Long Term Results in the Unilateral Cleft Lip Repair by Mulliken's Method

ABSTRACT

PURPOSE: The Mulliken's method is a one of the very excellent technique to correction of the unilateral cleft lip. It could decrease the need of additional operation and second operation by the early simultaneous correction of unilateral cleft lip and nasal deformity, at a time. Numerous procedures were advocated for the correction of nasal deformity, but with general dissatisfaction of the results, it became obvious that no one procedure is the ideal one. The authors have been operating on unilateral cleft lip by Mulliken's method and long term follow-up of postoperative result was evaluated. METHODS: The authors have done long term follow-up of results in the 75 cases unilateral cleft lip patient, during 1-7 years. That was repaired by simultaneous correction of cleft lip and nasal deformity by Mulliken's method at the period from June 1997 to December 2007. The patients were unilateral complete cleft lip 39 cases, unilateral incomplete cleft lip 36 cases. In the severe complete cleft lip cases, lip adhesion operation was done before definite operation. The mean age of unilateral cleft lip operation was 3.2 months. Five anthropometric parameters, which were upper lip, cutaneous lip and vermilion mucosa height, nasal tip protrusion, columella length were measured by Sliding Vernier Caliper. The anthropometric analysis was performed preoperatively, and the results were com pared with those of age- matched, normal children postoperatively in 6 months, 3, 5 and 7 years. T-tests were used to analyze the differences between the measurements. RESULTS: Long-term postoperative results were evaluated by anthropometrically. Most patients showed adequate growth of upper lip height, vermilion mucosa height and columella length. But nasal tip protrusion was relatively short compare to the normal value. Incomplete cleft lip group was nearly normal growth results than complete cleft lip group. CONCLUSION: In conclusion, we could make harmonious Cupid's bow, natural philtrum and lip, appropriate nasal shape by Mulliken's method. But nasal tip protrusion was under the normal values on complete and incomplete group. And incomplete group showed more good results than complete group. We have experienced repair of cleft lip by Mulliken's method with 75 cases of unilateral cleft lip patients and conclude that it is a very useful method.