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

Abstract

Objectives: The Anatomical Subunit Technique for unilateral cleft lip repair has gained popularity worldwide. The purpose of this study is to report our experience using this technique. Methods: 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon from 2015 to 2020. In addition to the demographic data, severity and type of the cleft lip, the surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon and rate of revision surgery were collected from Al-shifa plus 3 health electronic system. Parents’ satisfaction regarding scar quality, lip and nose aesthetic appearance was collected anonymously. The documented data were evaluated using statistical analysis. Results: 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects and showed 85% satisfaction rate with the postoperative scar, 77.5% satisfaction with the aesthetic appearance of nose. Conclusion: In our hands, the anatomical subunit technique resulted in a predictable result with high patient’s satisfaction rate as related to scar quality, nasal and lip symmetry in children with varying severity of cleft lip. Revision for vermilion excess was needed in 7 % of cases. The high percentage of consanguinity (52%) in our study highlight the need for more targeted national campaigns involving premarital counselling in the Omani population.
 Keywords: Cleft Lips, cheiloplasty, Oman, Surgical Technique, Millard Technique, Fisher, Consanguinity.