Primary lengthening of the columella in bilateral clefts of the lip
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The Skoog technique for cleft lip repair did not achieve normal columella length in children. This method resulted in significant scarring and flap complications, questioning its overall effectiveness.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Bilateral complete cleft lip and palate (BCLP) presents significant surgical challenges.
- Achieving adequate columellar length and minimizing scarring are key goals in BCLP repair.
Purpose of the Study:
- To evaluate the outcomes of the Skoog technique for two-stage repair of BCLP, focusing on columellar length and flap-related complications.
- To assess the long-term results and aesthetic impact of this specific surgical approach.
Main Methods:
- Seventeen children with BCLP underwent a two-stage lip and nasal floor repair using the Skoog technique, including a prolabial flap for columellar lengthening.
- Patients were reviewed at a minimum age of 2 years to assess surgical outcomes.
Main Results:
- None of the 17 children achieved normal columellar length.
- Six children exhibited obvious scarring, and five had flap bulging at the columellar base.
- Four children experienced flap displacement, with three requiring secondary forked flap revisions.
Conclusions:
- The Skoog technique for BCLP repair yields inconsistent results regarding columellar length.
- The procedure is associated with a high rate of flap complications and visible scarring.
- The observed complications and suboptimal aesthetic outcomes do not justify the use of this technique.
Abstract:
Children with bilateral complete cleft lip and palate were treated by a two stage repair of the lip and nasal floor, including a small prolabial flap to lengthen the columella according to the technique of Skoog. Seventeen of these children, now at least 2 years of age were reviewed. In no case was normal length of the columella obtained, six children had obvious scars, in five the flap bulged at the base of the columella, and in four there was a displacement of the flap toward the lip. Three cases have already required a secondary forked flap. We concluded that the results of this procedure are inconsistent and od not justify the additional scarring.