Strategic management of the minor-form and microform cleft lip: A long-term outcome assessment.

OBJECTIVE: The treatment of the lesser form cleft lip deformity (i.e., minor-form, microform, and mini-microform) is challenging to achieve patient satisfaction. There are no studies investigating how treatment outcomes balance patients' expectations and satisfaction with surgical or non-surgical care relative to the initial nasolabial findings. METHODS: Based on Mulliken's classification, consecutive records of patients with the lesser-form cleft lip from 1990 to 2015 were selected for analysis. Demographics, management, and revisions were reviewed. A panel analysis was performed based on the ratings from both professionals and non-professionals using patients' photographs. FACE-Q questionnaires were used to compare patient/parent-reported satisfaction to the normal controls. RESULTS: A total of 135 patients were included. All of the minor-form (23/23), 89% (58/65) of the microform, and 62% (29/47) of the mini-microform patients underwent surgery. Fifty-two percent (15/29) of the mini-microform patients, who underwent surgery, showed no significant improvement. Post-operative upper lip scars and remaining nasal asymmetry were the most common concerns in the treatment group. However, the FACE-Q results showed that patients experienced a statistically significant improvement in their overall facial appearance and social function in their respective groups. CONCLUSIONS: This study showed that differences exist in the perception of facial esthetics between the surgeon and the patient/parent. To achieve optimal individual treatment outcome and patient satisfaction, an awareness of the differences and treatment selection for patients are critical in surgical planning. This understanding and an open detailed discussion of overall long-term outcomes help in the management of patient expectations.

Clinical effect of triangle flap from nasal vestibule on minor unilateral incomplete cleft lip / 中华医学美学美容杂志

Objective To evaluate the clinical efficacy of triangle flap from the nasal vestibule on correcting the minor form unilateral incomplete cleft lip.Methods 72 patients with the minor-form unilateral incomplete cleft lip were invloved in this study.Based on different surgical procedures,all the patients were divided into two groups:36 patients were treated with harvesting a triangle flap from the nasal vestibule,rotating,increasing lip height;other 36 patients were treated with Millard method as control group.The positive photographs of two groups of patients were taken one year after surgery.Lip height,lip width,nostril width,nostril circumference and visible scar area were measured and compared statistically.Results Good rate of the group of the triangle flap from nasal vestibule was 91.6％ (33/36),but that of the group of Millard method was 72.2％ (29/36) (P＜0.05).The ratios of unaffected to affected sides of lip height,nostril circumference and nasal width in the triangle flap from nasal vestibule were 1.077±0.015,1.083±0.005,and 1.083±0.005;those of other group of Millard method were 1.078±0.013,1.095±0.005 and 1.096±0.015,respectively,with no significant difference (P＞0.05).But there was significant difference in laberal scar between the group of the triangle flap from nasal vestibule (0.510±0.004) mm2 and the control group of Millard method (0.830±0.009) mm2 (P＜0.05).Conclusions The nasal vestibule triangle flap method can significantly decrease the visible scar on lip and achieve the same good result compared to traditional Millard method.

Repair of Unilateral Incomplete Lesser Form Cleft Lip