Our Summary

This study was conducted at a medical center in Pakistan and it evaluated a surgical technique called Mulliken’s repair, which is commonly used for fixing bilateral cleft lip (a defect where both sides of the upper lip have a gap). The researchers included 51 patients with this condition in the study, checking them before surgery for other health issues or birth defects.

They grouped the patients according to the severity and symmetry of their cleft lips. They then assessed the results of the surgery right after and a week after the procedure. They used a scoring system to categorize the results as good, fair, or bad, based on specific measurements.

The results showed that before surgery, more than a third of the patients had mild cleft lips, about a tenth had moderate cleft lips, and close to a third had severe cleft lips. About a fifth had asymmetrical cleft lips. After surgery, the average score fell into the ‘good’ range. Over 60% of patients had good nasal symmetry and about 30% had satisfactory scores.

The study concluded that while Mulliken’s repair is widely used for bilateral cleft lip repair, the results can vary significantly. The scoring system they used is a helpful tool to objectively measure the outcomes.

FAQs

  1. What is Mulliken’s repair technique for bilateral cleft lip?
  2. How were patients with bilateral cleft lip deformity evaluated preoperatively in this study?
  3. What was the postoperative outcome score range and what does it indicate about the results of Mulliken’s repair technique?

Doctor’s Tip

A helpful tip a doctor might give a patient about cleft lip repair is to follow postoperative care instructions carefully, including keeping the surgical site clean and dry, avoiding activities that could put pressure on the repair site, and attending follow-up appointments to monitor healing progress. It is also important to communicate any concerns or changes in symptoms to the healthcare provider promptly.

Suitable For

Patients with bilateral cleft lip deformity are typically recommended for cleft lip repair surgery. In this study, patients with mild, moderate, severe, and asymmetrical bilateral cleft lips were included for evaluation of the early surgical outcome of Mulliken’s repair technique. Patients were evaluated preoperatively to exclude any associated congenital anomalies or comorbidities. The postoperative outcomes were assessed based on anthropometric measurements on outcome evaluation criteria, with good outcomes observed in the majority of cases. Nasal symmetry was also found to be good in a significant number of patients. Overall, Mulliken’s repair technique was found to be effective for patients with bilateral cleft lip deformity, with good early surgical outcomes.

Timeline

  • Preoperatively: The patient is evaluated to exclude any associated congenital anomalies or comorbidities. The severity of the bilateral cleft lip deformity is classified as mild, moderate, severe, or asymmetrical.
  • Surgery: The patient undergoes Mulliken’s repair technique for bilateral cleft lip.
  • Immediately postoperatively: The patient’s outcome is evaluated based on anthropometric measurements. The postoperative outcome score falls in the good outcome range for most patients. Nasal symmetry is also assessed.
  • One week postoperatively: The patient’s outcome is reassessed to ensure proper healing and recovery.
  • Long-term follow-up: The patient may require additional surgeries or interventions depending on their individual case. Overall, the early surgical outcome of Mulliken’s repair technique for bilateral cleft lip is positive, with good results seen in a majority of cases.

What to Ask Your Doctor

  1. What is the recommended age for cleft lip repair surgery?
  2. What are the potential risks and complications associated with cleft lip repair surgery?
  3. How many surgeries may be required to fully correct a bilateral cleft lip deformity?
  4. What is the expected recovery time and post-operative care for cleft lip repair surgery?
  5. Will additional follow-up appointments be necessary after the surgery?
  6. What are the long-term outcomes and potential challenges associated with bilateral cleft lip repair?
  7. Are there any specific dietary or feeding recommendations for a baby undergoing cleft lip repair surgery?
  8. How can I best support my child during the surgical and recovery process?
  9. Are there any specific techniques or approaches used in Mulliken’s repair for bilateral cleft lip that I should be aware of?
  10. What are the success rates and overall satisfaction levels reported by patients who have undergone Mulliken’s repair for bilateral cleft lip?

Reference

Authors: Khan M, Ullah H, Khan A, Hayat W. Journal: J Coll Physicians Surg Pak. 2023 Aug;33(8):906-909. doi: 10.29271/jcpsp.2023.08.906. PMID: 37553931