Choice of Incision for Primary Repair of Unilateral Complete Cleft Lip: A Comparative Study of Outcomes in 796 Patients

Abstract

Certain preoperative anatomical features may lead the surgeon to choose one particular incision pattern in preference to another, but in this study, it was found that one technique was essentially as good as the other. This suggests that the technique for closure of the underlying tissues is probably of more importance.

Unilateral cleft lip/nose repair using an equal bows /straight line advancement technique – A preliminary report and postoperative symmetry-based anthropometry

“…A recent study compared both Millard and Pfeifer repair techniques in a large number of patients and claimed that vermilion match, but not lip length, could be achieved better by the Millard method (Reddy et al, 2008). Some surgeons were aware of this fact and modified the Millard incision by adding a unilimb z-plasty just above the vermilion in an attempt to further lengthen the lip, particularly in complete wide cleft lips MartinezPerez, 1999, Salyer et al, 2009).…”

Modification of the Rotation-Advancement Principle in Cleft Lip Repair

“…It is reported that nasal tip projection and columella length of Chinese people are fast-growing features by 5 years of age. 6 The incision on the columella seems incompatible for a Chinese baby. A concave curve incision devised in the medial side can effectively lengthen the medial lip, which is devised by Pfeifer.…”

“…A concave curve incision devised in the medial side can effectively lengthen the medial lip, which is devised by Pfeifer. 6 In our design, the curve incision was made from the medial peak of the Cupid's bow to the nasal columella of the cleft side, and the philtral dimple was preserved. If the symmetry of the Cupid's bow was not achieved, a release incision in the nasal columella base was performed and preserved the natural columella.…”

Afroze Incision for Functional Cheiloseptoplasty

“…The 2 curves are brought together such that the highest and lowest points of 1 curve are approximated with the corresponding highest and lowest points of the other, thus creating a straight line. 2 On comparison of the 2 techniques, each has its own advantages and shortcomings. The Millard flap produced better results when considering vermilion approximation.…”

“…A prominent wave placed just above the mucocutaneous junction will tend to exaggerate this factor. 2 Afroze incision is a combination of 2 incisions, Millard incision on the noncleft side and Pfeiffer incision on the cleft side. The flap design is such that Millard flap on the noncleft side is 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.…”