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Bilateral cleft lip reconstruction.

M S Noordhoff

    Plastic and Reconstructive Surgery
    |July 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    This study details a muscle-repositioning banked fork-flap cheiloplasty technique for bilateral cleft lip repair over 8 years. The method enhances Cupid's bow reconstruction and columellar lengthening, aiming for tension-free closure and improved aesthetic outcomes.

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    Area of Science:

    • Plastic Surgery
    • Craniofacial Surgery
    • Pediatric Surgery

    Background:

    • Bilateral cleft lip presents complex surgical challenges.
    • Achieving optimal aesthetic and functional outcomes requires precise techniques.
    • Previous methods may result in scarring, contracture, and the need for secondary procedures.

    Purpose of the Study:

    • To describe an 8-year experience with a specific muscle-repositioning banked fork-flap cheiloplasty for bilateral cleft lip.
    • To evaluate the efficacy of using buccal mucosal flaps and inferior turbinate mucosa.
    • To detail techniques for Cupid's bow reconstruction and columellar lengthening.

    Main Methods:

    • A cohort of 140 patients with bilateral cleft lip underwent surgery using the described technique.

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  • Buccal mucosal flaps were utilized in the intercartilaginous incision.
  • Inferior turbinate mucosa was added for wound closure.
  • A lateral lip orbicularis muscle flap was employed for Cupid's bow reconstruction.
  • Muscle continuity was preserved and repositioned anterior to the premaxilla.
  • Columellar elongation was performed between 1 to 6 years of age, using nasal floor tissue or composite free ear grafts.

    • Main Results:

    • The technique facilitated alar cartilage repositioning and tension-free wound closure, reducing scarring and contracture.
    • The use of additional mucosa simplified complete wound closure.
    • Preservation of muscle continuity aimed to prevent the need for revision surgeries.
    • Columellar lengthening was successfully achieved through tissue advancement or grafting.

    Conclusions:

    • The muscle-repositioning banked fork-flap cheiloplasty is an effective method for bilateral cleft lip repair.
    • The described adjuncts, including mucosal flaps and specific muscle reconstruction, contribute to favorable outcomes.
    • This technique addresses key aspects of lip and nasal symmetry in cleft repair.