BACKGROUND: Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results of cleft lip revision following conversion to the modified inferior triangle. METHODS: A retrospective analysis of patients who underwent cleft lip revision using the modified inferior triangle was included. Standard preoperative and postoperative photographs were obtained and evaluated. Anthropometric points were placed and measurements performed. Results were corroborated by two independent, blinded reviewers (Pearson correlation test), and compared using the paired t test. RESULTS: Twenty-seven patients were included (mean age, 10.89 years; female, n = 10) over a 35-month period. Intraobserver and interobserver ratios were shown to be reliable. Significant differences (p < 0.05) were seen in the philtrum column height (PCH), hemilabial length (HL), and hemilabial length' (HL') preoperatively. No significant differences (p > 0.05) were noted in the PCH, HL, and HL' postoperatively. Significant changes (p < 0.05) between ΔPCH, ΔHL, and ΔHL' of cleft side and ΔPCH, ΔHL, and ΔHL' of noncleft side were found. Philtral height showed significant changes (p < 0.05) after conversion to the modified inferior triangle. Significant changes (p < 0.05) were found in the philtrum column width and mouth width. CONCLUSION: Cleft lip revision is effectively performed using the modified inferior triangle repair, improving the lip appearance with improved anthropometric measures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
BACKGROUND: Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results of cleft lip revision following conversion to the modified inferior triangle. METHODS: A retrospective analysis of patients who underwent cleft lip revision using the modified inferior triangle was included. Standard preoperative and postoperative photographs were obtained and evaluated. Anthropometric points were placed and measurements performed. Results were corroborated by two independent, blinded reviewers (Pearson correlation test), and compared using the paired t test. RESULTS: Twenty-seven patients were included (mean age, 10.89 years; female, n = 10) over a 35-month period. Intraobserver and interobserver ratios were shown to be reliable. Significant differences (p < 0.05) were seen in the philtrum column height (PCH), hemilabial length (HL), and hemilabial length' (HL') preoperatively. No significant differences (p > 0.05) were noted in the PCH, HL, and HL' postoperatively. Significant changes (p < 0.05) between ΔPCH, ΔHL, and ΔHL' of cleft side and ΔPCH, ΔHL, and ΔHL' of noncleft side were found. Philtral height showed significant changes (p < 0.05) after conversion to the modified inferior triangle. Significant changes (p < 0.05) were found in the philtrum column width and mouth width. CONCLUSION:Cleft lip revision is effectively performed using the modified inferior triangle repair, improving the lip appearance with improved anthropometric measures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors: Jenny F Yang; John Smetona; Joseph Lopez; Connor Peck; Navid Pourtaheri; Derek M Steinbacher Journal: Plast Reconstr Surg Glob Open Date: 2021-12-06