Evaluation of Elevated Nasal Clip Application in Unilateral Cleft Lip Nasal Deformity Correction
In brief
Elevated nasal clips better preserve nostril symmetry after cleft lip repair
In a randomized trial of patients with incomplete unilateral cleft lip, an elevated nasal clip preserved columella and nostril measurements better than a traditional retainer at 6 and 12 months. Separate follow-up cohorts showed nasal symmetry can worsen over time, including by 10 years, but the trial provides no long-term evidence that the clip prevents later relapse.
- Journal
- The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association (Q1)
- Published
- 8 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Shiming Zhang, Min Wu, Meijun Du, Jiali Chen, Ruixin Zeng, Xiang Li, et al.
- PMID
- 42847617
- DOI
- 10.1177/10556656261493236
Why clinicians should know about it
- Picked for Plastic and Reconstructive Surgery (top studies of the week, 11 October 2026): Prospective RCT, elevated nasal clip improves symmetry
- Picked for Otorhinolaryngology (top studies of the week, 11 October 2026): Elevated nasal clip improves symmetry after unilateral cleft lip repair
Abstract
BackgroundThis study aims to characterize the long-term relapse patterns and evaluate the effectiveness of a novel elevated nasal clip in maintaining postoperative nasal symmetry in patients with unilateral cleft lip nasal deformity.MethodsThis study included a preliminary retrospective analysis to contextualize long-term relapse patterns, followed by a prospective randomized controlled trial, which constituted the principal component of the work. First, we conducted a preliminary retrospective analysis to contextualize long-term relapse patterns: we reviewed 2 independent cohorts of patients who underwent primary unilateral cleft lip repair and were followed up at 5 and 10 years postoperatively, respectively. Second, the main component of this study was a prospective randomized controlled trial designed to evaluate the efficacy of the elevated nasal clip, with postoperative follow-up at 6 and 12 months. Both parts employed standardized frontal and basal-view facial photographs and identical anthropometric parameters to quantitatively assess nasal symmetry.ResultsLong-term follow-up revealed progressive relapse in nasal morphology, particularly in deviation of the nasal tip and nostril height asymmetry by 10 years postoperatively. These findings provide a clinical context underscoring the importance of maintaining early nasal symmetry after cleft lip repair. On this basis, we designed a prospective randomized controlled study to rigorously evaluate the efficacy of an elevated nasal clip in patients with incomplete unilateral cleft lip. Compared with the traditional retainer group, the elevated nasal clip group demonstrated significantly better preservation of columella ratio, nostril height ratio, and nostril area ratio, supporting its clinical value as a targeted adjunct for early nasal symmetry maintenance.ConclusionOur study confirmed the progressive and multidimensional nature of long-term nasal symmetry relapse following primary cleft rhinoplasty, underscoring the need for early and effective interventions. Recognizing this long-term vulnerability underscores the need for effective early interventions. In this context, our prospective study demonstrates that the elevated nasal clip provides individually targeted improvement in columella and nostril symmetry, supporting its promise as a practical adjunct for postoperative nasal remodeling after unilateral cleft lip repair.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.