Document Detail


Fourth-dimensional changes in nasolabial dimensions following rotation-advancement repair of unilateral cleft lip.
MedLine Citation:
PMID:  22286429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Repair of unilateral cleft lip requires three-dimensional craftsmanship and understanding four-dimensional changes.
METHODS: Ninety-nine children with unilateral complete or incomplete cleft lip were measured by direct anthropometry following rotation-advancement repair (intraoperatively) and again in childhood. Changes in heminasal width, labial height, and labial width were analyzed and compared measures depending on whether the cleft was incomplete/complete or involved left/right side.
RESULTS: Average heminasal width (sn-al) was set 1 mm less on the cleft side and measured only 0.7 mm less at 6 years. Labial height (sn-cphi) was slightly greater on the cleft side at repair and matched the noncleft side at follow-up. Vertical dimension (sbal-cphi) was slightly less at operation; the percent change was the same on both sides. Transverse labial width (cphi-ch) was set short on the cleft side and lengthened disproportionately, resulting in less than 1 mm difference at 6 years. All anthropometric dimensions grew less in complete cleft lips compared with incomplete forms; however, only labial height and width were significantly different. There were no disparities in nasolabial growth between left- and right-sided cleft lips.
CONCLUSIONS: Cleft side alar base drifts laterally and should be positioned slightly more medial and secured to nasalis or periosteum. Growth in labial height lags and, therefore, the repaired side should be equal to or slightly greater than on the normal side, particularly in a complete labial cleft. Transverse labial width grows more on the cleft side; thus, lateral Cupid's bow peak point can be marked closer to the commissure to match the labial height on the noncleft side.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors:
John B Mulliken; Richard A LaBrie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  129     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-30     Completed Date:  2012-03-19     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  491-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic and Oral Surgery, Children's Hospital Boston and Harvard Medical School, Boston, Mass. 02115, USA. john.mulliken@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Anthropometry
Cleft Lip / surgery*
Humans
Infant
Lip / anatomy & histology
Nose / anatomy & histology
Prospective Studies
Reconstructive Surgical Procedures / methods*
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2012 Feb;129(2):499-501   [PMID:  22286430 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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