No abstract available.
Cleft Lip* ; Congenital Abnormalities*

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Lip* ; Nose*

A notching deformity of the vermilion is one of the most common secondary lip deformities following unilateral cleft lip repair. It is due to inadequate approximation of the orbicularis marginalis muscle, vertical scar contracture, and inappropriate adjustment and suturing of the vermilion. During the primary repair, symmetric construction of vermilion is difficult. This is because the thickness and shape of the vermilion is different on both sides of the cleft. To prevent notching deformity of the vermilion, authors designed the incision line such as Tongue-in-Groove on the vermilion and has been utilizing this technique for the last several years and obtained quite satisfactory results. Hereby we present the technique and result.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Contracture ; Lip

lip operation or repeated secondary surgeries can result in tightness of the upper lip. In case, the degree of the resulting side-to-side tension is very severe, the possibility of a lip switch flap must be considered. When the lip tightness accompanies a loss of more than two-thirds of the Cupid's bow, an Abbe flap is an alternative. The disadvantages of Abbe flap are scar formation on the lower lip, design of incision line on the upper lip, disharmony of colors, and the dysfunction of the orbicularis muscle. These problems have been recognized in the literature and extreme discretion has been advised in its application. We experienced four cases of Abbe flap operation which were designed differently to correct the secondary unilateral or bilateral cleft-lip nasal deformities. The Abbe flap operations resulted in removal of the scars and tightness of the upper lip, reconstruction of the Cupid's bow, lengthening of the columella, and therefore secondary cleft-lip nasal deformity could be corrected. It is thought that carefully applied Abbe flap is an appropriate method to relieve horizontal tightness or flattening of the upper lip which occured after primary operation of cleft lip.]]>
Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Lip

A case of 13-year-old female with three-pairs/six-lines of labial frenulums and thumb and forefinger's deformity was reported. The frenulums of inferior lip were bigger than frenulum of superior lip. There was no family history and her mother didn't ill with infectious disease and injury in gestation.
Adolescent ; Female ; Humans ; Lip ; abnormalities ; Thumb ; abnormalities

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Nose*

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Skin*

The secondary correction of cleft lip nasal deformity (CLND) presents difficult surgical problems. Characteristically, nostrils are asymmetric. The present study was aimed to examine and compare the effect of Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base for augmentation of the nostril with or without lengthening the columella in CLND. The subjects were 28 patients with unilateral cleft lip, who had secondary nostril correction. The nostril correction methods were Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base. Facial photographs were taken before and 20 days after the operation. By using Adobe photoshop, the columella length and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. The degree of improvement of the columella length using Straith's alar web Z-plasty was 70.20%. And then Millard's alar web Z-plasty was 55.01%, alar web excision was 39.93%, and lateral V-Y advancement of the alar base was 16.38% in order. The degree of improvement of the nostril size using lateral V-Y advancement of the alar base was 55.26%. And then alar web excision was 52.72%, Millard's alar web Z-plasty was 34.86%, and Straith's alar web Z-plasty was 16.06% in order. Straith's alar web Z-plasty and Millard's alar web Z-plasty resulted in elongation of the columella, equalization of asymmetrical nostril, and enlargement of small nostrils. Alar web excision enlarged nostrils and restored symmetry. Lateral VY advancement of the alar base increased nostril width and enlarged nostrils. These results indicate that the correction of nostrils improve the shape and the symmetry of the nostrils in CLND.
Cleft Lip* ; Congenital Abnormalities* ; Humans

Even though it is generalized to perform synchronous lip and nasal correction, there are some cases in need of secondary correction of cleft lip nose deformity. In these procedures, the lengthening of columella plays an important role. We performed eighteen cases of the secondary cleft lip nose deformity correction using two different methods from 1997 to 2003. The central lip flap was used in eight patients and V-Y advancement flap in ten patients. Additional procedures including reverse U-incision, interdomal fixation sutures and suspension sutures were used for correction of combined deformity. Silastic nasal retainers were kept in all patients for 6 months. Both of central lip flap and V-Y advancement flap seems to be a good technique for lengthening columellar soft tissue. But new columella after V-Y advancement flap appeared to be too narrow and a bit unnatural looking and central lip flap left additional scar on the upper lip although it was conspicuous. We think that central lip flap is a better technique in a case with wide philtrum and narrow columella and V-Y advancement flap can be another choice in a columella with sufficient width.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip* ; Nose* ; Sutures

Secondary deformities can exist after repair of cleft lip by sophisticated method of primary cheiloplasty and can affect some or all of the previously cleft regions. There may be lip scar, nasal deformity, vermilion deficiency, and maxillary hypoplasia. The correction of secondary cleft deformities is difficult and requires efforts of a multidisciplinary team. There are many operative techniques for correction of the vermilion deficiency, for example double V-Y advancement mucosal flap or double pendulum flap etc. But, these methods are very complex and can remained the scar on vermilion. Twenty six patients of secondary cleft lip and nose deformity with vermilion deficiency were operated in our department from January 1999 to June 2002. The secondary cleft lip and nose deformity was corrected by various operative methods, and the vermilion deficiency corrected by using acellular human dermis(AlloDerm(R), Life Cell Corp., Woodlands, Texas). The three cases suspected for AlloDerm(R) to be absorbed showed that the augmentation of vermilion was poor but another cases showed satisfactory result with good augmentation of vermilion and minimal scar. In conclusion, vermilion augmentation using AlloDerm(R) has the several advantages such as simplicity, shorter operation time, and effectiveness compared with other surgical methods.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Nose*