Management of secondary labionasal deformities after bilateral cleft lip repair

Objective To evaluate the methods to correct the secondary nasolabial deformities after the surgical treatment in patients with bilateral cleft lip.Methods 23 patients were divided into three groups and treated with different operative techniques.Scar resection in upper lip,orbicularis oris muscle reconstruction,Z-plasty,V-Y plasty or double movable mucomuscular complex flaps for vermilion defects were applied to slight nasolabial deformities.In severe labionasal deformities,Forked flap was used at the upper lip to lengthen columella for patients who have enough upper lip tissue,while for those who have deficient upper lip tissue,the prolabium was advanced into columella for lengthening and an Abbe flap was adopted for upper lip reconstruction.Results Since 2000,we have treated 23 patients of secondary deformities of bilateral cleft lip.17 cases had good results,5 cases were improved and only one discontent.Conclusion The three operative techniques may be used for repairing secondary labionasal deformities of the patients with the bilateral cleft lip after the primary repair.