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Surgical closure of labial and alveolar cleft defects with a modified Millard technique: A prospective study of ten
Pierre Maitre1,2, Mathieu Jourdain1, Pauline Brignon1
1Small Animal Surgery Department - Veterinary Hospital, Oniris VetAgroBio College of Veterinary Medicine Food Science and Engineering, National Veterinary School of Nantes, Nantes, France.
Objective:
To provide a step-by-step description of canine lip/alveolar cleft repair, describe intra- and postoperative complications, and report mid-term clinical, functional and cosmetic outcomes.
Study Design:
Prospective study.
Animals:
A total of 10 client-owned puppies with unilateral or bilateral lip/alveolar clefts.
Methods:
Detailed clinical and historical data were recorded. The lip/alveolar clefts were repaired using a surgical technique adapted from human medicine including: (1) alveolar cleft and labial vestibulum repair, (2) cheilorhinoplasty and (3) palatal cleft repair when indicated. Intra- and postoperative complications, as well as clinical, functional and cosmetic outcomes, were recorded at 7 and 14 days and at a minimum of 3 months postoperatively. Cosmetic outcomes were evaluated using postoperative CT measurements.
Results:
A total of 10 puppies (4 males, 6 females) were included. Of these, six presented with unilateral lip/alveolar clefts (2 right-sided and 4 left-sided) and four presented with bilateral clefts. A total of 14 lip/alveolar clefts were repaired. Four dogs had a complete secondary palate cleft. No intraoperative surgical complications were reported. Three cases of minor dehiscence of the cheilorhinoplasty suture line were observed, all healed by second intention within 14 days postoperatively. One case of oronasal communication on the hard palate was successfully treated with minor revision surgery. Successful clinical and functional outcomes were reported for all dogs at the 3-month postoperative evaluation. Overall cosmetic outcomes were rated as good to excellent.
Conclusion:
The described step-by-step surgical technique resulted in good to excellent clinical, functional, and cosmetic outcomes.
Impact:
This technique offers a new surgical treatment with a low complication rate.