الفهرس 
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Abstract
Background : Although many trials have been made to augment the unilateral alar base depression, the ultimate aesthetic satisfaction has proven difficult to achieve. In our study, we present a novel submucosal dissection technique to harvest the vomer bone and use it as an onlay graft to correct the alar base depression. Methods : We collected a prospective cohort study of twenty patients with unilateral cleft lip nasal deformity. Using CorelDRAW X7 software, we obtained perioperative clinical photographs to analyze the nostril and lateral lip morphometric measurements on the cleft side. Computed Tomography scans were used to assess the required graft’s volume and to detect resorption. We performed vomerine ostectomy and placed and fixed the bone graft in with a lag screw over the alar base depression. Results : The lateral lip height showed a significant increase, in addition to alar base projection. The columellar angle, nostril height and width were aesthetically improved with the procedure combine with rhinoplasty maneuvres. Conclusions : It could be placed and fixed as onlay bone graft over the defect to correct the inferior displacement or to fill the defect to counteract the posterior displacement. It is considered an adjuvant procedure with the routine alveolar bone grafting to restore the normal aesthetics of the alar base with no need for major corrections such as distraction osteogenesis. The vomer bone is, therefore, a sufficient bone source for grafting with high viability and no resorption. More studies are planned to be conducted to measure the effect of vomer bone graft in bilateral secondary cleft lip nasal deformity patients.