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A New Microtia Reconstruction Method Using Delayed Postauricular Skin Flap.

The measurements made in the 1:1 standard basal view photographs have also been used in several of the outcome studies published from our center, as we continue to modify our surgical techniques and evaluate our surgical outcomes.1,2 We have found performing standard measurements from the basal view to be a reliable anthropometric method in studying nasal symmetry and growth in cleft patients. Performing the standard basal view measurements on all of our patients allows us to compare and objectively assess surgical outcomes using different surgical techniques. The AsherMcDade system is another commonly used system to evaluate nasal form and symmetry. It is a five-point ordinal scale rating the nasolabial appearance from 1 to 5, with 1 representing very good and 5 representing very poor appearance. The Asher-McDade system was initially used on photographs taken from the frontal and right profile views. Rubin et al. recently published the basal view reference photographs illustrating the Asher-McDade scale in evaluating form and symmetry in unilateral cleft lip and palate patients.3 The Likerttype scale used in the Asher-McDade system, however, simply does not allow for objective measurements and qualification of nasal asymmetry compared with the method described in our article.4 With regard to the question of whether primary caudal septum repositioning was used in either of the treatment groups, the answer is no. The technique advocated in our article was inspired by the technique described by Morselli et al., where the septum was separated from the premaxilla, and the cartilage in excess was removed by an inferior wedge-shaped chondrectomy.5 DOI: 10.1097/PRS.0000000000004431