Bilateral Complete Cleft Lip Repair and Primary Semi-open Rhinoplasty

2016 ◽  
pp. 227-230
Author(s):  
Ting-Chen Lu ◽  
Un-Chang See ◽  
Philip Kuo-Ting Chen ◽  
M. Samuel Noordhoff
Keyword(s):  
Cleft Lip ◽  
Open Rhinoplasty ◽  
Cleft Lip Repair

Primary Rhinoplasty in Unilateral Cleft Patients: The “Limited Open” Approach and Other Technical Considerations

2006 ◽  
Vol 43 (4) ◽  
pp. 492-498 ◽  
Author(s):  
Rajeev B. Ahuja
Keyword(s):  
Cleft Lip ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
Mattress Suture ◽  
Absolute Increase ◽  
Primary Rhinoplasty ◽  
Transcolumellar Incision ◽  
Cleft Lip Repair ◽  
Presurgical Orthopedics

Objective To validate a method of primary anatomic alar repositioning using a “limited open rhinoplasty” approach, along with cleft lip repair, without presurgical orthopedics. Methods The cleft lip deformities were repaired using a modified Tennison technique, and primary muscle union and gingivoperiosteoplasty were achieved in all cases. The alar cartilages were visualized using an inverted “U” incision on the cleft side and a rim incision on the noncleft side, without joining the two with a transcolumellar incision. The domes of the cartilages were approximated by a single horizontal mattress suture. Patients Thirty-five patients were operated on by this technique between March 1999 and February 2004. The patients ranged in age from 4 to 36 months (mean, 6 months). The follow-up ranged from 4 months to 4.5 years (mean, 18 months). Results Overall, the results for nasal shape and symmetry have been extremely good. Conclusions The technique used here provides an exposure just short of an “open” rhinoplasty without scarring the columella or nasal tip. Arch alignment and a symmetric and stable bony platform are generally achieved by 2 to 3 months after the surgery. In severe cases of complete clefts, we have observed an absolute increase in alar arch length as a result of tissue stretch.

scholarly journals Outcomes of Closed Versus Open Technique of Rhinoplasty During Primary Repair of Unilateral Cleft Lip: A Systematic Review

2018 ◽  
Vol 56 (1) ◽  
pp. 74-83 ◽  
Author(s):  
Rajshree Jayarajan ◽  
Anantharajan Natarajan ◽  
Ravindranathan Nagamuttu
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Primary Repair ◽  
Case Series ◽  
Open Rhinoplasty ◽  
Inclusion Criteria ◽  
Long Term Outcomes ◽  
Randomized Controlled ◽  
Cleft Lip Repair

Objective: Primary cleft rhinoplasty has almost become the norm in cleft practice. Although various closed and open rhinoplasty techniques are in use, there is no consensus as to which technique is superior in terms of outcome. The authors hypothesized that the long-term outcomes of open rhinoplasty during primary cleft lip repair in unilateral cleft is better than that of the closed method. This systematic review has been done to evaluate the hypothesis by a review and analysis of literature. Methods: Protocol was registered on the PROSPERO register of systematic reviews. PRISMA-P guidelines for the conduct of systematic review were followed. Literature search was done in various databases. The inclusion criteria were patients with nonsyndromic unilateral cleft lip undergoing rhinoplasty with primary cleft lip repair and preference given to studies comparing the 2 procedures. Results: Sixteen articles were selected based on inclusion criteria after screening 522 articles—1 randomized controlled trial, 2 retrospective cohorts, and 13 case series. Both closed and open techniques have achieved good symmetry of nostrils with no impairment of growth. No advantage of one technique over the other was noted. Conclusions: There is a paucity of randomized controlled trials and prospective studies on the subject to arrive at an evidence-based recommendation as to whether open or closed rhinoplasty during primary cleft lip repair gives better long-term outcomes. Due to insufficient evidence, the authors are not able to support or refute the hypothesis put forward in the review.

Unilateral Complete Cleft Lip Repair with Primary Semi-open Rhinoplasty

2016 ◽  
pp. 221-225
Author(s):  
Ting-Chen Lu ◽  
Un-Chang See ◽  
Philip Kuo-Ting Chen ◽  
M. Samuel Noordhoff
Keyword(s):  
Cleft Lip ◽  
Open Rhinoplasty ◽  
Cleft Lip Repair

Unilateral Cleft Lip Repair

1993 ◽  
Vol 20 (4) ◽  
pp. 647-657 ◽  
Author(s):  
Michael B. Lewis
Keyword(s):  
Cleft Lip ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

The unilateral cleft lip repair

2021 ◽  
Vol 42 (3) ◽  
pp. 102908
Author(s):  
Jeewanjot S. Grewal ◽  
Susan C. Yanik ◽  
Alexis M. Strohl-Bryan ◽  
Sherard A. Tatum
Keyword(s):  
Cleft Lip ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

Perioperative Management of Cleft Lip Repair: A Meta-Analysis and Clinical Practice Guideline

2021 ◽  
pp. 105566562098490
Author(s):  
Matthew Ranzer ◽  
Edward Daniele ◽  
Chad A. Purnell
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Wound Closure ◽  
Perioperative Management ◽  
Outpatient Surgery ◽  
Meta Analysis ◽  
Bottle Feeding ◽  
Perioperative Antibiotics ◽  
Cleft Lip Repair ◽  
Postoperative Feeding

Objective: Few studies have focused on perioperative management of cleft lip repair. We sought to evaluate the available data on this topic to create evidence-based clinical guidelines. Design: Systematic review, meta-analysis. Methods: A PubMed search was performed focusing on perioperative management of cleft lip repair. Studies were included if they included comparative data. A systematic review and meta-analysis was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Main Outcome Measures: Systematic review of literature regarding wound closure, postoperative arm restraints, perioperative antibiotics, outpatient or ambulatory surgery, or feeding restrictions postoperatively. Results: Twenty-three articles met inclusion criteria after initial screening of 3103 articles. This included 8 articles on wound closure, 2 on postoperative restraints, one on perioperative antibiotics, 6 on outpatient surgery, and 6 on postoperative feeding. Meta-analysis could be performed on dehiscence rates with postoperative feeding regimen and readmission rates after outpatient versus inpatient lip repair. There were few studies with low risk of bias. Outpatient cleft lip repair does not increase readmission (odds ratio [OR]: 0.92, 95% CI: 0.28-3.07). Allowing postoperative breastfeeding or bottle-feeding does not increase dehiscence (OR: 0.61, 95% CI: 0.19-1.95). There was no evidence of publication bias. Conclusion: Within the limitations of available data, there is no evidence of a clearly superior closure material. The evidence does not support use of postoperative arm restraints. The evidence does not support the use of preoperative nasal swabs for antibiotic guidance. With careful patient selection, outpatient cleft lip repair appears safe. The evidence supports immediate breastfeeding or bottle-feeding after cleft lip repair.

scholarly journals Atypical Outcomes of Nasal and Lip Appearance After Unilateral Cleft Lip Repair: Judgment by Professionals, Patients, and Laypeople

2021 ◽  
pp. 105566562098280
Author(s):  
Robin A. Tan ◽  
Frans J. Mulder ◽  
Roderic M. F. Schwirtz ◽  
David G. M. Mosmuller ◽  
Henrica C. W. De Vet ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Old Patients ◽  
Rank Score ◽  
Cleft Lip Repair ◽  
Typical Appearance ◽  
Unilateral Cleft Lip Repair ◽  
Insight Into

Objective: To gain more insight into the assessment of “atypical” nasal and lip appearance outcomes compared to “typical” appearance outcomes after unilateral cleft lip and palate (UCLP) repair, when judged by professionals, patients with repaired UCLP, and laypeople. Design: An online survey containing 3 series of photographs with various degrees of “typical” and “atypical” nasal and lip appearance outcomes after UCLP repair was sent to 30 professionals, 30 patients with repaired UCLP, and 50 laypeople in 2 countries. Participants were instructed to rank the photographs from excellent to poor based on overall appearance. Mean rank positions of photographs were analyzed and differences in mean rank score between “typical” and “atypical” results were assessed using a T-test. Agreement of ranking between the 3 groups was assessed with an analysis of variance analysis. Setting: Amsterdam UMC, location VUmc, Netherlands and Boston Children’s Hospital, Boston, USA. Patients: Photographs of 6- to 18-year-old patients with repaired UCLP. Results: “Atypical” appearance outcomes were ranked significantly less favorably (small nostril: P = 0.00; low vermillion border: P = 0.02; whistling deformity: P = 0.00) compared to “typical” outcomes. Difference between professionals, patients and laypeople in rank positioning the photographs was not statistically significant ( P = 0.89). Conclusions: Noses with a smaller nostril and lips containing a whistling deformity were perceived as poorer outcome compared to the “typical” results. Professionals, patients, and laypeople are in agreement when assessing these outcomes.

Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia

2021 ◽  
pp. 105566562098275
Author(s):  
Robertus Arian Datusanantyo ◽  
Magda Rosalina Hutagalung ◽  
Sitti Rizaliyana ◽  
Djohansjah Marzoeki
Keyword(s):  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Initial Size ◽  
Tertiary Center ◽  
Observational Cohort ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Junior Residents

Objective: This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Design: Observational cohort study. Setting: Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. Patients, Participants: From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. Interventions: We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. Main Outcome Measure(s): This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. Results: While nasal width and philtral height ratios decreased significantly ( P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged ( P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly ( P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged ( P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. Conclusion: In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.

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