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Comparison of Three Incisions to Repair Complete Unilateral Cleft Lip

Gosla Reddy, Srinivas M.D.S., M.B.B.S.; Reddy, Rajgopal R. B.D.S., M.B.B.S.; Bronkhorst, Ewald M. Ph.D.; Prasad, Rajendra B.D.S., M.D.S.; Kuijpers Jagtman, Anne Marie D.D.S., Ph.D.; Bergé, Stefaan M.D., D.D.S., Ph.D.

Plastic & Reconstructive Surgery: April 2010 - Volume 125 - Issue 4 - pp 1208-1216
doi: 10.1097/PRS.0b013e3181d45143
Pediatric/Craniofacial: Original Articles
Discussion

Background: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for primary unilateral cleft lip repair.

Methods: Patients with complete unilateral cleft lips (n = 1200) were enrolled and divided into three groups of 400 patients. Each group of patients was operated on with the Millard incision, Pfeifer wave line incision, or Afroze incision. Outcome assessments were performed 2 years postoperatively and consisted of assessment of the white roll, vermilion border, scar, Cupid's bow, lip length, nostril symmetry, and appearance of alar dome and base.

Results: With regard to white roll, vermilion border, scar, Cupid's bow, and lip length, the Afroze incision always gave superior results compared with the Millard or Pfeifer incision. Depending on the cut-off for treatment success, the Afroze incision also showed better results regarding nostril symmetry. With respect to the alar base and alar dome, all three incisions showed comparable outcomes.

Conclusion: The Afroze incision is superior regarding a broad spectrum of outcomes in a heterogeneous population of patients with unilateral cleft lip.

Hyderabad and Mangalore, Karnataka, India; and Nijmegen, The Netherlands

From the GSR Institute of Craniofacial Surgery; the Department of Preventive and Curative Dentistry, Radboud University Nijmegen Medical Center; A. B. Shetty Memorial Dental College and Hospital; and the Department of Orthodontics and Oral Biology, Cleft Palate Craniofacial Unit, and the Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center.

Received for publication June 12, 2009; accepted October 21, 2009.

Disclosure: The authors have no financial interest in this work, and no competing interests are declared.

Srinivas Gosla Reddy, M.D.S., M.B.B.S., GSR Institute of Craniofacial Surgery, 17-1-383/55, Vinaynagar Colony, I.S. Sadan, Saidabad, Hyderabad 500059, Andhra Pradesh, India, gosla@craniofacialinstitute.org

©2010American Society of Plastic Surgeons