A Novel Classification of Nasal Sill Morphology Provides Strategies for Secondary Cleft Rhinoplasty

Overview

Secondary cleft lip-nose deformities lack a standard classification, so surgeons rely on experience. The authors classified patients treated between August 2019 and July 2024 by the shape of the nasal sill on the base view and tailored surgery to each type.

Sections of note

• 276 patients.
• Type I 13 (4.71%), type II 25 (9.06%), type III 73 (26.45%), type IV 165 (59.78%).
• All patients were reported to have improved sill aesthetics and nasal symmetry.
• The authors present it as a first attempt at an objective standard for secondary cleft nasolabial surgery.
• Level of Evidence IV.

What it means for a patient

• The nostril floor and sill on the cleft side are a major source of visible asymmetry after cleft repair.
• A classification lets a surgeon explain which type you have and what operation matches it.
• Outcome claims are qualitative; no measurements or scores are given in the abstract.

Why this paper matters

It brings a structured classification to a large series in an area governed by surgeon preference. Limits: single centre, no quantified outcomes, no comparison of strategies.

Terms

• Nasal sill: the floor of the nostril opening where it meets the upper lip.
• Base view: the photograph taken from below the nose.
• Secondary cleft nasolabial deformity: residual lip and nose asymmetry after the original cleft repair.
• Nasolabial: relating to the nose and upper lip together.