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Philtral Ridge Repair with Nasolabial Muscle Reconstruction in Unilateral Microform Cleft Lip: Evaluation Based on
Liwen Zhu1, Yilue Zheng1, Di Wu1
1Department of Cleft Lip and Palate, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
Background:
Unilateral microform cleft lip presents with subtle but characteristic philtral deformities. Conventional repair techniques often yield conspicuous scarring or inadequate reconstruction of the underlying musculature and philtral contour. This study aimed to evaluate the outcomes of philtral ridge repair with small-incision nasolabial muscle reconstruction.
Methods:
A retrospective study was conducted on patients with unilateral microform cleft lip who underwent primary repair at our institute between September 2020 and October 2023. The procedure involved a small incision at the vermilion-cutaneous junction, release of abnormal muscle attachments, and reconstruction of the musculocutaneous framework to simulate physiological tension lines. Outcomes were assessed at a minimum of 12 months postoperatively using (1) expert evaluation using a modified visual analog scale (VAS) assessing philtral ridge prominence, groove, and scar and (2) objective three-dimensional anthropometric measurement of philtral ridge projection.
Results:
The 14 included patients had a mean age at surgery of 4.41 years (range: 9 months-9 years) and a mean follow-up duration of 27.21 months. The mean total VAS score was 4.24, indicating a good result. Preoperatively, the cleft-side philtral ridge projection was significantly lower than that of the noncleft side at the mid-philtrum and below the columella (p < 0.05). Following surgery, the cleft-side projection increased significantly at all three planes (p < 0.05). Postoperatively, no statistically significant differences between the cleft and noncleft sides were detected at the midlevel of the philtrum or below the nasal columella (p > 0.05).
Conclusions:
The nasolabial muscle tension line group reconstruction technique was associated with improved philtral ridge projection and favorable aesthetic outcomes in patients with unilateral microform cleft lip.
Level Of Evidence Iv:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .