DOI QR코드

DOI QR Code

Long-term results of unilateral cleft lip repair with multiple infantile hemangiomas including one involving the cleft side of the upper lip

  • Jeong, Dae Kyun (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Lee, Jae Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Choi, Soo Jong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
  • Received : 2019.03.30
  • Accepted : 2020.03.02
  • Published : 2020.05.15

Abstract

Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.

Keywords

References

  1. Mai CT, Cassell CH, Meyer RE, et al. Birth defects data from population-based birth defects surveillance programs in the United States, 2007 to 2011: highlighting orofacial clefts. Birth Defects Res A Clin Mol Teratol 2014;100:895-904. https://doi.org/10.1002/bdra.23329
  2. Kilcline C, Frieden IJ. Infantile hemangiomas: how common are they? A systematic review of the medical literature. Pediatr Dermatol 2008;25:168-73. https://doi.org/10.1111/j.1525-1470.2008.00626.x
  3. Yavuzer R, Latifoglu O, Ozmen S, et al. Unilateral cleft lip complicated by a hemangioma. Plast Reconstr Surg 2002; 110:1084-7. https://doi.org/10.1097/00006534-200209150-00013
  4. Lo LJ, Noordhoff MS, Chen YR. Cleft lip and hemangioma: a patient with Wolf-Hirschhorn syndrome. Ann Plast Surg 1994;32:539-41. https://doi.org/10.1097/00000637-199405000-00018
  5. Williams JK, Hitner JB, Wood RJ. Unilateral cleft lip repair in the presence of a vermilion hemangioma. Plast Reconstr Surg 1997;99:230-3. https://doi.org/10.1097/00006534-199701000-00035
  6. Frieden IJ, Eichenfield LF, Esterly NB, et al. Guidelines of care for hemangiomas of infancy. American Academy of Dermatology Guidelines/Outcomes Committee. J Am Acad Dermatol 1997;37:631-7. https://doi.org/10.1016/S0190-9622(97)70183-X
  7. Frieden IJ. Which hemangiomas to treat--and how? Arch Dermatol 1997;133:1593-5. https://doi.org/10.1001/archderm.1997.03890480119022
  8. Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics 2019;143:e20183475. https://doi.org/10.1542/peds.2018-3475
  9. Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial anomalies. American Cleft Palate-Craniofacial Association. March, 1993. Cleft Palate Craniofac J 1993;30 Suppl:S1-16.
  10. Chang LC, Haggstrom AN, Drolet BA, et al. Growth characteristics of infantile hemangiomas: implications for management. Pediatrics 2008;122:360-7. https://doi.org/10.1542/peds.2007-2767
  11. Couto RA, Maclellan RA, Zurakowski D, et al. Infantile hemangioma: clinical assessment of the involuting phase and implications for management. Plast Reconstr Surg 2012;130: 619-24. https://doi.org/10.1097/PRS.0b013e31825dc129
  12. Greene AK. Management of hemangiomas and other vascular tumors. Clin Plast Surg 2011;38:45-63. https://doi.org/10.1016/j.cps.2010.08.001