Comparison of Outcome of Modified Millard’s Incision and Delaire’s Functional Method in Primary Repair of Unilateral Cleft Lip: A Prospective Study

Background

Certain preoperative anatomical features may lead the surgeon to choose one particular incision pattern in preference to another. No one technique of cleft lip repair consistently produces ideal aesthetic and functional results.

Objectives

This study was conducted to compare the outcomes attained using two different designs of skin incision used for surgical correction of unilateral cleft lip.

Materials and Methods

Modified Millard’s incision and Delaire’s functional method techniques were performed and evaluated on 18 patients who received primary unilateral cleft lip repair. Soft-tissue measurements of the lip and nose were recorded preoperatively. Analysis was based on postoperative assessment of the white roll, vermilion border, scar, Cupid’s bow, lip length, and nostril symmetry and appearance of the alar dome and base. Chi-square and Fisher exact test, Student t test (two tailed, independent) and Student t test (two tailed, dependent) were used for statistical analysis of study parameters at 5 % level of significance.

Results

Preconceptions that one particular technique was better suited to certain preoperative cleft anatomical forms were not proven statistically. The outcome of our surgical methods was good and suggested quantitative changes with progressive diminution of asymmetry of the cleft and non cleft sides.

Conclusion

Lip length improvement was better in case of modified Millard’s incision. The Delaire’s functional method of cleft lip repair results in improved nasal symmetry due to correction of the abnormal insertions of the underlying musculature.

     

Publisher’s note

Due to their physicochemical properties, Tm₂O₃ nanoparticles have been employed in bioanalytical applications. In this report, body-centered shaped Tm₂O₃ nanoparticles with size of about 10 nm were successfully synthesized by the hydrothermal homogeneous method and used as a novel electrochemical biosensing platform for glucose based on a Tm₂O₃–Nafion modified electrode. Transmission electron microscopy (TEM) and energy-dispersive spectroscopy (EDS) were used to characterize the Tm₂O₃ nanoparticles, and cyclic voltammetry (CV) was used to investigate the electrochemical behavior of the modified electrode. The experimental results showed that glucose oxidase (GOD) immobilized on the Nafion–Tm₂O₃ film achieved direct electron transfer with an apparent heterogeneous electron transfer rate constant (k_s) of 3.27 ± 0.43 s⁻¹ and kept its bioactivity. Confirmation of the retained bioactivity can be demonstrated by its bioelectrocatalytic activity to the reduction of dissolved oxygen. The GOD/Tm₂O₃/Nafion/GC electrode displayed potential application for the fabrication of glucose biosensors with a linear glucose response up to 7 mM. Additionally, the biosensor based on the Tm₂O₃ nanoparticle-modified electrode exhibited good stability and selectivity. The successful practice of using the Tm₂O₃ modified electrode for the direct electrochemical analysis of proteins and the bioelectrocatalytic activity of enzymes offers an efficient strategy and a new promising platform for the application of rare earth oxide materials in the field of electrochemical sensors.