A Rare Presentation of Isolated Cleft of the Ala Nasi

The nose is the most prominent feature on the face, any asymmetry or irregularity in the nasal contour assumes a great significance. Craniofacial clefts other than cleft lip & palate are reported to be 1.4 to 4.9 per 100,000 live births. Of these, clefts of the nose are usually associated with other clefts. Isolated cleft of Ala is rare, 0.7% of all clefts reported by Monasterio. In an analysis of photographic records of 3,500 consecutive patients with craniofacial clefts including cleft lip & palate registered with us between 1985-2012 which were accessed through our database, 13 patients with nasal clefts were identified, seven out of which had Isolated cleft of Ala. All the patients were treated by the same technique of a posteriorly based full-thickness flap of the ala rotated into the defect and a Z plasty. Six of the seven patients healed without incident. One had a minor wound dehiscence which was managed conservatively. The study has emphasized how uncommon the ailment is and has provided a straightforward surgical method for its treatment. The authors believe that this relatively easy treatment, which even a junior surgeon can do, has good long-term results in the management of cleft Ala.