ABSTRACT
Lateral facial cleft is a very rare craniofacial malformation involving various degree of skeletal and soft tissue hypoplasia. For the reconstruction of the oral commissure, McCarthy and Fuleihan(1986) measured the distance between the unaffected philtral column and commissure and that distance is marked on the affected side of the upper lip. And it is moved 2 to 3mm lateral to allow for future wound contraction. The purpose of this study is to analyze the postoperative shift of the oral commissure in the lateral facial cleft. We have reconstructed lateral facial cleft and divided them into two groups. In group A, the distance between the commissure and philtral column is marked on the unaffected side and transferred to the affected side. And the transferred point was moved 2 to 3 mm in the lateral direction. In group B, the transferred point to the affected side was exactly the same distance between the commissure and philtral column on the unaffected side. This study involved 19 patients aged from 2 months to 3 years (mean age of 20.8 months) with lateral facial cleft who underwent the commissuroplasty from June 1997 to August 2002. Group A and group B involved 10 and 9 lateral facial clefts, respectively. By using the caliper, each patient's postoperative upper lip width was measured on both the unaffected side and the affected side by one panel. Follow-up was available in 12 patients. In group A, oral commissural point was lateralized by 2.57mm on average, and the mean follow-up period was 3 years and 2 months. In group B, oral commissural point was lateralized by 0.82mm on average, and mean follow-up period was 1 year and 10 months. In all patients, oral commissural points were displaced laterally. In conclusion, we have noticed the reconstructed oral commissural point was lateralized. And we propose that the point which is selected as the site of the reconstructed commissure should be moved more in the medial direction.
Subject(s)
Humans , Follow-Up Studies , Lip , Wounds and InjuriesABSTRACT
An Abbe cross-lip flap can be used when there is a deficiency of upper lip tissue and a disproportion between the upper and lower lip. This flap is particularly useful when reproduction of a central fullness or pout in the upper lip is desired. It should be designed to mimic the missing or deformed philtrum. A total of 21 cases of tight upper lip resulting from secondary deformities of unilateral and bilateral cleft lip were treated using the Abbe cross-lip flap(11 cases were unilateral and 10 cases were bilateral). In conclusion, advantages of Abbe cross-lip flap are as followings: 1)It is very efficacious to correct the tight upper lip 2)Widening of upper lip and simultaneous narrowing of lower lip can correct a disproportion between the upper and lower lip. 3)Central flap can recreate a philtrum like effect. 4)There was no significant scar problems in lower lip donor site. 5)In case of combined maxillary retrusion, best results were obtained after orthodontic and/or orthognatic treatment.