Our Summary

This research paper explores whether one type of surgery for cleft lip repair, known as rhinoplasty, is better than another. The two surgical techniques in question are ‘open’ and ‘closed’ rhinoplasty. The researchers believed that ‘open’ rhinoplasty might have better long-term results than the ‘closed’ method. To investigate this, they looked at a range of studies on the topic.

After examining 522 studies, they selected 16 that specifically compared the two techniques. These included one randomized controlled trial, two retrospective cohorts, and 13 case series. The findings showed that both ‘open’ and ‘closed’ procedures were effective in achieving symmetry of the nostrils without impairing growth.

However, the researchers couldn’t find enough evidence to definitively say whether one technique was better than the other. There were not enough randomized controlled trials or prospective studies to make an evidence-based recommendation.

In simple terms, the study was inconclusive. Both ‘open’ and ‘closed’ rhinoplasty techniques seem to work well for cleft lip repair, and more research is needed to determine if one is superior.

FAQs

  1. What are the two types of surgical techniques for cleft lip repair mentioned in the research paper?
  2. What were the findings of the research regarding the effectiveness of ‘open’ and ‘closed’ rhinoplasty?
  3. Why was the study unable to definitively state which rhinoplasty technique is superior for cleft lip repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft lip repair is to follow post-operative care instructions closely to ensure proper healing and optimal results. This may include keeping the surgical site clean, avoiding certain activities that could put strain on the repair, and attending follow-up appointments as scheduled. It’s also important to communicate any concerns or symptoms to the doctor promptly.

Suitable For

Patients who are recommended for cleft lip repair surgery typically include infants born with a cleft lip, children with a cleft lip that affects their appearance and speech development, and adults who may have lived with a cleft lip their entire lives and wish to improve their appearance. The timing of the surgery may vary depending on the individual case, but it is generally recommended to be done within the first few months of life to ensure proper development of the lips and facial structures. Additionally, patients with associated cleft palate may also undergo cleft lip repair surgery as part of a comprehensive treatment plan.

Timeline

Before cleft lip repair:

  • Patient is born with a cleft lip, which may be diagnosed during a prenatal ultrasound or at birth
  • Patient undergoes evaluations by a multidisciplinary team of healthcare professionals, including plastic surgeons, speech therapists, and orthodontists
  • Patient may undergo presurgical orthopedic treatment to align the cleft lip and palate
  • Patient and family receive counseling and support to prepare for the surgery

After cleft lip repair:

  • Patient undergoes cleft lip repair surgery, which is typically performed when the child is around 3-6 months old
  • Patient may need additional surgeries as they grow to improve the appearance and function of the lip and nose
  • Patient receives postoperative care and follow-up appointments to monitor healing and address any complications
  • Patient may need ongoing speech therapy, orthodontic treatment, and psychological support to address any challenges related to the cleft lip and palate

Overall, the process of cleft lip repair involves a combination of surgeries, therapies, and support services to help the patient achieve optimal outcomes in terms of appearance, function, and overall well-being.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft lip repair, specifically regarding rhinoplasty techniques, may include:

  1. What are the differences between ‘open’ and ‘closed’ rhinoplasty techniques for cleft lip repair?
  2. What are the potential risks and benefits of each technique?
  3. How will the choice of technique impact the long-term results of my cleft lip repair?
  4. Are there specific factors about my individual case that make one technique more suitable than the other?
  5. What is the recovery process like for each technique?
  6. Are there any potential complications or side effects associated with either technique?
  7. How experienced are you in performing both ‘open’ and ‘closed’ rhinoplasty procedures for cleft lip repair?
  8. Can you provide me with any before and after photos of patients who have undergone each technique?
  9. What is the success rate of each technique in achieving symmetry and overall aesthetic results?
  10. Are there any alternative treatment options to consider aside from ‘open’ and ‘closed’ rhinoplasty for cleft lip repair?

Reference

Authors: Jayarajan R, Natarajan A, Nagamuttu R. Journal: Cleft Palate Craniofac J. 2019 Jan;56(1):74-83. doi: 10.1177/1055665618787689. Epub 2018 Jul 10. PMID: 29989835