Retrospective Subjective Evaluation of Aesthetic Outcome in Secondary Cleft Lip Deformities Operated with Abbe's Flap

Abstract

The distribution of cleft lip and palate in literature iscleft lip and palate at 46%, followed by isolated cleft palate at 33%, then isolated cleft lip at 21%. The majority of bilateral cleft lips (86%) and unilateral cleft lips (68%) are associated with cleft palate. Males are predominant in cleft lip and palate population, whereas females have more of isolated cleft palates. 1 The primary cleft lip surgery has undergone vast improvement in technique, but revision of residual lip deformity continues to be a major challenge. The marked horizontal tightness of the cleft upper lip attributes to deficient tissue and intense scarring. The situation is ABSTRACT Background: The Abbe's flap is most commonly used to repair the full thickness defects of the lip that do not involve the commissure. The Abbe flap was first introduced to correct the secondary deformity of bilateral cleft lip. By this pedicled flap, we are able to equalize the disparity which existed between the tight upper lip and excessive lower lip. Aims to study retrospective subjective evaluation of aesthetic outcome in secondary cleft lip deformities operated with Abbe's flap. Methods: 29 patients operated during the period of January 2007-December 2011 for correction of secondary cleft lip and nasal deformity with Abbe's flap with or without rhinoplasty were included in our retrospective study. The secondary corrective surgeries were performed by a single surgeon. The photographs of the patients were retrospectively assessed by two plastic surgeons and one oral and maxillofacial surgeon, other than the one who performed the surgery. 29 patients operated during the period of January 2007-December 2011 for correction of secondary cleft lip and nasal deformity with Abbe's flap with or without rhinoplasty were included in our retrospective study. The secondary corrective surgeries were performed by a single surgeon. The photographs of the patients were retrospectively assessed by two plastic surgeons and one oral and maxillofacial surgeon, other than the one who performed the surgery. Results: Out of 29 patients with secondary cleft deformities 12 were male and 17 were female. Average follow up period was 3 years. Multiple variables of the nose and the lips were used to assess the aesthetic outcome of Abbe's flap. Conclusion: As per the subjective retrospective analysis of our study we have come to the conclusion that Abbe's flap is a work horse for correction of shortage of tissue for the secondary cleft lip deformities. Uniform satisfactory outcome was obtained with a more natural contour and more satisfactory proportion of both lips.

Cleft Rhinoplasty- Columellar lengthening prolabial reconstruction with Abbe flap

“…This approach for understanding the success of rhinoplasty has been previously studied, published, and accepted. [ 2 3 ] To the best of our knowledge, this study is the first of its kind, which appreciates the outcome of rhinoplasty of BCLP patients. Few other studies have been in this approach,[ 2 3 7 ] but none of them employed the ROEQ kind of approach.…”

“…[ 2 3 ] To the best of our knowledge, this study is the first of its kind, which appreciates the outcome of rhinoplasty of BCLP patients. Few other studies have been in this approach,[ 2 3 7 ] but none of them employed the ROEQ kind of approach. The effective lengthening of columella with Abbe flap serves many purposes:[ 5 6 8 ]…”

“…All patients had undergone various degrees of presurgical orthodontics and would require further postsurgical orthodontics for refinement of the technique. [ 2 3 4 5 6 7 ]…”

“…The release incision of the oral mucosa and muscle from the premaxilla and pyriform margin allowed the medial advancement of the lateral lip segments without tension. [ 2 3 4 5 6 7 ]…”

“…[ 1 ] In complete CLP rehabilitation, such a deformed, “crooked nose” poses a significant challenge. [ 2 ] In cases of deficiency, the columellar lengthening procedure (CoLP) is the most viable treatment procedure. However, the type of CoLP needs to be chosen on the degree of nasolabial deformity.…”