Lower lip repair in Van der Woude syndrome

Van der Woude syndrome is an unusual congenital malformation. It combines lower lip sinuses with a cleft lip and/or palate. The asymmetry appears more pronounced due to lower lip hypotonia and procheilia, which are more unaesthetic than the fistulae themselves. The malformation of the orbicularis oris muscle in its medial part induces the hypotonic aspect of the lower lip, which contrasts with the retracted scarred upper lip after the cleft has been repaired. It is also responsible for a real bilabial asymmetry. For many years, the most common surgical treatment was simple excision of the sinuses. Bad functional repair results prompted the authors to try another surgical procedure, the split-lip advancement technique as described by Mutaf. The authors report here on 8 operated children out of 25 patients followed up for Van der Woude syndrome. They evaluated the results according to the appearance of the lip when relaxed, its functional aspect, and the satisfaction of the parents or the child. Our results point to the importance of early surgical treatment, radical excision of dysplastic tissue and the repair of lip muscles to restore good lip functionality and satisfactory bilabial symmetry. The technique now used in our department has made it possible for us to achieve these goals.