Surgical treatment in unilateral cleft lip-nose patients: long-term follow-up using a personal approach based on rose and spina techniques.

A 24-year follow-up with simultaneous treatment of the lip, nose, and palate in the neonatal period is presented. The first author operated on 92 patients in the neonatal period using a personal approach based on the Rose and Spina techniques. Technical details of the primary repair are described. The unilateral cleft lip-nose is operated on through a curved skin incision, with an upper third Z-plasty. Extensive detachment of the musculature is realized without incising the sulcus. Two flaps close the mucosal layer in an S-shaped position. The nose is approached through a precartilaginous incision on the cleft side, and "V-Y" advancement of a mucocartilaginous flap is realized to restore the normal alar cartilage shape and position. The follow-up showed normal development of the ala with position maintenance without nasal stenosis in 95% of the cases. Good lip functional results were seen in 100% of the cases. Minimal skin scar revision procedures were required in 10% of the cases.