Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment

Abstract

Objectives The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison–Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison–Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison–Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison–Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison–Randall repairs. Both Millard and Tennison–Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

Cleft Lip/Nasal Deformities After Plastic Surgery for Unilateral Cleft Lip/Palate: A Prospective Study at a Large Hospital in Vietnam

“…This is also a statement by many surgeons worldwide. 9 , 10 In our study, the lip was too short in 34.8%, equivalent to that reported by Rajanikanth et al, but lower than that reported by Cheema SA and Asim M (63%). 6 , 7 …”

“…This is also a statement by many surgeons worldwide. 9,10 In our study, the lip was too short in 34.8%, equivalent to that reported by Rajanikanth et al, but lower than that reported by Cheema SA and Asim M (63%). 6,7 In patients with unilateral cleft lip, the short lip is often due to the selection of surgical methods that are not suitable for the type of cleft, such as the straight incision method or the rotation and advancement flap (incorrect rotation and advancement).…”

Sagittal Jaw Relationship of Different Types of Cleft and Non-cleft Individuals

“…A linear cephalometric analytic obtained by projecting straight lines from the A and B points, respectively, unto the functional occlusal plane at 90 • and measuring the horizontal distance form point AO to BO direction of the jaw utterly influenced by the earlier treatment protocol such as time and techniques of primary surgeries (7)(8)(9)(10)(11)(12). The detrimental effect of palatoplasty on sagittal growth of maxilla has been widely documented in literature (9) but whether cheiloplasty impedes the growth is still in controversy (8,13). A number of researchers found that cheiloplasty has an effect on maxillary incisors, alveolar bone and development of maxilla as well whether some researchers claimed no effect on maxillary development (7,11,12,14,15).…”

Dental Characteristics of Different Types of Cleft and Non-cleft Individuals

“…Likewise, maxillary arch constriction (maxillary growth retardation) is a common dental problem of CLP patients, resulting in a concave facial profile ( Alam et al, 2019 ), class III malocclusion ( Alam et al, 2013 ), midfacial growth deficiency ( Alam et al, 2013 , 2019 ), and congenitally missing and malformed teeth. Orthodontic anomalies like crowding, rotation, and malposition of teeth are also commonly observed ( Haque and Alam, 2015a ; Haque et al, 2018 ; Adetayo et al, 2019 ). In the current study, maximum alterations in 8 different DC were found to be mostly altered in relation to upper incisors [U1-FH, U1-SN, U1-UOP, IIA, and U1-NA (degree)].…”