الفهرس 
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Abstract
In fact, cleft lip and cleft palate are considered the commonest congenital anomalies of the head and neck. All cases of cleft lip with or without cleft palate are accompanied by various deformities. CLND is one of the most challenging parts in cleft lip and palate care.
Clinically, UCLND is manifested by the following: retro-displacement of the alar dome on the cleft side, excessively obtuse angle between medial &lateral crura on cleft side, buckling of the ala inward on the cleft side, with webbing of the alar arch, the columella on the cleft side is shorter and positioned obliquely.
In fact, the explanation for the pathogenesis of the nasal deformity varies: Stark&Kaplan, Pigott, Millard, and Pfeiffer all agree that there is a reduction in the amount of primordial tissue caused by disorder in the migration, differentiation, and proliferation of neural crest cells, this opinion is referred as ”the intrinsic theory”.
On the other hand, Green, Atherton, Huffman, Lierle, Stenstrom and Oberg postulated that the nasal deformity happened as a result of extrinsic forces that act to distract the nasal structures. This hypothesis is referred as ”the extrinsic theory”.
The optimum time to carry out correction of a CLND is still controversial. Salyer described primary correction of the CLND at the time of lip repair. Brown&McDowell reported that these actions didn’t have any effect on growth and that they provide moderate improvement of the asymmetric nasal deformity. Recently, Kim et al. documented that the repair of cleft lip and nasal deformity simultaneously in Asian subjects revealed symmetry of nostril and nasal dome projection, better balanced growth and better development of the alar complex without interference with nasal growth.
The aim of our prospective study was to address the soft tissue element in UCLND according, symmetry, and parent’s satisfaction. It was conducted on twenty patients presenting with UCLND over the period from Nov 2016 to Dec 2018.
All cases in the study yielded fair results based on the symmetry of the nostrils. Based on the finding of this study we do not recommend handling the soft tissue in UCLND as it does not affect the final esthetic outcome.