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Evaluation of the Effectiveness Using the Modified Straight Line Closure Method in Unilateral Cleft Lip Patients From
Abdoljalil Kalantar-Hormozi1, Mohammad B Zeydabadi1, Mehran Noori1
1Department of Plastic and Craniofacial Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, 15 Khordad Hospital.
Background:
Unilateral cleft lip repair has evolved significantly, with ongoing debate regarding optimal surgical techniques that results on a good scar. While rotation-advancement methods remain prevalent, modern modifications of straight-line approaches offer potential advantages in scar concealment and anatomic preservation.
Patients And Methods:
This prospective study evaluated a modified straight-line closure technique in 90 patients (40 male and 50 female) aged 3 to 24 months with complete (n=35) or incomplete (n=55) unilateral cleft lip. Key technical features included precise anatomic landmark identification, orbicularis oris muscle reconstruction, and alar base stabilization. No transverse or oblique incisions were used on the lip skin from the nostril to the Cupid bow. Outcomes were assessed at 6 months to 10 years postoperatively using anthropometric analysis of standardized photographs by 2 independent plastic surgeons.
Results:
The technique achieved good symmetry outcomes, with 94.4% of cases showing ≤2 mm philtral column discrepancy and 100% demonstrating ≤2 mm vertical lip height difference. Nasal symmetry was particularly notable (mean alar base discrepancy: 0.68±0.74 mm, P <0.001). Cupid bow proportions (0.27±0.04, P <0.001) and vermilion continuity (88.9% without notching) were well-maintained. No significant differences emerged between complete and incomplete clefts ( P >0.05).
Conclusion:
The modified straight-line approach produces consistent, reproducible outcomes across cleft types, combining the simplicity of traditional straight-line repairs with refinements addressing historical limitations. Its ability to achieve simultaneous labial and nasal correction makes it a valuable alternative to rotation-advancement approaches, particularly when prioritizing scar quality and anatomic subunit preservation.
