Bilateral Cleft Nasal Repair Workup

  • Author: Donald R Laub Jr, MD, MS, FACS; Chief Editor: Jorge I de la Torre, MD, FACS   more...
 
Updated: Aug 15, 2011
 

Laboratory Studies

Laboratory studies are not routinely required in healthy infants. If the child's status is in any doubt, studies may be used preoperatively to confirm the child's suitability for surgery.

Expected results of a complete blood cell count are as follows:

  • Hemoglobin value of at least 10 g/100 mL
  • Hematocrit value of 35%
  • WBC count of less than 10,000/µL
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Imaging Studies

Chest radiographs are not routinely required in healthy infants. If the child's respiratory status is in any doubt, radiographs may be used preoperatively to confirm the absence of a respiratory infection or any other pulmonary anomalies that may compromise the patient's intraoperative or postoperative course.

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Contributor Information and Disclosures
Author

Donald R Laub Jr, MD, MS, FACS  Professor, Departments of Surgery and Pediatrics, University of Vermont College of Medicine; Medical Director of the Vermont State Cleft Palate-Craniofacial Clinic; Fletcher-Allen Health Care

Donald R Laub Jr, MD, MS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association for Hand Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, AO Foundation, Association for Academic Surgery, Northeastern Society of Plastic Surgeons, and Vermont State Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

David W Leitner, MD  Professor, Department of Surgery, Division of Plastic Reconstructive and Cosmetic Surgery, University of Vermont College of Medicine, Burlington

David W Leitner, MD is a member of the following medical societies: Alpha Omega Alpha, American Society of Plastic and Reconstructive Surgery, and Northeastern Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Larry Hollier, Jr, MD  Assistant Professor, Department of Plastic Surgery, Baylor University College of Medicine

Larry Hollier, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, AO Foundation, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

R Edward Newsome, MD†  Former Program Director and Chief of Plastic Surgery, Henderson Chair in Surgery, Former Assistant Dean for Graduate Medical Education, Tulane University School of Medicine

R Edward Newsome, MD† is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic and Reconstructive Surgery, American Society of Plastic Surgeons, and Louisiana State Medical Society

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS  Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

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A diagram of normal nasal anatomy. Note the acute angle of genu of the lower lateral cartilages and the vertical orientation of the nares.
A diagram of nasal anatomy of a person with bilateral cleft lip. Note the obtuse angle of the genu of the lower lateral cartilages and the horizontal alignment of the nares.
Lengthening the columella by advancing skin from the prolabium (large red arrow) tends to increase the angle of the lower lateral cartilages (small red arrows) and broadens the tip.
Lengthening the columella by an interdomal suture (blue) moves the lower lateral cartilages medially (red arrows) and defines the nasal tip.
Intraoperative view of an open rhinoplasty on a patient with blilteral cleft lip.
Intraoperative view of an open rhinoplasty on a patient with blilteral cleft lip, after placement of an intradomal suture.
 
 
 
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