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Incidence of Secondary Lip Correction for Children With Unilateral Cleft Lip: A Single-Center Retrospective Study
Zhuo Zhang1, Mai Miyabe, Daichi Morioka
1From the Department of Plastic Surgery, Showa University, Tokyo, Japan.
Insights
This study found a 9.6% revision rate for cleft lip (CL) repair, which is lower than other centers. Factors like surgeon preference influence revision rates, which may change over time.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Secondary lip correction rates for cleft lip (CL) vary significantly across treatment centers.
- Understanding these revision rates is crucial for evaluating cleft care effectiveness.
Purpose of the Study:
- To determine the incidence of secondary lip correction in a large cohort of patients with cleft lip.
- To identify clinical factors associated with the need for revision surgery.
Main Methods:
- Retrospective review of infants with unilateral cleft lip (CL) undergoing primary cheiloplasty between 2006 and 2012.
- Tracking patients until 2017 to determine the rate of lip revisions by age 8.
Main Results:
- A total of 490 infants had primary lip repair; 47 (9.6%) required revision surgery by age 8.
- No significant differences in revision rates were observed based on sex or cleft side.
- Surgeon-specific revision rates varied from 2.8% to 15.2%.
Conclusions:
- The overall revision rate of 9.6% is relatively low compared to other centers.
- Revision rates alone do not fully assess repair techniques or cleft care programs.
- Surgeon preference and evolving patient factors influence revision indications.
Background:
Numerous reports have described the incidence of secondary lip correction for patients with cleft lip (CL), and this incidence broadly varies among centers. The purpose of this study was to determine this revision rate for a reasonably large number of patients in our center and identify the clinical factors that contribute to the revision rate.
Methods:
A retrospective chart review was conducted for all infants with unilateral CL with or without cleft palate who underwent primary cheiloplasty at our cleft center from 2006 to 2012. Four surgeons were in charge of almost all operations. We investigated how many children underwent lip revisions by the end of 2017.
Results:
In total, 490 infants underwent primary lip repair, and 47 underwent revision surgery by the age of 8 years. Half of them (24 children) underwent revisions at the age of 5 or 6 years. There was no significant difference in the revision rate by sex or cleft side. The revision rate in children with CL only tended to be lower than that in children with alveolar cleft or cleft palate, but it was not significantly associated with the cleft type. The revision rate ranged from 2.8% to 15.2% among surgeons.
Conclusions:
The overall revision rate was 9.6%, which is relatively lower than that in other cleft centers. However, the repair technique and cleft care program should not be evaluated using the revision rate only. Various factors, including surgeons' preference, contribute to the indications for revision, and these factors can change with age. We plan to follow up the patients until our completion of the cleft care program and report the final revision rate.
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