Comparison of nasal symmetry in closed, semi-open and open tip rhinoplasty following primary cleft lip repair: Systematic review and meta analysis

Aim: The purpose of the present research was to assess the amount of nasal symmetry achieved through closed, semi-open, open tip rhinoplasty after primary cleft lip repair. Methodology: Protocol was registered on the PROSPERO register of systematic reviews. PRISMA-P guidelines for the conduct of systematic review were followed. Literature search was done in various databases. The inclusion criteria were patients with non-syndromic unilateral cleft lip undergoing rhinoplasty with primary cleft lip repair and preference given to studies comparing the 3 procedures. Results: Sixteen articles were selected based on inclusion criteria after screening 522 articles—1 randomized controlled trial, 2 retrospective cohorts, and 13 case series. Both closed and open techniques have achieved good symmetry of nostrils with no impairment of growth. No advantage of one technique over the other was noted. Conclusion: There is a paucity of randomized controlled trials and prospective studies on the subject to arrive at an evidence-based recommendation as to whether open or closed rhinoplasty during primary cleft lip repair gives better long-term outcome