Cheiloplasty for False Median Cleft Lip Associated With Holoprosencephaly: The Use of Skin Graft for Philtrum Reconstruction, the Risk of Simultaneous Columella Reconstruction.

A false median cleft lip is a congenital malformation associated with holoprosencephaly. Cheiloplasty is an effective treatment for false median cleft lip. In the past, holoprosencephaly had a poor prognosis with extremely low survival rates; consequently, cheiloplasty was rarely performed. However, with the recent improvement in survival and prognosis with advances in medical care, patients survive and can now undergo cheiloplasty. We report a case of cheiloplasty performed using a skin graft for philtrum reconstruction. The lip contour was satisfactory because the insufficient tissue was resolved by filling the skin graft, which could not be resolved by midline suture closure. We did not perform columella reconstruction considering the safety; however, oxygenation temporarily destabilized owing to postoperative airway stenosis. Careful postoperative management is necessary even if the columella is not reconstructed.

Case Report of Complete Second Branchial Fistula.

Background: Branchial fistulas are anomalies of embryonic development of the branchial apparatus, with the most common being second branchial fistulas. However, complete fistulas are infrequent and may relapse. Furthermore, they are difficult to manage without adequate treatment. Methods: This article presents the case of a complete second branchial fistula in a 1-year-old female patient who had a sinus on the right side of the neck since birth. Excision of the fistula tract was performed without preoperative fistulography. The tract was then ligated and dissected immediately below the mucosa. Results: The postoperative course was uneventful, and there was no evidence of recurrence. Conclusions: Previous case reports have also demonstrated good outcomes without excision of the internal opening or tonsillectomy.