COMPARISON OF OUTCOMES BETWEEN LINEAR VERSUS TRIANGULAR FLAP REPAIR TECHNIQUES AT VERMILION IN UNILATERAL CLEFT LIP REPAIR
Abstract
Background: Surgery for unilateral cleft lip repair has evolved over centuries. Many studies givedetailed inside to this process of evolution of various techniques and their modifications. Objectiveswere to compare linear repair of Millard rotation advancement technique and triangular flap techniqueof Nordhoff, at vermilion in unilateral cleft lip repair. Methods: This cross-sectional analytical studywas conducted at Departments of Plastic Surgery, Services Institute of Medical Sciences, and WAPDATeaching Hospital Complex, Lahore form Jan 2004 to Dec 2011. Patients presenting with unilateralcleft lip deformity were included in the study. In the early part of the study (2004–2008), only Millardlinear repair at vermilion was the routine practice. Last consecutive 40 cases repaired with thistechnique during this period were selected for the study. From 2009 to 2011 the unilateral cases wereoperated with Nordhoff triangular flap repair. A group of 40 consecutive cases repaired with thistechnique was also selected for the study. In both groups, the postoperative period exceeded one year.Results were compared for the presence of notch on repaired vermilion area. Results: Notch was absentin 29 cases (72%) treated with Millard Technique whereas Noordhoff Technique Group showed ahigher number of 34 cases (85%). On other extreme, a notch of more than 1 mm was evident in twocases (5%) of Millard technique only and Noordhoff technique did not show this wide notch atvermilion. Similarly, two subgroups of 0.5 mm notch and 0.5–1 mm notch had a slightly highernumber of cases in group dealt with Millard technique (5 and 4 cases respectively) as compared tocases dealt by Noordhoff technique (3 cases in each subgroup). Conclusion: Nordhoff triangular flaprepair at vermilion reduces the chances of notching to minimum due to break in the linear repair invermilion and also helps in reconstructing a symmetrical vermilion by bringing in the vermilion fromlateral to medial segment.Keywords: Flap repair, cleft lip, congenitalReferences
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