Modiolus-Based Dynamic Reconstruction for Transverse Facial Cleft: A Retrospective Cohort Study

Area of Science:

• Craniofacial surgery
• Plastic surgery
• Congenital anomaly repair

Background:

• Transverse facial cleft is a rare congenital anomaly affecting oral commissure aesthetics and function.
• Conventional surgical techniques often yield suboptimal results in restoring facial symmetry.
• An enhanced approach focusing on modiolus and orbicularis oris reconstruction aims to improve outcomes.

Purpose of the Study:

• To evaluate the long-term aesthetic outcomes of an enhanced surgical technique for transverse facial cleft repair.
• To compare the efficacy of priority modiolus reconstruction with conventional repair methods in achieving commissural symmetry.

Main Methods:

• Retrospective cohort study of 20 patients with unilateral transverse facial cleft.
• Comparison between conventional repair (n=9) and priority modiolus reconstruction (n=11).
• Objective anthropometric measurements and subjective evaluations (Face-Q, VAS) were used.

Main Results:

• Modiolus reconstruction group showed significantly improved immediate postoperative lower cheilion spread angle (ΔLCSA).
• Long-term follow-up revealed significant differences in multiple perioral measurements, indicating enhanced commissural symmetry, especially during mouth opening.
• Professional evaluations (VAS) confirmed superior commissural symmetry in the reconstruction group at long-term follow-up.

Conclusions:

• Priority modiolus reconstruction leads to superior static and dynamic commissural symmetry in transverse facial cleft repair.
• The enhanced technique demonstrates maintained long-term outcomes compared to conventional repair.