Bilateral Cleft Lip Repair

Video Type: CVideo
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Author: James Phillips
Published:
Specialties: Otolaryngology, Pediatric Otolaryngology, Plastic Surgery
Schools: University of Arkansas for Medical Sciences, Vanderbilt University
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Basic Info

Contributors: Larry Hartzell

Repair of the bilateral cleft lip deformity can be challenging to the cleft and craniofacial surgeon.  The goals of an acceptable repair must include precise continuity of the cupid's bow, maximizing philtral length, and establishing a mucosa lined sulcus.  We present an example of a repair of the bilateral incomplete lip as described by Millard.

DOI: http://dx.doi.org/10.17797/qefi9lqbam

Advanced

Procedure

Bilateral cheiloplasty

Indications

Bilateral cleft lip

Contraindications

Medically unfit for general anesthesia. Poor nutrition for compromised healing.

Instrumentation

Setup

General plastics set up including calipers, straight beaver blade, and skin hooks

Preoperative Workup

Pre-operative photos, Hemoglobin and hematocrit, preoperative parental counseling

Anatomy and Landmarks

External landmarks of the upper lip: Cupids bow, philtrum, philtral dimple, cutaneous white roll, wet and dry vermillion, nasal base.

Advantages/Disadvantages

This repair provides the option of banking redundant skin at the bilateral nasal base as "fork flaps" which may be used later on if collumellar lengthening is anticipated to be necessary. This technique also provides the "E-flap" which gives fullness to the tubercle of the upper lip.

Complications/Risks

Bleeding, infection, poor wound healing, unacceptable scarring.

Disclosure of Conflicts

none

Acknowledgements

References

1. Noordhoff, MS. (1986) Bilateral cleft lip reconstruction. Plastic and Reconstructive Surgery. Jul;78(1):45-54.
2. Oh, SJ. (2008) Reconstruction of bilateral cleft lip and nose deformity. Journal of Craniofacial Surgery. Sep;19(5):1353-8.

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