Study of individual operation designs for bilateral cleft lip repair

Objective To detect the individual sequence operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip. Methods 20 patients with bilateral cleft lip and cleft palate were treated. All patients were performed bilateral cleft lip adherence operation at postnatal 10 ～40 days,and then performed bilateral cleft lip repair operation at postnatal 6～10 months. We made a addition small cut in prolabium or lateral lip to keep the shape symmetry of lip and Cupid bow. During operation,sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures.The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap. Results Bilateral cleft lip adherence operation well restrained ahead growth of anterior process of premaxillary bone and diminished fissure of prealveolar,and created satisfactory condition for later bilateral cleft lip plasty. Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up,the results were satisfactory in the width and chubbiness of the nose bottom,the shapes of nostril and Cupid's bow were good without whistle deformity. The apperance of upper lip was good in either dynamic or static state. Conclusion Excellent shapes and function of the nose and lip,and opportunity for two-stage repair could be obtained with the individual sequence operative technique,which being believed important methods for the primary repair of bilateral cleft lip.