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“Comparison of the Fisher Anatomic Subunit and Modified Millard Rotation-Advancement cleft lip repairs.”

Patel, Terral A. BS1; Patel, Krishna G. MD1

Plastic and Reconstructive Surgery: May 7, 2019 - Volume PRS Online First - Issue - p
doi: 10.1097/PRS.0000000000005847
Original Article: PDF Only

Background: When analyzing cleft lip repair techniques, the modified rotation-advancement repair (RA) is most widely utilized; however, the anatomic subunit approach (AS) is gaining popularity. The purpose of this study was to compare the outcomes of these two surgical techniques by the same surgeon.

Methods: Anthropometric measurements were performed on post-operative photos of cleft lip repairs performed by a single surgeon As described by Rossell-Perry et al., four parameters were measured: lip height, lip width, vermilion height, and alar base width. An aesthetic ratio of cleft to non-cleft side for each measurement was used as a quantitative measure of outcome. Qualitative analysis of cleft lip repair was evaluated using the Steffensen's criteria.

Results: 12 modified rotation-advancement repairs and 10 anatomic subunit repairs were analyzed. A one sample t-test assessed the difference of each aesthetic ratio from the perfect ratio of 1.00. For repairs involving an incomplete cleft lip, statistically significant asymmetry was detected in vermilion height for the rotation-advancement repair and no measurements in the anatomic subunit approach. For repairs involving a complete cleft lip, statistically significant asymmetry was detected in lip height, vermilion height, and alar base for the rotation-advancement repair and in lip height for the anatomic subunit approach.

Conclusions: Our findings show that when separating the complete and incomplete cleft lips, the rotation-advancement technique seemed to have asymmetry in more parameters than the anatomic subunit approach. This seems to suggest that the outcomes of the anatomic subunit technique are less dependent on cleft lip severity.

1. Department of Otolaryngology, Medical University of South Carolina; Charleston, SC

Financial Disclosure Statement: We have no disclosures.

Corresponding author: Terral Patel, BS, Head and Neck Surgery, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425 USA.

©2019American Society of Plastic Surgeons