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Modified Lip Revision Surgery for the Severe Whistle Lip Deformity in Bilateral Cleft Lip
M I Falguera-Uceda1, A Sanjuan-Sanjuan2, A Dean-Ferrer3
1Staff, Oral and Maxillofacial Surgery Department, University Hospital Reina Sofía, Córdoba, Spain.
Purpose:
Whistle deformity is a sequela of primary surgical repair of the bilateral cleft lip that leads to a vertical tissue deficiency and a nonfunctional orbicularis oris muscle in the medial portion of the upper lip. This sequel is significantly limiting functionally and esthetically. We propose a complete labial revision with a secondary cheiloplasty of Mulliken and a submucosal inferiorly based flap in the central tubercle to increase the volume at this usually deficient area.
Methods:
We present our series of 9 patients with whistle deformity who underwent our modified technique. Width and length lip measurements were analyzed pre- and postoperatively.
Results:
There was a significant decrease in the width of the philtrum (mean 18.7% and 37% measured at the columella base and Cupid's apexes, respectively), an increase in the labial length (mean 11.2%), and improvement of the shape and volume of the vermilion in its middle third. All patients reported a very good to excellent improvement in the function and shape of their lips.
Conclusions:
The addition to a complete revision cheiloplasty of our inferiorly based submucosal flap technique solved in a single operation the function of the orbicularis oris and the normal labial anatomy with good functional outcomes in all cases and improved esthetic results.
