A Surgical and Educational Video of the Inferior Turbinate Mucosal Flap for the Nasal Floor and Intraoral Reconstruction in Unilateral Complete Cleft Lip Repair

2020 ◽  
Vol 57 (8) ◽  
pp. 1045-1050
Author(s):  
Rafael Denadai ◽  
Pang-Yun Chou ◽  
Soyeon Jung ◽  
Nobuhiro Sato ◽  
Dax Carlo G. Pascasio ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Inferior Turbinate ◽  
Original Description ◽  
Educational Video ◽  
Mucosal Flap ◽  
Intraoral Reconstruction ◽  
Nasal Floor ◽  
Cleft Lip Repair ◽  
Key Steps ◽  
Rotation Advancement

Since the original description of Millard rotation advancement principle for cleft lip repair, many important contributions have subsequently been described by other surgeons worldwide. However, the reconstruction of the nasal floor and intraoral lining has received less attention over time. This article demonstrates a modified unilateral complete cleft lip repair using the rotation advancement principle plus multipurpose inferior turbinate mucosal flap. The accompanying videos display the 10 key steps for rationale, design, and proper execution of the inferior turbinate mucosal flap for the nasal floor and intraoral reconstruction.

Principalization of the Anatomical Subunit Approximation Technique of Unilateral Cleft Lip Repair

FACE ◽  
2021 ◽  
pp. 273250162110304
Author(s):  
Jordan W. Swanson ◽  
Aaron C. Van Slyke ◽  
David K. Chong
Keyword(s):  
Cleft Lip ◽  
Original Description ◽  
Senior Author ◽  
Approximation Technique ◽  
Paradigm Shifts ◽  
Essential Components ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
High Degree ◽  
Rotation Advancement

Background: The Anatomical Subunit Approximation cleft lip repair advantageously achieves a balanced lip contour with the line of repair placed along seams of aesthetic subunits. Since Fisher’s original description, it has been adopted widely and adapted, but some surgeons find the transition away from a cut-as-you-go approach challenging. Methods: We present an adapted Anatomic Subunit Approximation technique based on essential components of Fisher’s repair. The order of surgical execution is emphasized. Paradigm shifts are presented to help the surgeon used to more traditional rotation advancement techniques understand the Subunit philosophy. Minor adaptations such as surgically releasing lateral lip elements prior to marking are discussed. Results: A total of 53 eligible patients were treated with unilateral cleft lip repair by the senior author (D.C.) between February 2008 and April 2012 at Royal Children’s Hospital in Melbourne, Australia. Representative cases were chosen to demonstrate achievable results with the described technique. Conclusion: The proposed technique employs essential skin markings to achieve an anatomic subunit approximation lip repair, and appears to facilitate surgical outcomes with a high degree of symmetry. Core principles of repair include precise anatomical planning, tissue component separation, and muscle-driven advancement.

scholarly journals Cleft Lip Repair: Technical Refinements for the Wide Cleft

2010 ◽  
Vol 3 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Eric Meyer ◽  
Alan Seyfer
Keyword(s):  
Congenital Malformations ◽  
Cleft Lip ◽  
Common Type ◽  
Upper Lip ◽  
Vast Array ◽  
Triangular Flap ◽  
Aesthetic Results ◽  
Cleft Lip Repair ◽  
Rotation Advancement

Clefts of the lip and palate are among the most common congenital malformations. A unilateral deformity is the most common type of cleft, but even within this subgroup there is a great deal of variety due to the accompanying severe distortion of the upper lip, cheek, nose, and maxilla. To repair such a variety of clefts with good aesthetic results, several general incisional approaches should be mastered along with a variety of subtle techniques that improve the end product. The most common repair utilized in America is the Millard rotation-advancement technique. This is partly due to the perceived superiority in results compared with other repairs and the ease with which this repair can be taught to residents. This repair places the scar along an artificial philtral column and is often quite sufficient in small clefts. Unfortunately, adoption of this “one size fits all” approach can limit the arsenal of the surgeon facing the vast array of differing cleft lip deformities. For example, the modified triangular flap, or Tennison-Randall repair, can be of value when presented with the wider unilateral cleft lip. In an effort to not only demonstrate that excellent results can be achieved when incisional patterns (Millard and Tennison) are used appropriately (small versus large clefts), we compared the results of two types of repairs, performed by a single surgeon over a period of 30 years. In addition, a variety of subtle techniques are reviewed to assist in obtaining excellent aesthetic results for any size repair.

scholarly journals Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip

2017 ◽  
Vol 3 (2) ◽  
pp. 52-60
Author(s):  
Rani Septrina ◽  
Gentur Sudjatmiko
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
Before And After ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Palate Patient ◽  
Vertical Height ◽  
Rotation Advancement

Background: Cheiloplasty, the earliest surgical procedure in cleft lip and palate patient, has impact on functional and aesthetical appearance1. The Gentur’s technique is a method of cleft lip surgery that has been developed by him and has been used in RSUPN Cipto Mangunkusumo/Faculty of Medicine Universitas Indonesia2. It uses the rotation-advancement, small triangular, preventing notching concepts with some other details to overcome the wide cleft. This study was conducted to answer whether the Gentur’s technique gives symmetrical result in anthropometric measurements. Methods: Cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients underwent cheiloplasty procedure. Direct anthropometric data before and after procedure were analyzed using SPSS17. Anthropometric data such as cupid’s bow, vertical height, horizontal height, vermillion and nostril were noted. Results: From 14 patients, we found 9 patients who underwent surgery in 3 months of age (64.3%) are mostly female (n=9, 64.3%), have complete defect (n=12, 85.8%) and left sided defect (n=8, 57.1%). Gentur’s technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid’s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author is able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and palatal collapse (57.1%). Conclusion: Gentur’s technique is able to utilize tissue deficiency to create ideal lip and nose in unilateral cleft lip repair even in patients with wide gap.

scholarly journals Prevalence of cleft lip: A retrospective hospital based study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1911-1917
Author(s):  
Pranati T ◽  
Dhanraj Ganapathy ◽  
Adimulapu Hima Sandeep
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Single Centre ◽  
Multi Centre Study ◽  
Congenital Birth Defects ◽  
Repair Procedure ◽  
Cleft Lip Repair ◽  
And Gender ◽  
Gender Variations ◽  
Rotation Advancement

Amongst the most frequent congenital birth defects are facial malformations, including cleft lips associated with or without cleft palate (CL/P) and cleft palate (CP). Although the incidence of such malformations worldwide is around 1.5 per 1,000 live births, the rate for CL/P ranges six-fold and for CP three-fold. The study aims to determine the prevalence and gender variations of isolated cleft lip among patients who have visited Saveetha Dental College and have undergone primary cleft lip repair procedure. A retrospective study was conducted and data collection was done from dental archives pertaining from June 2019 to April 2020. Data consisted of patients with isolated cleft lip who underwent primary cleft lip repair procedure. Data was imported to IBM SPSS Version 20 for statistical analysis. Results were tabulated. From this study, it has been observed that prevalence of isolated cleft lip is more among males (55.6%) compared to females (44.4%) and belonging to the age group 0 to 6 years. Millard's technique (rotation advancement technique) is the most commonly employed technique for primary cleft lip repair. Male predilection observed (statistically not significant). This study was conducted in a single centre – Saveetha Dental College. Extensive multi centre study with increased sample size is to be done.

Cleft Lip Repair

2019 ◽  
pp. 503-518
Author(s):  
Samuel Lance ◽  
Catherine Tsai ◽  
Amanda Gosman
Keyword(s):  
Surgical Technique ◽  
Plastic Surgery ◽  
Clinical Evaluation ◽  
Postoperative Care ◽  
Cleft Lip ◽  
Surgical Techniques ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair ◽  
Rotation Advancement

Understanding the anatomy and surgical technique for repair of the unilateral and bilateral cleft lip remain essential to the practice of plastic surgery. This chapter summarizes the relevant anatomy, clinical evaluation, surgical technique, and postoperative care of the cleft lip patient. Step-by-step surgical descriptions and illustrations are provided along with commentary regarding common pitfalls encountered with these techniques. The surgical techniques described are a modified Millard rotation advancement technique for repair of the unilateral cleft lip and a modified Byrd repair for correction of the bilateral cleft lip.

Three-dimensional facial morphology, following primary cleft lip repair using the triangular flap with or without rotation advancement

2002 ◽  
Vol 30 (6) ◽  
pp. 337-342 ◽  
Author(s):  
Tomohiro Yamada ◽  
Yoshihide Mori ◽  
Katsuhiro Minami ◽  
Katsuaki Mishima ◽  
Toshio Sugahara
Keyword(s):  
Cleft Lip ◽  
Three Dimensional ◽  
Facial Morphology ◽  
Triangular Flap ◽  
Cleft Lip Repair ◽  
Rotation Advancement

scholarly journals Primary unilateral cleft lip repair

2009 ◽  
Vol 42 (S 01) ◽  
pp. S62-S70
Author(s):  
H. S. Adenwalla ◽  
P. V. Narayanan
Keyword(s):  
Deleterious Effect ◽  
Cleft Lip ◽  
Surgical Correction ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Rotation Advancement

ABSTRACTThe unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

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