Revisiting straight-line repair in unilateral complete cleft lip: a comparison with rotation-advancement repair

Abstract

Rotation-advancement repair (RAR) has been the most widely used technique for unilateral cleft lip repair. We recently used a straight-line repair with medial orbicularis muscle lengthening (SLR-ml) technique, based on the hypothesis that it could minimize the postoperative scar appearance without causing s short-lip deformity when muscle reorientation is performed correctly. A retrospective cohort study was conducted on unilateral complete cleft lip patients who underwent cheiloplasty between 2009 and 2017. Two cheiloplasty techniques were compared: RAR and SLR-ml. Outcomes were evaluated by assessing follow-up photographs using three methods: (1) glance impression on a five-point scale, (2) Manchester Scar Scale, and (3) indirect anthropometry. Seventy-one patients were analysed: 41 in the RAR group (28 male, 13 female) and 30 in the SLR-ml group (15 male, 15 female). The glance impression (P = 0.506) and Manchester Scar Scale (P = 0.347) scores did not differ between the groups. According to the symmetry ratio (cleft side value/non-cleft side value), vertical lip height (P = 0.804), horizontal lip length (P = 0.881), and Cupid's bow width (P = 0.122) did not differ significantly between the groups. The preoperative lip height discrepancy was not correlated with the postoperative vertical lip height. The SLR-ml method can be regarded as a successful tool for symmetric repair of unilateral cleft lip.

Single Surgeon’s Experience in Repair of Median Cleft Lip: A Case Series of 5 Median Craniofacial Dysplasia Patients

“…When compared with the symmetrical median excision, this method prevents philtral widening and leaves a vertical scar only along the original philtral ridge. 14 Patient 5 had a hypoplastic type of median craniofacial dysplasia with a complete median cleft lip and palate along with agenesis of the bony premaxilla, prolabium, and columella. Infants with severe forms of holoprosencephaly usually have a poor prognosis with <1 year of lifespan and are not appropriate candidates for surgical correction.…”

“…Therefore, a modified version of straight-line repair was performed in patient 4 with an asymmetrical design using the two third of a Cupid’s bow from one side, resulting in a more natural appearance of the Cupid’s bow and philtral ridge. When compared with the symmetrical median excision, this method prevents philtral widening and leaves a vertical scar only along the original philtral ridge 14…”

The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction

“…It has been used in studies evaluating upper lid blepharoplasty scar, 8 paramedian forehead flap, 9 thyroidectomy scar, 10 and cleft lip scar. 11 The MSS relies on qualitative grading compared with the surrounding skin instead of necessitating an exact measurement, which makes it easy to use. However, its straightforward nature jeopardizes interrater reliability, and it may not be detailed enough to comprehensively evaluate scar.…”