What's in a Name?-A Scoping Review of Published Unilateral Cleft Lip Repair Techniques

ObjectiveTo quantify the number of published cleft lip repair techniques that are described in substantial detail to be reproduced.DesignPRISMA-compliant scoping review.SettingN/A.Patients, Participants66 published articles.InterventionsPrimary unilateral cleft lip repair.Main Outcome MeasuresData on 14 predefined steps: use of pre-surgical devices, skin design and marking, local anesthesia technique, skin dissection, muscle dissection, mucosal management, frenuloplasty/frenulum management, muscular reapproximation, nasal floor closure, vermillion closure, skin closure, alar management, rhinoplasty, and post-operative stenting.ResultsFour techniques were identified as being "original": Rose, Mirault, Hagedorn, and Millard. Millard's technique was modified the most (n = 24, 36.4%). In total, 27 (40.9%) articles reported their technique design as "straight line," 31 (47.0%) "rotation advancement," and 8 (12.1%) "anatomic subunit." Skin marking design was the most detailed step with 53 (80.3%) articles; muscular dissection and re-approximation were both described in 47 (71.2%). The least reported step was frenulum management with only 1 (1.5%) described. No articles reported all 14 intra-operative steps, and only 2 (3.0%) reported 13/14 steps.ConclusionsDespite substantial modifications in cleft lip surgery, there is a paucity of in-depth descriptions of the steps of repair. For trainees, this can be a barrier to gaining understanding of lip repair. As the appetite for cleft surgery education grows globally, consistency in terminology and accuracy in describing technical steps is crucial.