Need a second opion... i am going back and forth with 30462/30460 vs 30400/30410 ???

PREOPERATIVE DIAGNOSIS: Right-sided unilateral cleft lip nasal
deformity and airway obstruction.

POSTOPERATIVE DIAGNOSIS: Right-sided unilateral cleft lip nasal
deformity and airway obstruction.

PROCEDURE PERFORMED:
1. Intranasal endoscopy.
2. Primary cleft rhinoplasty with V-Y advancement flap.
3. Placement of nostril retainer.

DESCRIPTION OF PROCEDURE: Under general anesthesia, the patient was
prepped and draped in the usual sterile fashion. Intranasal
examination showed near complete 100% obstruction of the airway due
to large vestibular webbing. As a result, Marcaine with epinephrine
was injected. The nostril was elevated. A V-Y advancement cut was
made into the mucosa where there was a tethering band and abnormal
fiber fat. A skin flap was elevated. The abnormal fiber fat was
excised. Quilting sutures were used to elevate the skin flaps for
the V-Y advancement into a more normal position relieving the
tethering. Also, quilting sutures were used to then bring the
lateral nasal sidewall into position to quilt it together to close
the gap where the abnormal fiber fat had been removed. Following
this, nasal splints were placed.

The patient tolerated the procedure well with no complications. The
patient was sent to recovery.