Modified Lip Revision Surgery for the Severe Whistle Lip Deformity in Bilateral Cleft Lip

Falguera-Uceda, María Isabel; Sanjuan-Sanjuan, Alba; Ferrer, Alicia Dean; Alamillos, Francisco-Jesús; Heredero, Susana

doi:10.1016/j.joms.2021.10.009

Cited by 2 publications

(1 citation statement)

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“…Since 1970, multiple reconstructive methods to address whistle deformity have been described, ranging from adjacent tissue transfer techniques to autografting from the tongue and labia. 1 Among these reconstructive options, the wide-hinged island swing transposition labial enhancement (WHISTLE) flap procedure by Grewal et al 2 has gained popularity. This technique creates an island of labial tissue used to reconstruct the central defect.…”

Section: Introductionmentioning

confidence: 99%

Modifications to the WHISTLE Flap Procedure for Correction of Secondary Cleft Lip Deformities

Collar Yagas,

Bautista,

Chen

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: The whistle deformity, a deficiency of tissue in the central upper lip, is a consequential outcome of primary cleft lip repair. Among multiple described reconstructive options, the wide-hinged island swing transposition labial enhancement (WHISTLE) flap procedure by Grewal et al has been shown to be a reliable technique that restores the continuity of the orbicularis oris muscle and creates a more natural appearing tubercle and central lip element. This article aims to refine the WHISTLE flap procedure with the addition of tailored mucomuscular flaps and an upper lip-lengthening mucosal Z-plasty. Methods: A total of 11 patients with a whistle deformity were examined. All underwent the WHISTLE flap procedure with tailored mucomuscular flaps and a mucosal Z-plasty. The patients were followed for a period of from 6 to 51.5 months. Pre- and postoperative photographs were used for objective outcome comparison. Results: From 2018 to 2023, a total of 11 patients with a whistle deformity were included in the final cohort, comprised four bilateral and seven unilateral cleft lips. Ten cases (90.1%) resulted in satisfactory postoperative cosmetic appearance and did not require further interventions. A single patient with a significant preoperative discrepancy between the upper and lower lip volumes had a postoperative residual deformity. None of the patients demonstrated any functional deficits associated with the procedure. Conclusions: The WHISTLE flap procedure with the proposed individual tailoring of the mucomuscular flap and Z-plasty for mucosal scar lengthening has excellent cosmetic outcomes and can be considered as the primary treatment modality in most patients with a whistle deformity.

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Section: Introductionmentioning

confidence: 99%