Thomas J Sitzman1, John A Girotto, Jeffrey R Marcus. 1. Madison, Wis.; Durham, N.C.; and Rochester, N.Y. From the Division of Plastic, Reconstructive, and Maxillofacial Surgery, Duke University Medical Center, and the Division of Plastic and Reconstructive Surgery, University of Rochester Medical Center.
Abstract
BACKGROUND: The purpose of this study was to report objectively on practice trends in unilateral cleft lip repair in the United States and Canada. This study details current technique preferences, modifications, and adjunct procedure use. METHODS: All surgeons in the American Cleft Palate-Craniofacial Association and the Canadian Society of Plastic Surgeons (n = 1138) were mailed a survey inquiring about their management of unilateral cleft lip. RESULTS: Responses were received from 622 surgeons (55 percent response rate), of whom 269 currently perform cleft surgery. The results arise from this group of 269 active cleft surgeons. Eight-four percent of surgeons perform rotation advancement for complete unilateral cleft lip repair. Nine percent perform a variation of the triangular flap repair. Among those using rotation advancement, 45 percent use a modified technique. The most common modifications are the Noordhoff vermilion flap, the Mohler modification, and the Onizuka triangular advancement flap. Surgeons rarely use more than one technique in their practice, and 86 percent use the same repair for every unilateral cleft lip. Over half of surgeons routinely perform some form of primary nasal correction. Lip adhesion, presurgical orthopedics, nasoalveolar molding, and postoperative nasal stenting are performed by limited numbers of respondents, and the use of these surgical adjuncts is discussed. CONCLUSIONS: Rotation advancement remains the most frequently used technique for unilateral cleft lip repair. However, almost half of those using rotation advancement perform a modification to the original technique. Surgeons should be familiar with both the rotation advancement repair and its common modifications. Among adjunct procedures, only primary nasal correction currently garners widespread use.
BACKGROUND: The purpose of this study was to report objectively on practice trends in unilateral cleft lip repair in the United States and Canada. This study details current technique preferences, modifications, and adjunct procedure use. METHODS: All surgeons in the American Cleft Palate-Craniofacial Association and the Canadian Society of Plastic Surgeons (n = 1138) were mailed a survey inquiring about their management of unilateral cleft lip. RESULTS: Responses were received from 622 surgeons (55 percent response rate), of whom 269 currently perform cleft surgery. The results arise from this group of 269 active cleft surgeons. Eight-four percent of surgeons perform rotation advancement for complete unilateral cleft lip repair. Nine percent perform a variation of the triangular flap repair. Among those using rotation advancement, 45 percent use a modified technique. The most common modifications are the Noordhoff vermilion flap, the Mohler modification, and the Onizuka triangular advancement flap. Surgeons rarely use more than one technique in their practice, and 86 percent use the same repair for every unilateral cleft lip. Over half of surgeons routinely perform some form of primary nasal correction. Lip adhesion, presurgical orthopedics, nasoalveolar molding, and postoperative nasal stenting are performed by limited numbers of respondents, and the use of these surgical adjuncts is discussed. CONCLUSIONS:Rotation advancement remains the most frequently used technique for unilateral cleft lip repair. However, almost half of those using rotation advancement perform a modification to the original technique. Surgeons should be familiar with both the rotation advancement repair and its common modifications. Among adjunct procedures, only primary nasal correction currently garners widespread use.
Authors: Michelle Kornbluth; Richard E Campbell; John Daskalogiannakis; Elizabeth J Ross; Patricia H Glick; Kathleen A Russell; Jean-Charles Doucet; Ronald R Hathaway; Ross E Long; Thomas J Sitzman Journal: Cleft Palate Craniofac J Date: 2018-02-20
Authors: Thomas J Sitzman; Adam C Carle; Jaclyn N Lundberg; Pamela C Heaton; Michael A Helmrath; Carroll-Ann Trotman; Maria T Britto Journal: Cleft Palate Craniofac J Date: 2019-10-09
Authors: Cassio Eduardo Raposo-Amaral; André Pecci Giancolli; Rafael Denadai; Frederico Figueiredo Marques; Renato Salazar Somensi; Cesar Augusto Raposo-Amaral; Nivaldo Alonso Journal: Plast Surg Int Date: 2012-12-20