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Incidence of Secondary Lip Correction for Children With Unilateral Cleft Lip

A Single-Center Retrospective Study

Zhang, Zhuo MD; Miyabe, Mai MD; Morioka, Daichi MD; Nomura, Misako MD; Tosa, Yasuyoshi MD; Ohkubo, Fumio MD; Kadomatsu, Koichi MD

doi: 10.1097/SAP.0000000000001935
Head and Neck Surgery

Background Numerous reports have described the incidence of secondary lip correction for patients with cleft lip (CL), and this incidence broadly varies among centers. The purpose of this study was to determine this revision rate for a reasonably large number of patients in our center and identify the clinical factors that contribute to the revision rate.

Methods A retrospective chart review was conducted for all infants with unilateral CL with or without cleft palate who underwent primary cheiloplasty at our cleft center from 2006 to 2012. Four surgeons were in charge of almost all operations. We investigated how many children underwent lip revisions by the end of 2017.

Results In total, 490 infants underwent primary lip repair, and 47 underwent revision surgery by the age of 8 years. Half of them (24 children) underwent revisions at the age of 5 or 6 years. There was no significant difference in the revision rate by sex or cleft side. The revision rate in children with CL only tended to be lower than that in children with alveolar cleft or cleft palate, but it was not significantly associated with the cleft type. The revision rate ranged from 2.8% to 15.2% among surgeons.

Conclusions The overall revision rate was 9.6%, which is relatively lower than that in other cleft centers. However, the repair technique and cleft care program should not be evaluated using the revision rate only. Various factors, including surgeons' preference, contribute to the indications for revision, and these factors can change with age. We plan to follow up the patients until our completion of the cleft care program and report the final revision rate.

From the Department of Plastic Surgery, Showa University, Tokyo, Japan.

Received December 25, 2018, and accepted for publication, after revision February 18, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Daichi Morioka, MD, Department of Plastic Surgery, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8866 Japan. E-mail:

Online date: June 20, 2019

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