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Reducing the Cleft Nose Deformity in Bilateral Cleft Lip Repair.

ABSTRACT: Repair of a bilateral cleft lip and nose deformity remains a challenge. The nose remains the main persisting stigma for patients, deserving an equal amount of attention as the lip during the repair. We share 3 technical principles to help achieve the optimal nasolabial result and minimize cleft nose deformity after bilateral cleft lip repair. Firstly, cephalad rotation of C-flaps from the prolabium is used to define the nasolabial angle. Secondly, the nasal base and contour is set before the lip repair, as the vectors and tension of nasal repair differ from the vector and tension of the orbicularis oris muscle closure. Thirdly, different suspension and shaping stitches are used to define alar shape and position after lower lateral cartilage release, avoiding additional scars.

SUBMITTER: Dhooghe NS

PROVIDER: S-EPMC7787283 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Reducing the Cleft Nose Deformity in Bilateral Cleft Lip Repair.

Dhooghe Nicolas S NS Chong David K DK

Plastic and reconstructive surgery. Global open 20201217 12

Repair of a bilateral cleft lip and nose deformity remains a challenge. The nose remains the main persisting stigma for patients, deserving an equal amount of attention as the lip during the repair. We share 3 technical principles to help achieve the optimal nasolabial result and minimize cleft nose deformity after bilateral cleft lip repair. Firstly, cephalad rotation of C-flaps from the prolabium is used to define the nasolabial angle. Secondly, the nasal base and contour is set before the lip ...[more]

PMID: 33425627

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The PAX1 locus at 20p11 is a potential genetic modifier for bilateral cleft lip.

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Cleft Lip Repair Competence Can Be Evaluated with High-fidelity Simulation.

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The Use of an Inferior Pennant Flap during Unilateral Cleft Lip Repair Improves Lip Height Symmetry.

Project description:BackgroundTo improve the rotation of Cupid's bow and achieve sufficient vertical lip height, several variations of the Millard rotation-advancement have incorporated a small laterally based triangular flap above the cutaneous roll. This study uses three-dimensional photogrammetry to evaluate the outcomes of unilateral cleft lip repairs performed with and without pennant flaps.MethodsThree-dimensional photographs were analyzed to assess postoperative lip height asymmetry in 90 unilateral cleft lip patients (58 complete and 32 incomplete) treated between 2001 and 2012. Cleft lip repairs were performed by three pediatric cleft surgeons using different techniques. Thirty-nine of 90 procedures (43 percent) used an inferiorly placed triangular flap. All patients were photographed at least 9 months postoperatively (mean, 4.2 years). Lip height asymmetry was based on the vertical distances from the subnasale to the peaks of Cupid's bow.ResultsRegression analysis revealed that the use of a pennant flap was a significant predictor of postoperative lip height asymmetry (β = 4.2 percent, p = 0.015). The surgeon performing the repair was also a significant factor in patients with complete cleft lips (β = 3.6 percent, p = 0.005). All three surgeons achieved greater lip height symmetry when a pennant flap was performed.ConclusionsThe results of unilateral cleft lip repairs are affected by both the surgeon and the surgical technique. Procedures that used a pennant flap showed better philtral height symmetry than nonpennant repairs.Clinical question/level of evidenceTherapeutic, III.

| S-EPMC4708256 | biostudies-literature

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