Modern Unilateral Cleft Lip and Nasal Repair: Controversies from Presurgical Orthopedics to Surgical Techniques to Postoperative Care

Current trends in unilateral cleft lip repair

“…The Tennison-Randall approach is unique in that it involves a philtrum-lengthening back-cut that extends from the cleft Cupid's bow peak into the philtrum. The opening of this cut is filled by a laterally based triangular flap whose width is the measured deficiency in lip height [5 ▪ ]. This geometric approach is precisely measured and thought to be easier to teach to the inexperienced surgeon.…”

“…84% of surgeons that responded indicated they perform a Millard repair for complete UCL (45% of which use a modified Millard with the most common modifications being the Mohler and Noordhoff) [1]. The Mohler modification differs from the standard Millard in that the rotation back-cut is placed on the columella instead of the upper lip, with the C-flap used to fill the defect created by the downward rotation of the Cupid's bow [5 ▪ ]. The Noordhoff modification utilizes a lateral lip triangular flap (at Noordhoff's point) to reconstruct the vermilion [5 ▪ ].…”

“…The Mohler modification differs from the standard Millard in that the rotation back-cut is placed on the columella instead of the upper lip, with the C-flap used to fill the defect created by the downward rotation of the Cupid's bow [5 ▪ ]. The Noordhoff modification utilizes a lateral lip triangular flap (at Noordhoff's point) to reconstruct the vermilion [5 ▪ ]. Other data gathered from this initial survey indicated that over half of surgeons performed some form of primary nasal correction [1].…”