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Vertical lengthening of the unilateral cleft lip after a triangular flap repair
Authors:T Sugihara  H Minakawa  Y Yamamoto  T Ohura
Institution:(1) Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Sapporo, Japan;(2) Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Kita 15, Nishi 7, Kita-ku, 060 Sapporo, Japan
Abstract:Summary A triangular flap repair for unilateral cleft lip is stated to have the potential problem of creating a lip that is too long. Although preoperative measurements were performed with calipers, the gap created in the medial segment was directly measured during the procedure, in order to determine the size of the flap more precisely. Ninety patients with complete unilateral cleft lips underwent a triangular flap repair using this method. The symmetry of the Cupid's bow was evaluated at a follow-up period averaging between six years and three months. Sixty-two lips obtained ldquosymmetryrdquo and the remaining 28 cases showed a lip which was ldquotoo longrdquo; none of the lips were ldquotoo shortrdquo. The comparison between 27 primary palate clefts (UCLA) and 63 primary and secondary palate clefts (UCLP) showed no significant difference in the surgical result. The preoperative shortness of the lip on the cleft side was significantly greater in the ldquotoo longrdquo group (5.01 ± 0.95 mm) than in the ldquosymmetryrdquo group (4.40 ± 0.87 mm). The width of the flap used was significantly larger in the ldquotoo longrdquo group (3.76 ± 0.79 mm) than in the ldquosymmetryrdquo group (3.42 ± 0.69 mm). The triangular flap repair with intraoperative measurements is considered to be beneficial, although preoperative measurements provide an optimal design in most cases. It is suggested that the use of a wider triangular flap results in a lip which tends to be too long in spite of the preoperative shortness on the cleft side.
Keywords:Unilateral cleft lip  Triangular flap repair  Overlengthening  Intraoperative planning
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