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Principles of Cleft Lip Repair: Conventions, Commonalities, and Controversies

Marcus, Jeffrey R. M.D.; Allori, Alexander C. M.D., M.P.H.; Santiago, Pedro E. D.M.D.

Plastic & Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 764e–780e
doi: 10.1097/PRS.0000000000003148
CME
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Learning Objectives: After reading this article, the participant should be able to: 1. Understand the principles of contemporary methods for repair of unilateral and bilateral cleft lip. 2. Understand the design elements of a poor repair that predispose to a suboptimal outcome.

Summary: The authors describe the evaluation and management of unilateral and bilateral cleft lip (with or without cleft alveolus and with or without cleft palate). Each deformity is presented in a “principles-based” manner. For unilateral cleft lip, the authors discuss common modifications of rotation-advancement and Fisher’s anatomical subunit approach. In expert hands, both techniques can give excellent results. For bilateral cleft lip, Mulliken’s method is presented. Methods for synchronous correction of the cleft lip nasal deformity are also discussed.

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Durham, N.C.

From the Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center; and Duke Cleft and Craniofacial Center, Duke Children’s Hospital.

Received for publication January 6, 2016; accepted July 6, 2016.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Jeffrey R. Marcus, M.D., Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, DUMC 3974 Plastic Surgery, 200 Trent Drive at Erwin Road, Durham, N.C. 27710, jeffrey.marcus@duke.edu

©2017American Society of Plastic Surgeons