Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Correction of Minor-Form and Microform Cleft Lip Using Modified Muscle Overlapping with a Minimal Skin Incision

  • Kim, Min Chul (Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine) ;
  • Choi, Dong Hun (Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine) ;
  • Bae, Sung Gun (BL Plastic Surgery Clinic) ;
  • Cho, Byung Chae (Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine)
  • Received : 2017.03.29
  • Accepted : 2017.05.10
  • Published : 2017.05.22
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Abstract

Background In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. Methods The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. Results Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. Conclusions The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.

Keywords

References

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Cited by

  1. Mini‐microform cleft lip with complete cleft alveolus and palate: A case report vol.61, pp.4, 2017, https://doi.org/10.1111/cga.12415
  2. Nasal sill augmentation: an overlooked concept in rhinoplasty-a technical note and review of the literatures vol.43, pp.1, 2017, https://doi.org/10.1186/s40902-021-00298-3