A Philtral Reconstruction and the Correction of Alar Base Depression Using a Transposition of the Orbicularis Oris Muscle Flap In Secondary Cleft Lip Repair

ABSTRACT

The philtrum of the upper lip is important to the facial contour and general appearance of individuals. In patients who have undergone cleft lip surgery, reconstruction of the philtrum is important in restoring the normal appearance of the upper lip and it also helps in diverting people`s attention away from the surgical scar. Several methods of philtral dimple creation have been used, but the postoperative results have not always been satisfactory. Between 1991 and 1997, reconstruction of the philtrum with unilateral cleft nasal deformity was performed in 43 patients, transposing the orbicularis oris muscle of the central upper lip to the depressed alar base. Using this method, efforts were made to achieve reconstruction of the philtrum and correction of alar base depression simultaneously. The results were rated good to excellent by a panel of judges using the ordinary scale method. Although reconstruction of the philtral dimple and correction of the depressed alar base were very successful, reconstruction of philtral column(especially the upper portion) was not satisfactory. Therefore, other procedures such as temporal fascial grafts in the upper portion of the philtral column should also be considered at the time of primary surgery or revisional surgery.