it is useful, while others denied the usefulness. And as always, i had to rely on research articles for answers.

I found an article authored by V K Yeow, P K Chen, Y R Chen and S M Noordhoff on the topic of The use of nasal splints in the primary management of unilateral cleft nasal deformity.

The authors mention that the Craniofacial Center of Chang Gung Memorial Hospital frequently performs primary surgical repair of the cleft lip nasal deformity, from where they performed their study. The lower lateral cartilage does have a propensity to retain its memory over time, though, which can lead to a repetition of the preoperative nose deformity. In order to preserve the proper position of the nose, it is and was recommended to use a nasal retainer for at least 6 months. The purpose of this study was to qualitatively evaluate the advantages of unilateral cleft nasal splinting as the initial type of treatment.

Retrospectively, data from two groups of 30 individuals with complete unilateral cleft lips were gathered and examined. The second group used the nasal retainer diligently for at least six months after surgery, whereas the first group acted as a control (no nasal retainers). At the age of three months, the main lip was repaired on each patient. The outcomes were photographed and evaluated when the patients were between the ages of 5 and 8 years old. The criteria employed to evaluate the nasal result were columella tilt, alar base level, alar cartilage slump, and nostril symmetry.

The initial scores were determined by the presence of any persistent nasal deformity, and the second set was determined by general look. It was discovered that patients who utilized the nasal stent had statistically lower mean ratings of residual nasal deformity for all four metrics than patients who did not (p values ranged from 0.0001 to 0.005). Additionally, there was a statistically significant difference in the four criteria’ overall appearance scores for the patients who utilized the nasal stent following surgery and those who did not (p values ranged from 0.0001 to 0.01).

The findings demonstrate that the postoperative nasal retainer, used as the first line of treatment for unilateral cleft nasal deformity, preserves and maintains the nose’s corrected position following initial lip and nasal correction, producing a noticeably more pleasing cosmetic outcome.

This study proves that the nasal retainer should be worn postoperatively for at least 6 months by all patients receiving primary repair of a full unilateral cleft deformity.

For more information on the research article, please lookup The use of nasal splints in the primary management of unilateral cleft nasal deformity, by V K Yeow, P K Chen, Y R Chen, S M Noordhoff
PMID: 10190430 DOI: 10.1097/00006534-199904050-00002