Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia

Abstract

Objective: This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Design: Observational cohort study. Setting: Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. Patients, Participants: From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. Interventions: We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. Main Outcome Measure(s): This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. Results: While nasal width and philtral height ratios decreased significantly ( P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged ( P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly ( P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged ( P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. Conclusion: In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.

Experience of Unilateral Cleft Lip Repair using the Anatomical Subunit Technique in an Omani Population over a Five-Year Period

“…Various techniques have been used by plastic surgeons to correct cleft lip anomalies, 9,11 all of which aimed to establish the best functional rehabilitation and aesthetical acceptance. [11][12][13] Rose's straight-line repair was one of the first described techniques to repair cleft lip, this technique was published in 1891, followed by the rotation advancement technique for unilateral cleft lip repair which was introduced by Dr. Ralph Millard in 1955, this technique is initiated by forming an incision just below the nostril which continues to run vertically to the philtral ridge. [13][14][15] Millard's technique has undergone a number of refinements throughout the years but probably remains the most common technique used in unilateral cleft lip repair worldwide.…”

“…19 The major adjustment of this technique was to extend the incision to the noncleft philtral column. 12 With this modification, two major shortcomings have arisen, first was the complex appearance of the scar under the nasal sill which did not blend with the anatomical landmarks, second was that in order to avoid the under rotation and elevation of the cupid's bow peak, the lateral lip segment was shortened. 12 To address the mentioned shortcomings, Dr.David M. Fisher proposed the anatomic subunit technique first published in 2005.…”

“…12 With this modification, two major shortcomings have arisen, first was the complex appearance of the scar under the nasal sill which did not blend with the anatomical landmarks, second was that in order to avoid the under rotation and elevation of the cupid's bow peak, the lateral lip segment was shortened. 12 To address the mentioned shortcomings, Dr.David M. Fisher proposed the anatomic subunit technique first published in 2005. 12 As the name suggests, this technique respects the anatomical subunits of the lip and is based upon accurate pre-operative measurements.…”

“…12 To address the mentioned shortcomings, Dr.David M. Fisher proposed the anatomic subunit technique first published in 2005. 12 As the name suggests, this technique respects the anatomical subunits of the lip and is based upon accurate pre-operative measurements. 12 This technique preserved the transverse length of the lateral lip by creating a cutaneous triangle flap above the white roll to correct the height of the medial lip.…”

“…12 As the name suggests, this technique respects the anatomical subunits of the lip and is based upon accurate pre-operative measurements. 12 This technique preserved the transverse length of the lateral lip by creating a cutaneous triangle flap above the white roll to correct the height of the medial lip. 12 Ever since this technique has been introduced, the anatomical subunit technique has gained notable popularity.…”