A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique

Background: This study describes a 20-year experience of treating patients with unilateral cleft lip. During this time, various techniques were used including Millard's technique and its modification and two types of geometrically designed procedures. The study objective was to compare surgical...

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Main Author: Percy Rossell-Perry
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2016-09-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197226
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author Percy Rossell-Perry
author_facet Percy Rossell-Perry
author_sort Percy Rossell-Perry
collection DOAJ
description Background: This study describes a 20-year experience of treating patients with unilateral cleft lip. During this time, various techniques were used including Millard's technique and its modification and two types of geometrically designed procedures. The study objective was to compare surgical outcomes of different surgical techniques for unilateral cleft lip repair. Materials and Methods: This is a retrospective audit of outcomes after unilateral cleft lip repair performed by a single surgeon since 1995. Of the 827 patients who underwent surgery, 277 met the criterion of having anthropometric measurements performed ≥1 year postoperatively. The patients were stratified into three groups according to cleft severity: incomplete, complete with less deficiency (3–6 mm difference between cleft and non-cleft lip height) and complete with more deficiency (>6 mm difference between cleft and non-cleft lip height). Anthropometric measurements, scar assessment and complications were recorded. Results: There were no differences in outcomes between Millard and Reichert-Millard techniques for incomplete unilateral cleft lip. For complete unilateral cleft lip and less tissue deficiency, lip symmetry was better using upper rotation advancement plus double unilimb Z-plasty than the Reichert-Millard technique. For complete unilateral cleft lip and more tissue deficiency, lip symmetry was better after triple unilimb Z-plasty than after upper rotation advancement plus double unilimb Z-plasty. Conclusions: We presented a 20-year experience performing unilateral cleft lip repair. An individualised classification system with corresponding surgical techniques was successfully used during this period. The individualised surgical protocol used in this study allowed us to achieve improved surgical outcomes.
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spelling doaj-art-d14d15711e6c4e85b043984a46a4cd902025-08-20T03:24:01ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2016-09-01490334034910.4103/0970-0358.197226A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty techniquePercy Rossell-Perry0Faculty of Human Medicine, Post Graduate Studies San Martin de Porres University, Lima, PeruBackground: This study describes a 20-year experience of treating patients with unilateral cleft lip. During this time, various techniques were used including Millard's technique and its modification and two types of geometrically designed procedures. The study objective was to compare surgical outcomes of different surgical techniques for unilateral cleft lip repair. Materials and Methods: This is a retrospective audit of outcomes after unilateral cleft lip repair performed by a single surgeon since 1995. Of the 827 patients who underwent surgery, 277 met the criterion of having anthropometric measurements performed ≥1 year postoperatively. The patients were stratified into three groups according to cleft severity: incomplete, complete with less deficiency (3–6 mm difference between cleft and non-cleft lip height) and complete with more deficiency (>6 mm difference between cleft and non-cleft lip height). Anthropometric measurements, scar assessment and complications were recorded. Results: There were no differences in outcomes between Millard and Reichert-Millard techniques for incomplete unilateral cleft lip. For complete unilateral cleft lip and less tissue deficiency, lip symmetry was better using upper rotation advancement plus double unilimb Z-plasty than the Reichert-Millard technique. For complete unilateral cleft lip and more tissue deficiency, lip symmetry was better after triple unilimb Z-plasty than after upper rotation advancement plus double unilimb Z-plasty. Conclusions: We presented a 20-year experience performing unilateral cleft lip repair. An individualised classification system with corresponding surgical techniques was successfully used during this period. The individualised surgical protocol used in this study allowed us to achieve improved surgical outcomes.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197226cleft lip repairmillard techniqueunilateral cleft lip
spellingShingle Percy Rossell-Perry
A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
Indian Journal of Plastic Surgery
cleft lip repair
millard technique
unilateral cleft lip
title A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
title_full A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
title_fullStr A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
title_full_unstemmed A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
title_short A 20-year experience in unilateral cleft lip repair: From Millard to the triple unilimb Z-plasty technique
title_sort 20 year experience in unilateral cleft lip repair from millard to the triple unilimb z plasty technique
topic cleft lip repair
millard technique
unilateral cleft lip
url http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197226
work_keys_str_mv AT percyrossellperry a20yearexperienceinunilateralcleftliprepairfrommillardtothetripleunilimbzplastytechnique
AT percyrossellperry 20yearexperienceinunilateralcleftliprepairfrommillardtothetripleunilimbzplastytechnique