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Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration
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Two-stage unilateral cleft lip repair.

Sherard A Tatum1

  • 1Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Upstate Medical University, Syracuse, NY 13210, USA.

Facial Plastic Surgery : FPS
|May 23, 2007
PubMed
Summary

A two-stage cleft lip repair offers a solution for complex unilateral cleft lip deformities. This method avoids alotomy and improves scar placement for better aesthetic and functional outcomes.

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Current trends in unilateral cleft lip repair.

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Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Pediatric Surgery

Background:

  • Unilateral cleft lip reconstruction presents challenges, especially in wide clefts with malaligned arches.
  • The standard Millard repair can result in unsatisfactory scar placement and may require alotomy, potentially impacting growth.
  • Existing methods like nasoalveolar molding are not universally available or practical.

Purpose of the Study:

  • To present a two-stage surgical approach for managing complex unilateral cleft lip deformities.
  • To evaluate the aesthetic and functional outcomes of this two-stage repair technique.
  • To demonstrate an alternative to traditional methods that avoids alotomy and improves scar aesthetics.

Main Methods:

  • A two-stage surgical repair protocol for unilateral cleft lip.
  • Stage 1: Full-thickness straight-line repair with tip rhinoplasty at 4-6 weeks of age.
  • Stage 2: Modified Millard repair at approximately 6 months of age, with no need for alotomy.

Main Results:

  • The two-stage repair effectively manages wide clefts and malaligned alveolar arches without alotomy.
  • Lip scar placement is improved, extending to the nasolabial crease rather than crossing the philtrum at a lower level.
  • Early lip repair facilitates passive approximation of alveolar segments, aiding subsequent palate closure.
  • Over 10 years of use have yielded satisfying aesthetic and functional results.

Conclusions:

  • A two-stage lip repair is a viable and effective method for complex unilateral cleft lip reconstruction.
  • This technique offers improved aesthetic outcomes regarding scar location and avoids the need for alotomy.
  • The approach provides functional benefits by aiding alveolar alignment and facilitating palate closure.

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