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Nasolabial Revisions in Unilateral Incomplete Cleft Lip: One Surgeon's 28-Year Experience
Stephan P K Tan1, Ingrid M Ganske1, John B Mulliken1
1From the Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School.
Plastic and Reconstructive Surgery
|March 21, 2020
Summary
Surgical repair of unilateral incomplete cleft lip requires careful attention to labial revisions, with mucosal free margin adjustments being most common. Nasal revisions are infrequent, contrasting with higher rates in complete cleft lip cases.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Unilateral incomplete cleft lip repair presents a unique surgical challenge.
- Achieving optimal aesthetic and functional outcomes often requires meticulous technique.
- This study evaluates long-term revision rates for a specific surgical approach.
Purpose of the Study:
- To analyze revision rates and types following surgical repair of unilateral incomplete cleft lip.
- To identify trends in revision frequency over a 28-year period.
- To compare revision rates with those of complete cleft lip repairs.
Main Methods:
- Retrospective review of 136 patients with unilateral incomplete cleft lip treated between 1985 and 2013.
- Inclusion criteria defined clefts as 30-90% of cutaneous labial height.
- Data collection included types and rates of revisions; photographic review assessed need for revision in non-revised cases.
Main Results:
- Fifty-seven percent of patients required revision of the mucosal free margin.
- Less than 10% needed other minor labial revisions.
- Fifteen percent underwent nasal revision, primarily for lower lateral cartilage reelevation. Increased free border revisions were noted over time.
Conclusions:
- Nasal revision rates for unilateral incomplete cleft lip are lower than for complete forms.
- Labial revisions, particularly of the free margin, are more common.
- Increased surgeon awareness of vermilion-mucosal deficiency likely contributes to more frequent free margin revisions.
