Fig. 4. Operative views from case 3. (A) Clinical features of the cleft deformity at 8 months of age. (B) Clinical features of the cleft deformity at 28 months of age. (C) The alveolar gap measures 10 mm at its widest point. (D) The nasal floor is absent due to the cleft deformity, revealing the inferior turbinate mucosa. (E) The superior margin of the turbinate flap is sutured to the pyriform margin, and the inferior margin is sutured to the mucosal part of the lateral nasal flap, forming a composite flap for the lateral tissue of the nasal floor lining. (F) The medial mucosal flap is rotated and sutured to the free margin of the turbinate flap to reconstruct the nasal floor. (G) Functional muscular reconstruction is performed. (H) The operation finalized with primary rhinoplasty, Cupid’s bow creation, and cutaneous refinements.
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