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Long-Term Evaluation of the Lip and Nose in Bilateral Complete Cleft Lip Patients following Lip Adhesion and Secondary Nose Correction

  • Kim, Ryuck Seong (Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine) ;
  • Seo, Hyung Joon (Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine) ;
  • Park, Min Suk (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)
  • 발행 : 2022.07.15

초록

Background Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip. Methods A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained. Results All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter (p < 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater (p < 0.05) than in the control group. Conclusion Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.

키워드

과제정보

This work was supported by a clinical research grant from Pusan National University Hospital in 2022.

참고문헌

  1. Byrd HS, Ha RY, Khosla RK, Gosman AA. Bilateral cleft lip and nasal repair. Plast Reconstr Surg 2008;122(04):1181-1190 https://doi.org/10.1097/PRS.0b013e3181858f33
  2. Chung KH, Lo LJ. One-stage versus two-stage repair of asymmetric bilateral cleft lip: a 20-year retrospective study of clinical outcome. Plast Reconstr Surg 2018;141(05):1215-1224 https://doi.org/10.1097/PRS.0000000000004327
  3. Patel TA, Patel KG. Comparison of the fisher anatomical subunit and modified Millard rotation-advancement cleft lip repairs. Plast Reconstr Surg 2019;144(02):238e-245e https://doi.org/10.1097/PRS.0000000000005847
  4. Zaidi SH, Rehman JU, Rahman HU, Ahmed N. Lip adhesion- a viable alternative to pre-surgical orthodontics for the management of wide cleft lips in third world countries. J Ayub Med Coll Abbottabad 2018;30(02):171-174
  5. Raposo-Amaral CE, Denadai R, Almeida RRG, Marques FF, Lee MM, Raposo-Amaral CA. Does a premaxillary setback and lip adhesion have a negative impact on lip outcome in bilateral cleft patients? J Craniofac Surg 2017;28(07):1730-1736 https://doi.org/10.1097/SCS.0000000000003875
  6. Gatti GL, Lazzeri D, Romeo G, Balmelli B, Massei A. Effect of lip adhesion on maxillary arch alignment and reduction of a cleft's width before definitive cheilognathoplasty in unilateral and bilateral complete cleft lip. Scand J Plast Reconstr Surg Hand Surg 2010;44(02):88-95 https://doi.org/10.3109/02844310903569378
  7. Kalanzi EW, Gatti GL, Massei A. The role of lip adhesion in the treatment of cleft lips. East Cent Afr J Surg 2004;9:61-66
  8. Millard DRJ Jr. Refinements in rotation-advancement cleft lip technique. Plast Reconstr Surg 1964;33:26-38 https://doi.org/10.1097/00006534-196401000-00003
  9. Schendel SA. Anthropometry of the head and face. Plast Reconstr Surg 1995;96:480 https://doi.org/10.1097/00006534-199508000-00036
  10. Garfinkle JS, King TW, Grayson BH, Brecht LE, Cutting CB. A 12-year anthropometric evaluation of the nose in bilateral cleft lipcleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction. Plast Reconstr Surg 2011;127(04):1659-1667 https://doi.org/10.1097/PRS.0b013e31820a64d7
  11. Chang CS, Liao YF, Wallace CG, et al. Long-term comparison of the results of four techniques used for bilateral cleft nose repair: a single surgeon's experience. Plast Reconstr Surg 2014;134(06):926e-936e
  12. Aburezq H, Daskalogiannakis J, Forrest C. Management of the prominent premaxilla in bilateral cleft lip and palate. Cleft Palate Craniofac J 2006;43(01):92-95 https://doi.org/10.1597/04-114r.1
  13. Iino M, Sasaki T, Kochi S, Fukuda M, Takahashi T, Yamaguchi T. Surgical repositioning of the premaxilla in combination with twostage alveolar bone grafting in bilateral cleft lip and palate. Cleft Palate Craniofac J 1998;35(04):304-309 https://doi.org/10.1597/1545-1569_1998_035_0304_srotpi_2.3.co_2
  14. Rogers BO. Cleft craft: the evolution of its surgery, vol 2: bilateral and rare deformities. JAMA 1978;240:1282 https://doi.org/10.1001/jama.1978.03290120076039
  15. Bardach J, Salyer KE, Randall P. Surgical techniques in cleft lip and palate. Second Edition. Plast Reconstr Surg 1992;90(01):130 https://doi.org/10.1097/00006534-199207000-00025
  16. Kim DC, Mulliken JB. Direct anthropometry of repaired bilateral complete cleft lip: a long-term assessment. Plast Reconstr Surg 2017;140(02):326e-332e
  17. Kim SK, Kim TH, Park SS, et al. Surgical treatment of the unilateral and bilateral cleft lip patients using Mulliken method: 10 year results. Arch Craniofac Surg 2012;...:13 https://doi.org/10.7181/acfs.2018.19.1.13
  18. Mulliken JB, Kim DC. Repair of bilateral incomplete cleft lip: techniques and outcomes. Plast Reconstr Surg 2013;132(04):923-932 https://doi.org/10.1097/PRS.0b013e31829f4b81
  19. Levy-Bercowski D, Abreu A, DeLeon E, et al. Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J 2009;46(05):521-528 https://doi.org/10.1597/07-236.1
  20. Nechala P, Mahoney J, Farkas LG. Digital two-dimensional photogrammetry: a comparison of three techniques of obtaining digital photographs. Plast Reconstr Surg 1999;103(07):1819-1825 https://doi.org/10.1097/00006534-199906000-00002
  21. Ferrario VF, Sforza C, Serrao G, Ciusa V, Dellavia C. Growth and aging of facial soft tissues: a computerized three-dimensional mesh diagram analysis. Clin Anat 2003;16(05):420-433 https://doi.org/10.1002/ca.10154