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The Double Unilimb Z-Plasty Technique for Whistler Deformity Repair in Unilateral Cleft Lip Patients

An Anthropometric Study

Rossell-Perry, Percy MD, FACS*; Cotrinal-Rabanal, Omar DDS

doi: 10.1097/SAP.0b013e318295de73
Head and Neck Surgery

Objective The purpose of this study was to evaluate the symmetry in lip and vermillion height after using the double unilimb Z-plasty method for whistler deformity repair.

Design This is a retrospective audit of 1 surgeon’s outcome of 52 consecutive performed whistler deformity repairs.

Setting Data from the Outreach Surgical Center Program, Lima, Peru, were used.

Patients Since 2009, 52 adult patients with lip deformity related to unsatisfactory unilateral cleft lip repair were operated on using the double unilimb Z-plasty. All these patients met the study criterion of having anthropometric measurements performed at least 1 year postoperatively.

Main Outcome Measures Data collection of lip and vermilion height was performed at the right and left side of the lip, immediately before the surgery (preoperatory) and at least 1 year postoperatively. The lip measurements were obtained using calipers.

Analysis The matched pair t test analyses were performed when the assumptions required were met. When the normality assumption was not met, the Wilcoxon signed rank test, a nonparametric test, was used to assess the statistical significance of differences between the cleft side and the noncleft side.

Results The study found no statistically significant differences between the right and left side in lip height (P = 0.51) and vermilion height (P = 0.57) after lip repair using the double unilimb Z-plasty technique measured at least 1 year postoperatively.

Conclusions The findings suggest that the double unilimb Z-plasty technique is a good alternative to address the whistler deformity related to the unilateral cleft lip primary repair. This is a simple method, easy to perform by surgeons, for whistler deformity management in unilateral cleft lip patients.

From the *Outreach Surgical Center, ReSurge International; and†ARMONIZAR Foundation, Lima, Peru.

Received August 29, 2012, and accepted for publication, after revision, April 5, 2013.

This manuscript was presented at 70th ACPA’s Annual Meeting Orlando, USA, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Percy Rossell-Perry, MD, FACS, Schell St 120, Apartment 1503, Miraflores, Lima 18, Peru. E-mail:

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