scholarly journals Anatomic landmark approach to reconstruction of asymmetric midline cleft lip due to Pai syndrome

2020 ◽  
Vol 47 (5) ◽  
pp. 483-486
Author(s):  
Danielle L. Sobol ◽  
Benjamin B. Massenburg ◽  
Raymond W. Tse
Keyword(s):  
Surgical Outcome ◽  
Cleft Lip ◽  
Surgical Repair ◽  
Upper Lip ◽  
Anatomic Landmarks ◽  
First Report ◽  
Anatomic Landmark ◽  
Methodical Approach ◽  
Midline Cleft

Midline clefts of the upper lip are rare, and it is therefore important that surgeons have access to a methodical approach for when these presentations are encountered. We adapted principles of the anatomic subunit approximation for unilateral cleft lip, to the repair of midline clefts. The overt use of anatomic landmarks to define the repair results in a design that inherently adjusts to varying degrees of clefts and can accommodate asymmetries. The “measure twice, cut once” style is an advantage to new surgeons and to surgeons who seldom encounter this presentation. We describe the details of surgical repair in the context of a patient with Pai syndrome and associated nasal hamartomas that resulted in nasolabial asymmetry. This is the first report of surgical outcome following treatment of Pai syndrome and includes early and 5-year follow-up. The system of repair that we describe is applicable to both symmetric and asymmetric midline clefts.

scholarly journals Secondary bilateral cleft lip-nose deformity correction by rhinoplasty with simultaneous Abbe flap

2014 ◽  
Vol 47 (01) ◽  
pp. 20-24 ◽  
Author(s):  
Nitin J. Mokal ◽  
Manpreet Juneja
Keyword(s):  
Cleft Lip ◽  
Perioperative Complications ◽  
Deformity Correction ◽  
Flap Necrosis ◽  
Upper Lip ◽  
Bilateral Cleft Lip ◽  
Nose Deformity ◽  
Abbé Flap ◽  
Cleft Lip Nose

ABSTRACTAim: The purpose of this article is to review modification and outcome of secondary rhinoplasty along with Abbι flap for correction of secondary bilateral cleft lip deformity. Materials and Methods: A total of thirteen patients of secondary bilateral cleft lip-nose deformity having tight upper lip, lack of acceptable philtral column, Cupid′s bow definition, irregular lip scars, and associated nasal deformity were selected. All the patients received Abbι flap and simultaneous nasal correction. All cases were treated during a period of three years. Mean patient age at the time of the operation was 21 years, and ranged from 16 to 27 years. The average follow-up period was three years. Results: Assessment of results was based on comparing preoperative and postoperative clinical photographs done by surgeon and patient relatives and patient satisfaction questionnaires. The columellar lengthening and upper lip vermillion correction achieved was satisfactory. There were no perioperative complications such as airway obstruction, bleeding, infection, wound disruption, or flap necrosis.

scholarly journals Median cleft lip: A new method of surgical repair

2010 ◽  
Vol 43 (01) ◽  
pp. 111-113
Author(s):  
B. V. Khandekar ◽  
S. Srinivasan ◽  
N. J. Mokal
Keyword(s):  
Cleft Lip ◽  
Surgical Repair ◽  
New Method ◽  
Muscle Repair ◽  
Median Cleft ◽  
Midline Cleft

ABSTRACTThe aim is to discuss a new method of muscle repair in midline cleft lip. Three patients with midline cleft lip were repaired with our technique of muscle repair and the results evaluated. Our new method of muscle repair in the form of ‘Z’ helps in forming the philtral dimple.

Midline cleft of upper lip: Review and surgical repair

2014 ◽  
Vol 67 (7) ◽  
pp. 1002-1003 ◽  
Author(s):  
Gaurav Deshpande ◽  
Alex Campbell ◽  
Rasika Jagtap ◽  
Carolina Restrepo
Keyword(s):  
Surgical Repair ◽  
Upper Lip ◽  
Midline Cleft

Median Cleft of the Lip: Its Significance and Surgical Repair

1993 ◽  
Vol 30 (1) ◽  
pp. 94-96 ◽  
Author(s):  
James Apesos ◽  
Gregg M. Anigian
Keyword(s):  
Surgical Technique ◽  
Cleft Lip ◽  
Surgical Repair ◽  
Surgical Reconstruction ◽  
Upper Lip ◽  
Facial Cleft ◽  
Median Cleft ◽  
Median Facial Cleft Syndrome ◽  
Associated Abnormalities

Median cleft lip is a midline vertical cleft through the upper lip in the absence of a prolabial remnant. This may occur as a sporadic event or be part of an inherited sequence of anomalies. A failure of formation or fusion of the medial nasal prominences derived from the frontonasal prominence is ultimately responsible for this aberration. Two categories of dysplasia are associated: (1) frontonasal deformity associated with hypotelorism and (2) median facial cleft syndrome associated with hypertelorism. A patient presents with median cleft lip, mild bifid nose, and hypertelorism. Following surgical reconstruction, a good result is achieved. The embryology, implications for associated abnormalities, and surgical technique for treating these cases are discussed.

scholarly journals Median cleft lip: an uncommon and unique anomaly

2019 ◽  
Vol 6 (8) ◽  
pp. 3035
Author(s):  
Vivek Parameswara Sarma
Keyword(s):  
Central Nervous System ◽  
Nasal Septum ◽  
Cleft Lip ◽  
Relevant Literature ◽  
Upper Lip ◽  
Craniofacial Malformations ◽  
Median Cleft ◽  
The Central Nervous System ◽  
Associated Abnormalities ◽  
Midline Cleft

Median or midline cleft lip [MCL] is an uncommon anomaly characterized by a midline vertical cleft through the upper lip and are either isolated or part of multiple anomalies. It can involve the pre-maxilla, the nasal septum, and the central nervous system. MCL includes Complete (42%), Incomplete (49%), and Minor forms (9%). The three main groups distinguished were: 1. Isolated MCL; 2. MCL with craniofacial malformations; and 3. MCL with extra-facial malformations. To analyze two operated cases of median cleft lip and review the relevant literature. The details of two cases of median cleft lip that were operated in 2017 were analysed. Both cases underwent wedge excision with the classical inverted V incision and muscle reconstruction with satisfactory result. Both the patients had no syndromic association or associated anomaly. All cases of MCL require evaluation for associated abnormalities. Isolated MCL can be repaired surgically with a good outcome. 

The use of a stifle flexion device to manage avulsion of the lateral head of the gastrocnemius muscle in a cat

2012 ◽  
Vol 25 (03) ◽  
pp. 246-249 ◽  
Author(s):  
J. Grierson ◽  
A. P. Moores ◽  
A. Pratesi
Keyword(s):  
Postoperative Period ◽  
Gastrocnemius Muscle ◽  
Suture Anchor ◽  
Surgical Repair ◽  
Normal Function ◽  
Diagnosis And Treatment ◽  
First Report ◽  
Lateral Head

SummaryThis report describes the diagnosis and treatment of a traumatic avulsion of the lateral head of the gastrocnemius muscle in a threeand- a-half-year-old male neutered Domestic Shorthaired cat. Surgical repair was achieved using a modified three-loop pulley suture pattern passed through a suture anchor inserted at the point of origin of the tendon and around the fabella. A stifle flexion device was utilised during the postoperative period to protect the repair. Follow-up at five months showed a return to normal function. This is the first report of avulsion of the lateral head of the gastrocnemius in a cat.

Aesthetic Enhancement of the Vermilion Using Dermofat Graft in Patients With Cleft Lip Deformity

2021 ◽  
pp. 105566562110017
Author(s):  
Kyung Hoon Chung ◽  
Karel A. deLeeuw ◽  
Hsiu-Hsia Lin ◽  
Lun-Jou Lo
Keyword(s):  
Cleft Lip ◽  
Qualitative Assessment ◽  
Patient Questionnaire ◽  
Upper Lip ◽  
Lower Lip ◽  
Quantitative Image ◽  
Dermofat Graft ◽  
Reproducible Method ◽  
The Mean

Background:There is an increasing patient expectation for better esthetics, manifesting through anatomical harmony, projection, and volume of the upper lip relative to the lower lip, in patients with cleft deformity. The aim of this study is to investigate the outcome of vermilion augmentation using autologous dermofat graft (DFG) to enhance the lip using both quantitative and qualitative assessment.Methods:Patients with secondary cleft lip deformity who received the surgical treatment in our institution from 2015 to 2018 were recruited. Panel assessment was performed on standardized preoperative and postoperative digital photographs. A patient questionnaire was used for the reported outcome. Image processing and analyses were applied to measure the lip change. Statistical analyses were performed.Results:A total of 91 patients were included. The mean age at operation was 22.7 years, and postoperative follow-up was 3.6 years. There were no complications in the study group. The panel assessment showed significant improvement ( P < .00001) on upper lip vermilion in both frontal and lateral profile views. Ninety-five percent of patients reported improvement of the upper lip projection and volume. Quantitative image analysis showed an increase in the upper lip vermilion ratio in 97% of the cases in frontal views and improvement of the vermilion projection in 87% of the cases in the superimposed lateral views.Conclusions:The use of DFG is an effective and reproducible method for vermilion augmentation and aesthetic enhancement in patients presenting with upper lip insufficiency relative to the lower lip.

Correction of whistle deformity secondary to cleft lip repair by V-Y plasty: a simple and effective technique

2021 ◽  
Vol 14 (12) ◽  
pp. e246303
Author(s):  
H Hari Kishore Bhat ◽  
Varsha Haridas Upadya
Keyword(s):  
Local Anaesthesia ◽  
Cleft Lip ◽  
Surgical Repair ◽  
Effective Procedure ◽  
Muscle Repair ◽  
Upper Lip ◽  
Effective Technique ◽  
Outpatient Procedure ◽  
Surgical Options ◽  
Cleft Lip Repair

Several techniques are available for the surgical repair of the cleft lip, however, avoiding secondary deformities and achieving consistent results remains a challenge. The whistle deformity is a secondary lip deformity characterised by inadequate fullness of the central upper lip with abnormal exposure of the central incisors when the lips are at rest, giving a whistling appearance. The causes include scarring of the vermilion and failure to restore the mucosal or muscular continuity. Various surgical options are available ranging from simple procedures like V-Y plasty and Z-plasty to complex procedures like complete lip redo, locoregional flaps, fillers and grafts. V-Y plasty is a simple, effective procedure for lip lengthening that can be performed under local anaesthesia as an outpatient procedure. It is less technique sensitive and also allows for some degree of muscle repair. We present a case of whistle deformity satisfactorily corrected with V-Y plasty.

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