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Upper Triangular Flap Method for Primary Repairs of Incomplete Unilateral Cleft Lip Patients

Minor to Two-Thirds Way Defects

Koh, Kyung S. MD, PhD*; Oh, Tae Suk MD*; Song, Jin Woo MD

doi: 10.1097/SAP.0b013e318295dceb
Head and Neck Surgery
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Incomplete unilateral cleft lips show a wide range of deformities, ranging from microform to near-complete clefts. Because there are different amounts and qualities of tissue present on the cleft and non–cleft sides, surgical approaches should make distinctions based on the remnant tissue. A new procedure using an upper triangular flap that combines characteristics of both rotation advancement and straight line repair was applied and the surgical results were reviewed. Between June 2007 and April 2011, 28 patients with minor to two-thirds way unilateral cleft lips [minor (n = 12), one-third (n = 2), halfway (n = 11), and two-thirds way (n = 3)] were subjected to the upper triangular flap method. The patients ranged in age from 62 days to 6 years (mean, 9 months). The average follow-up period was 25 months (range, 12–60 months). The repairs were successful in all 28 patients without complications. The scar was acceptable because it ran along the vertical philtral columns. During the follow-up period, long lip deformities and Cupid bow drooping were not observed in any of the patients. However, misalignment of the white skin roll was observed due to insufficient rotation at the cleft side in 1 patient. The repairs of minor to two-thirds way unilateral cleft lips using the upper triangular flap method allowed for a symmetric Cupid bow and philtrum. Moreover, this method allowed for satisfactory nostril sill reconstruction with acceptable scarring. The upper triangular flap method is recommended as an alternative to conventional methods for repair of minor to two-thirds way incomplete unilateral cleft lips.

From the *Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine; and †Department of Plastic Surgery, Inje University, Seoul Paik Hospital, Seoul, Korea.

Received December 25, 2012, and accepted for publication, after revision, April 5, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Kyung S. Koh, MD, PhD, Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 poongnap 2-dong, Songpa-gu, Seoul 138-736, Korea. E-mail: kskoh@amc.seoul.kr.

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