Afroze Incision for Functional Cheiloseptoplasty

Abstract

Repair of unilateral cleft lip is a fascinating and challenging procedure. Although a great number of operations have been described for the unilateral cleft lip repair, none fulfill all the plastic surgical criteria, and in most cases, cleft lip repairs require secondary operations in an attempt to achieve described goals of primary cheiloplasty. The Afroze incision is a combination 2 incisions, that is, the Millard incision on the noncleft side and Pfeiffer incision on the cleft side. The flap design is the Millard flap on the noncleft side rotated downward, and the peak of the distal curve of the Pfeiffer flap is positioned in the triangular defect formed by the movement of the Millard flap. The proximal curve lengthens downward to receive the Millard's "C" flap. The advantage of this technique is that there is no tension on the postoperative scar because the incision is essentially horizontal in nature, and the contracture of the scar occurs horizontally rather than vertically. Primary septal repositioning is performed, which provides stability and exact positioning of the previously lifted alar crus of the cleft side and nasal tip, and the nose can grow in a balanced way with equal muscular force being exerted on both sides. This incision can be used in all types of complete unilateral cleft lip regardless of the width of the cleft, shortening the cleft lip segment.

“Septoplasty” Performed at Primary Cleft Rhinoplasty: A Systematic Review of Techniques and Call for Accurate Terminology

“…Our included articles consisted of 11 studies describing primary cleft septoplasty and 17 studies describing secondary cleft septoplasty (Table 2, Table 3). 1,6–32 We defined primary cleft septoplasty as septoplasty performed at primary cleft lip repair. Secondary cleft septoplasty included all septoplasty performed at a secondary cleft lip or nasal revision, with the lowest listed age to be 14 years, “after skeletal maturity,” or “after multiple cleft nasal operations.”…”

Strategy for Correction of the Whistling Deformity in Secondary Cleft Lip Reconstruction

“… 6 The typical clinical findings of the whistle deformity include upper lip notching, bulging on the lateral lip segment, volume deficiency, and a defect of the upper lip. 7 …”

Intraoperative Vascular Anatomy, Arterial Blood Flow Velocity, and Microcirculation in Unilateral and Bilateral Cleft Lip Repair

“…using a previously published surgical technique. 10 Before the skin incision, 1 ml of lidocaine (1%) with epinephrine (1:100,000) was injected submucosally and intramuscularly along the incision markings. Bipolar cautery was used to stop bleeding that was not stopped by compression (Force FX coagulation system; Valleylab, Boulder, Colo.).…”