Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Correction of Secondary Cleft Lip Deformities by Scar Excision and Abbe Flap Coverage: Photogrammetric Analysis

이차구순열변형에서 상순반흔제거술 후 Abbe 피판을 이용한 재건: 사진계측학적 연구

  • Han, Ki-Hwan (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Kwak, Min-Ho (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Yeo, Hyeon-Jung (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Kwon, Hyuk-Joon (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Kim, Jun-Hyung (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Son, Dae-Gu (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine)
  • 한기환 (계명대학교 의과대학 성형외과학교실) ;
  • 곽민호 (계명대학교 의과대학 성형외과학교실) ;
  • 여현정 (계명대학교 의과대학 성형외과학교실) ;
  • 권혁준 (계명대학교 의과대학 성형외과학교실) ;
  • 김준형 (계명대학교 의과대학 성형외과학교실) ;
  • 손대구 (계명대학교 의과대학 성형외과학교실)
  • Received : 2011.07.20
  • Accepted : 2011.08.31
  • Published : 2011.11.10
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Abstract

Purpose: The Abbe flap procedure has been used to correct disharmony of the upper and lower lips as well as for making a philtrum for patients with secondary cleft lip deformities. But the Abbe flap procedure adds two scars in addition to the prior operative scar on the upper lip. This study was conducted to determine the treatment outcomes of esthetic subunit excision of the scar on the philtrum and Abbe flap coverage for correction of cleft lip deformities with photogrammetric analysis. Methods: This study investigated a total of 11 patients with cleft lip deformities who underwent scar excision with Abbe flap coverage, and the patients were followed up for at least 6 months. Under general anesthesia, a mushroom-shaped Abbe flap was drawn on the lower lip with a width of 8 mm and a height 1~2 mm longer than that of the philtral midline. The epidermis and dermis of the scar on the upper lip were excised. In the cases with alar base depression, the orbicularis oris muscle was split vertically and transposed to the alar base. The Abbe flap was harvested as a pedicled flap containing a small amount of muscle and this was rotated 180-degree to be inserted into the upper lip. Mucosa, muscle, subcutaneous tissue and skin were closed in layers. The flap was divided at the 7~14 postoperative day. The postoperative outcomes were evaluated by using photogrammetric analysis. Three indices were measured from the standard clinical photographs taken before and after the surgery. For anthroposcopic assessment, observers described the postoperative outcomes using an ordinary scale method. Results: The postoperative values obtained in the photogrammetric analysis showed improvement as compared with the preoperative ones. Improved anthroposcopic outcomes were also noted. Conclusion: Scar excision and Abbe flap coverage were proven to be effective in improving protrusion and the height of the upper lip, the scar of the upper lip and the symmetry of Cupid's bow and the philtral column, as well as formation of the philtral dimple.

Keywords

References

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