Postoperative lip and nose forms following primary bilateral cleft lip repair selecting one/two stage surgery in comparison to those of healthy children

摘要

Purpose: To analyze the short-term outcomes for the lip and nasal forms after primary treatment following our surgical strategy for bilateral cleft lip with/without palate (BCL± P) repair selecting one- or two-stage surgery at Kagoshima University Hospital. Patients and methods: Twenty-one patients with BCL±P were treated and followed up over 1 year (1-6 years). Patients underwent primary lip repair by one- or two-stage surgery depending on the prolabium height, medial-upward advancement of nasolabial components, and vestibular expansion using two cleft margin flaps. The postoperative lip and nasal forms were longitudinally measured using serial color photographs and were compared to those of 18 age- and sex-matched healthy Japanese children. Results: Postoperative lip form showed the upper lip height and vermilion mucosal height were significantly increased compared with the preoperative values. The vermilion/cutaneous lip height ratio was improved to the same level as that of controls at 3 years of age. Symmetry of lip and nasal forms was successfully achieved postoperatively, but the nasal height was still smaller than that of controls. Conclusions: Our surgical management strategy for BCL±P will provide well-balanced and symmetrical lip and nasal forms, except for the nasal height, without damaging an infant's prolabium.