Primary unilateral incomplete cleft lip repair by a modified rotational advancement technique

J Stomatol Oral Maxillofac Surg. 2023 Apr;124(2):101325. doi: 10.1016/j.jormas.2022.11.001. Epub 2022 Nov 3.

Abstract

Purpose: This study aimed to describe a modified technique for primary unilateral incomplete cleft lip repair together with postoperative outcomes assessment.

Study design: A Retrospective study.

Participants and setting: Photos of 64 consecutive patients with nonsyndromic primary unilateral incomplete cleft lip were reviewed. Of the 64 participants for the study sample, 32 patients had received Millard rotational advancement technique (RA), while the other 32 had modified rotational advancement technique (MRA) with preserving the nasal sill intact. It was conducted at a university-affiliated tertiary hospital between 2013 and 2021.

Main measures: The lip measures were represented by lip height and width, vermillion height, midline-philtrum angle, and angle of Cupid's bow peaks. The nasal measures involved columella length and angle, nostril height and width, and ala width. Both descriptive and comparative data analyses were calculated.

Results: Symmetrical lip height, lip width, philtrum angle, Cupid's bow, as well columellar length, and alar width were obtained following the MRA technique. No significant difference was found between the MRA and RA groups concerning the preoperative lip height, Cupid's bow angle, columellar length and angle. However, the postoperative lip height, width and columellar length were greater in MRA group than RA group (P= .001, 0.004 and 0.002, respectively). On the other hand, the MRA group had significantly smaller columellar and Cupid's bow peaks angles than RA group (0.53±0.36 vs 1.21±0.91 and 1.34±1.84 vs 3.14 ± 2.97, respectively).

Conclusions: The MRA technique has obtained satisfactory lip and nasal outcomes in terms of lip height, lip width, philtrum angle, Cupid's bow, columellar length, and alar width while keeping the nasal sill intact.

Keywords: Anthropometric; Cleft lip; Columella; Cupid's bow; Nostril sill; Surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cleft Lip* / surgery
  • Humans
  • Lip / surgery
  • Nose / surgery
  • Retrospective Studies