scholarly journals The refinement of the median tubercle of cleft lip

2018 ◽  
Vol 51 (02) ◽  
pp. 131-136
Author(s):  
Jyotsna Murthy
Keyword(s):  
Revision Surgery ◽  
Cleft Lip ◽  
Upper Lip ◽  
Modified Technique ◽  
Repair Materials ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

ABSTRACT Aim: Repair of cleft lip aims to bring symmetry and provide normal aesthetics for the lip. Several techniques have been employed; however, the finer aspect of median lip tubercle has not been emphasised in cleft lip repair. Materials and Methods: We have modified cleft lip repair, both unilateral and bilateral, preserving all the tissues of the median tubercle to provide normal-looking median tubercle of the lip. The modified technique was carried out by a single surgeon on 322 cases of unilateral cleft lip and 68 cases of bilateral cleft lip. Follow-up was done for 1–3 years on these children to evaluate the outcome. Results: The evaluation showed excellent results in more than 80% of patients in unilateral cleft lip repair, on 1–3 years of follow-up; 20% had acceptable results. Of 68 patients with bilateral cleft lip, none had any complication, and excellent results were obtained in 70%. Result was rated acceptable in 30%; 15% may need revision surgery for white roll and vermilion adjustment. Conclusion: We present the technique of reconstructing a normal-looking median tubercle in cleft lip repair. The technique was modified based on the study of normal upper lip and embryology of cleft lip, with emphasis on creating better median tubercle of the lip.

Labial-Nasal Evaluation for Nasal Floor Reconstruction With the New Triangular Flap in Unilateral Cleft Lip Repair

2021 ◽  
pp. 105566562110630
Author(s):  
Yingmeng Liu ◽  
Chenghao Li ◽  
Meilin Yao ◽  
Chialing Tsauo ◽  
Min Wu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Statistical Significance ◽  
Width Ratio ◽  
Lateral Side ◽  
Height Ratio ◽  
Modified Technique ◽  
Nasal Floor ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

In this study, we present a modified technique for primary cleft lip repair with a rotation triangular flap from the cleft lateral side to reconstruct the nasal floor; and evaluate the outcome compared with traditional Millard repair. 40 patients with unilateral cleft lip were included in this research. The patients were divided into 2 groups; 17 patients treated with the Millard technique, and 23 patients treated with the newly modified technique. 14 measurement indexes were employed to evaluate the nose-lip morphology of postoperative patients with UCCL in standardized photographs preoperatively, postoperatively and 1-year follow-up. For lip symmetry, statistical significance was detected in the measurements of the vertical philtral height ratio indicating that the newly modified technique resolve the shortage of lip height on the cleft side 1-year follow-up. ( P < .05). In addition, statistical significance was detected in the 1-year postoperative columellar angle, alar width ratio, nostril width ratio, nostril height ratio, and nostril shape (cleft) ( P < .05), showing more successful repair of the nose compared with the traditional repair. The modified unilateral cleft lip repair with rotation triangle flap from the cleft lateral side was beneficial in the correction of lip and nasal deformity in and had positive effects on labial symmetry.

scholarly journals Precision Dermal Fat Grafting for Vermillion Deficiencies in Patients With Unilateral and Bilateral Cleft Lip

2019 ◽  
Vol 57 (1) ◽  
pp. 127-131
Author(s):  
Oksana A. Jackson ◽  
Alfred Lee ◽  
Elena Nikovina ◽  
Alison E. Kaye
Keyword(s):  
Cleft Lip ◽  
Scar Tissue ◽  
Fat Grafting ◽  
Fat Graft ◽  
Aesthetic Outcome ◽  
Upper Lip ◽  
Lip Augmentation ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair ◽  
The Aesthetic

Objective: Deficiencies of the upper lip vermilion occur with some frequency following repair of unilateral and bilateral clefts of the lip and can compromise the aesthetic outcome. The presence of dense scar tissue within the lip at the cleft site as well as intrinsic vermillion deficiencies can make long-lasting correction of this deformity challenging. We describe a technique to address vermillion deficiencies after cleft lip repair. Design: A novel lip augmentation technique for correction of residual vermilion deficiencies after unilateral and bilateral cleft lip repair is presented. This technique combines precise placement of a contoured dermal fat graft with local tissue (V-Y) rearrangement. Conclusion: In our experience, this method of lip augmentation following either unilateral or bilateral cleft lip repair can restore upper lip vermillion symmetry and provide predictable and durable results in patients with mild to severe vermillion deficiency.

scholarly journals Secondary bilateral cleft lip-nose deformity correction by rhinoplasty with simultaneous Abbe flap

2014 ◽  
Vol 47 (01) ◽  
pp. 20-24 ◽  
Author(s):  
Nitin J. Mokal ◽  
Manpreet Juneja
Keyword(s):  
Cleft Lip ◽  
Perioperative Complications ◽  
Deformity Correction ◽  
Flap Necrosis ◽  
Upper Lip ◽  
Bilateral Cleft Lip ◽  
Nose Deformity ◽  
Abbé Flap ◽  
Cleft Lip Nose

ABSTRACTAim: The purpose of this article is to review modification and outcome of secondary rhinoplasty along with Abbι flap for correction of secondary bilateral cleft lip deformity. Materials and Methods: A total of thirteen patients of secondary bilateral cleft lip-nose deformity having tight upper lip, lack of acceptable philtral column, Cupid′s bow definition, irregular lip scars, and associated nasal deformity were selected. All the patients received Abbι flap and simultaneous nasal correction. All cases were treated during a period of three years. Mean patient age at the time of the operation was 21 years, and ranged from 16 to 27 years. The average follow-up period was three years. Results: Assessment of results was based on comparing preoperative and postoperative clinical photographs done by surgeon and patient relatives and patient satisfaction questionnaires. The columellar lengthening and upper lip vermillion correction achieved was satisfactory. There were no perioperative complications such as airway obstruction, bleeding, infection, wound disruption, or flap necrosis.

scholarly journals Lip Symmetry Evaluation Of The Gentur's Method Compared To Fisher Techniques For Unilateral Cleft Lip Repair

2018 ◽  
Vol 4 (1) ◽  
pp. 95-100
Author(s):  
Prasetyanugraheni Kreshanti ◽  
Muhammad Irsyad Kiat
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Modified Technique ◽  
Nasal Vestibule ◽  
Base Position ◽  
Alar Base ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Rotation Advancement

Background : Cleft lip and palate are the most common congenital anomalies that were found in plastic surgery. There are so many techniques for unilateral cleft lip repair. Rotation-advancement method by Gentur based on Millard technique has become the most widely used in unilateral cleft lip repair in RSCM. The Fisher technique repair is a modified technique based on approximation of anatomical subunit of the lip. The purpose of this study is to objectively compare and evaluate the lip symmetry of these two techniques. Method : Two senior board-certified plastic surgeons will perform different surgical techniques for the unilateral cleft lip: rotation-advancement technique by Gentur and Fisher technique. This study prospectively analyzed preoperative and postoperative of randomized single blinded patients who underwent unilateral cleft lip repair performed by each surgeon in 2016. Using caliper, facial points on the cleft and non-cleft sides were measured, including height and symmetry of Cupid’s bow, width and height of the nasal vestibule, height of the vermilion, and alar base position. Ratios of cleft side to non cleft side measurements were calculated to standardize comparisons between patients. Result : From July-October 2016, 14 patients performed surgery as preliminary data, showed that there are statistically difference in length of design and surgery time. Preoperative, comparable of cupid’s bow and vermillion showed statistically difference. Although, we found no statistically difference in postoperative ratio. Conclusion : Lip symmetry outcomes after cheiloplasty procedure are same between Gentur method and Fisher technique.

Correction of Tethered Upper Lip Deformity Following Bilateral Cleft Lip Repair

2011 ◽  
Vol 66 (6) ◽  
pp. 627-632
Author(s):  
Mehmet Mutaf ◽  
Ertan Günal ◽  
Arif Türkmen ◽  
Mahmut Sunay
Keyword(s):  
Cleft Lip ◽  
Upper Lip ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair

Correction of Post-Cleft Lip Nostril Floor Stenosis: Para-Alar Flap Combined With Lip Revision

2020 ◽  
pp. 105566562098022
Author(s):  
Karam A. Allam ◽  
Ahmed Elsherbiny
Keyword(s):  
Cleft Lip ◽  
Donor Site ◽  
Case Series ◽  
Retrospective Case ◽  
Case Series Study ◽  
Secondary Deformity ◽  
Reconstructive Option ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

Post-cheiloplasty nostril floor stenosis is a scarcely reported secondary deformity. The aim of the current study was to assess the outcome of para-alar flap for management of nostril floor stenosis post-unilateral cleft lip repair. This is a retrospective case series study reviewing consecutive patients presenting with nostril floor stenosis following repair of unilateral cleft lip who were managed by the inferiorly based para-alar flap and lip revision. Differential nostril width was measured preoperative, immediate, and late postoperative. We reported 8 patients (3 boys and 5 girls) with an average age of 9.8 years (range: 4.5-19). Satisfactory results with good nostril symmetry measures were achieved, and no restenosis has been observed during the follow-up periods. The donor site scars were negligible. There was no reported partial or total flap loss. Para-alar flap was found to be an effective reconstructive option for patients with nostril floor stenosis post-unilateral cleft lip repair and can be combined safely with cleft lip revision.

scholarly journals Experience of unilateral cleft lip repair using the Anatomical Subunit Technique in an Omani population over a 5 year period

2021 ◽  
Author(s):  
Sheikhan Al Hashmi ◽  
Malak Al Wahaibi ◽  
Sony P. Varghese ◽  
Maather Al Abri ◽  
Moath A. Shummo ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Cleft Lip ◽  
Demographic Data ◽  
Electronic System ◽  
Patient’S Satisfaction ◽  
Satisfaction Rate ◽  
Aesthetic Appearance ◽  
Scar Quality ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

Objectives: The Anatomical Subunit Technique for unilateral cleft lip repair has gained popularity worldwide. The purpose of this study is to report our experience using this technique. Methods: 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon from 2015 to 2020. In addition to the demographic data, severity and type of the cleft lip, the surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon and rate of revision surgery were collected from Al-shifa plus 3 health electronic system. Parents’ satisfaction regarding scar quality, lip and nose aesthetic appearance was collected anonymously. The documented data were evaluated using statistical analysis. Results: 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects and showed 85% satisfaction rate with the postoperative scar, 77.5% satisfaction with the aesthetic appearance of nose. Conclusion: In our hands, the anatomical subunit technique resulted in a predictable result with high patient’s satisfaction rate as related to scar quality, nasal and lip symmetry in children with varying severity of cleft lip. Revision for vermilion excess was needed in 7 % of cases. The high percentage of consanguinity (52%) in our study highlight the need for more targeted national campaigns involving premarital counselling in the Omani population. Keywords: Cleft Lips, cheiloplasty, Oman, Surgical Technique, Millard Technique, Fisher, Consanguinity.

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