Document Detail

Surgical repair of transverse facial cleft: oblique vermilion-mucosa incision.
MedLine Citation:
PMID:  19709939     Owner:  NLM     Status:  MEDLINE    
Various surgical techniques have been reported for the repair of the transverse facial cleft using a straight-line closure, Z- or W-plasty, local flaps, etc. However, several problems remain such as deviation, distortion and scars in the commissure and cheek. To resolve these problems, we studied the anatomy of the commissure again and devised the most reasonable method for repair of the transverse facial cleft. In our new method, oblique vermilion and mucosa incision lines, 45 degrees to the vermilion-cutaneous junction, were designed. After mucosal closure, the orbicularis muscle was reconstructed by cross-overlap joining the upper muscular bundle over the lower muscular bundle at an angle of 90 degrees. The skin was sutured using horizontal straight-line closure with a small Z-plasty lateral to the nasolabial fold. We performed the new method on seven macrostomias. The patient cohort consisted of four girls and three boys, and their ages ranged from 4 months to 3 years. Symmetrical commissure and natural oral movement was obtained in the past five cases. The scar around the commissure and cheek was inconspicuous in all cases. The new method used the oblique vermilion-mucosa incision and straight-line closure, the cross-overlap joining of the muscular bundles at an angle of 90 degrees , and the horizontal straight-line skin closure with a small Z-plasty lateral to the nasolabial fold. This method, which is anatomically reasonable, can construct a symmetrical and natural commissure without conspicuous scars.
Akiyoshi Kajikawa; Kazuki Ueda; Yoko Katsuragi; Taro Hirose; Emiko Asai
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-08-25
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  63     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1269-74     Citation Subset:  IM    
Copyright Information:
Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan.
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MeSH Terms
Child, Preschool
Face / surgery*
Facial Asymmetry / surgery*
Follow-Up Studies
Mouth Mucosa / surgery*
Reconstructive Surgical Procedures / methods*
Suture Techniques

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

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