Unilateral Cleft Lip Repair Using the Chang Gung Technique

Abstract

Objective This retrospective study analyzed the outcomes of patients undergoing complete or incomplete unilateral cleft lip repair using the Chang Gung technique. The goal was to compare the symmetry and change of the technique through the measurement of anthropometric points on digital photographs. Methods From 2010 to 2016, a total of 274 complete and incomplete cleft lip patients without other craniofacial deformities were included in the study. All included patients had a minimum 1-year follow-up with frontal view photographs taken. The vermilion area, lip width, vermilion height, lateral lip length, lip height, and Cupid's bow width of both cleft and noncleft sides were measured for all patients. The Cleft Lip Component Symmetry Index was used to determine the symmetry of the cleft and noncleft sides in both incomplete and complete cleft groups. Results A total of 152 complete and 122 incomplete cleft lip patients were included in the study. The mean Cleft Lip Component Symmetry Index values showed that the vermilion area, lip height, and Cupid's bow width were symmetric on both cleft and noncleft sides. Lip width and lateral lip length were noted to be shorter, whereas the vermilion height was thicker on the cleft side than on the noncleft side. Significant differences between the complete and incomplete cleft group measurements were found for lateral lip length and lip height, and complete cleft measurements were shorter than those for incomplete clefts. There were no significant differences in vermilion area, lip width, vermilion height, and Cupid's bow width. Conclusions The outcome analysis showed that vermilion height reduction and modifications could be made for both complete and incomplete groups. The complete cleft lip has been found to have a significantly shorter lateral lip length and lip height, reflecting a more severe anatomical soft tissue deficiency in this group. A long-term outcome anthropometric point study may further verify the results of this surgical technique.

Unilateral Cleft Lip Repair: Technical Maneuvers to Achieve Vermilion and Mucosal Height

“…Symmetry was compared using the Cleft Lip Component Symmetry Index (CLCSI), a ratio of measurements on the cleft side to the noncleft side; here we focus on the vermilion and mucosal height. 18 The CLCSI was calculated using measurements from three-dimensional or two-dimensional photographs taken at a mean of 314 days postoperatively (range 52–1121 days). Three-dimensional photographs were taken at routine follow-up visits for seven patients.…”

“…Measurements are considered asymmetric if they are greater than 1.05 (excessive) or less than 9.05 (deficient). 18 All statistical analyses were performed utilizing SAS Studio software (version 3.8; SAS Institute Inc., Cary, N.C.).…”

Symmetry of the Vermillion Height after Modified Rotation-Advancement Cheiloplasty

“…Previous studies have investigated the growth of the lip after cheiloplasty through anthropometric measurements using the extended Mohler, Tennison-Randall, Millard, and LeMesurier techniques [5][6][7]. In our center, the modified rotation advancement [8] for unilateral cleft lip repair incorporates Mohler's incision, the small, lower triangular flap, and the vermilion triangular flap [9]. Outcome studies of the modified rotation advancement cheiloplasty show the vermillion height is higher in both complete and incomplete lips at the 1-year follow-up [8].…”

“…In our center, the modified rotation advancement [8] for unilateral cleft lip repair incorporates Mohler's incision, the small, lower triangular flap, and the vermilion triangular flap [9]. Outcome studies of the modified rotation advancement cheiloplasty show the vermillion height is higher in both complete and incomplete lips at the 1-year follow-up [8]. However, a longer follow-up result was not investigated.…”