Effect of Lip Closure on Facial Growth in the Surgically Induced Cleft Rabbit

Eisbach, Karl J.; Bardach, Janusz

doi:10.1177/019459987808600526

Cited by 13 publications

(3 citation statements)

References 15 publications

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“…[18][19][20][21] Animal studies by Eisbach and Bardach demonstrated higher lip pressures and decreased sagittal maxillary growth in postnatal rabbits. 22,23 In contrast, scarless in-utero repair of CL in rabbits resulted in no difference in maxillary growth compared to controls. 24 A study comparing lip repair with and without wide tissue undermining of the maxilla in beagles found higher lip pressures with undermining but no significant difference in maxillary growth.…”

Section: Introductionmentioning

confidence: 90%

Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Celie

Wlodarczyk

Tapia

et al. 2022

The Cleft Palate Craniofacial Journal

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Midface hypoplasia (MFH) is a long-term sequela of cleft lip and palate repair, and is poorly understood. No study has examined the aggregate data on sagittal growth restriction of the midface following repair of the lip, but not palate, in these patients. A systematic review of 3780 articles was performed. Twenty-four studies met inclusion criteria and 11 reported cephalometric measurements amenable to meta-analysis. Patients with Veau class I-III palatal clefts were included so long as they had undergone only lip repair. Groups were compared against both noncleft and unrepaired controls. Cephalometrics were reported for 326 patients (31.3% female). Noncleft controls had an average SNA angle of 81.25° ± 3.12°. The only patients demonstrating hypoplastic SNA angles were those with unilateral CLP with isolated lip repair (77.4° ± 4.22°). Patients with repaired CL had SNA angles similar to noncleft controls (81.4° ± 4.02°). Patients with unrepaired CLP and CL tended toward more protruding maxillae, with SNA angles of 83.3° ± 4.04° and 87.9° ± 3.11°, respectively. Notably, when comparing SNA angles between groups, patients with CLP with isolated lip repair had significantly more hypoplastic angles compared to those with repaired CL ( P < .0001). Patients with CLP with isolated lip repair were also more hypoplastic than noncleft controls ( P < .0001). In contrast, there was no significant difference between the SNA of patients with repaired CL and controls ( P = .648). We found that cleft lip repair only appeared to contribute to MFH in the setting of concurrent cleft palate pathology, suggesting that scarring from lip repair itself is unlikely to be the predominant driver of MFH development. However, studies generally suffered from inadequate reporting of timing, technique, follow-up time, and cleft severity.

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Section: Introductionmentioning

confidence: 90%

Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Celie

Wlodarczyk

Tapia

et al. 2022

The Cleft Palate Craniofacial Journal

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“…In isolated cleft lip, maxillary growth patterns following surgical repair is less clear. Animal studies have shown statistically significant effect on the cephalometric growth of the maxilla ( 96 , 97 ). Clinical follow up, however, mostly fails to demonstrate appreciable effects on maxillary growth in children ( 95 , 98 ).…”

Section: Follow Upmentioning

confidence: 99%

Cleft Lip – A Comprehensive Review

2013

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Orofacial clefts comprise a range of congenital deformities and are the most common head and neck congenital malformation. Clefting has significant psychological and socio- economic effects on patient quality of life and require a multidisciplinary team approach for management. The complex interplay between genetic and environmental factors play a significant role in the incidence and cause of clefting. In this review, the embryology, classification, epidemiology, and etiology of cleft lip are discussed. The primary goals of surgical repair are to restore normal function, speech development, and facial esthetics. Different techniques are employed based on surgeon expertise and the unique patient presentations. Pre-surgical orthopedics are frequently employed prior to definitive repair to improve outcomes. Long term follow up and quality of life studies are discussed.

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“…In bilateral cleft lip deformity, there is no consensus regarding how to address this deficiency, as the absence of orbicularis oris muscle in the prolabium precludes an anatomic reconstruction of the upper lip muscle in this patient population. Many surgeons do not advocate joining the muscle under the prolabium [5][6][7][8] , citing decreased tension on the premaxilla after closure, possibly improving long-term midface projection [9][10][11] . However, lack of muscle repair under the prolabium results in widening of the prolabial skin.…”

Section: The Upper Lip Deformitymentioning

confidence: 99%