Our Summary

This research paper is a thorough review of various surgical techniques used for repairing a specific type of cleft lip, which can also affect the nose’s symmetry. The researchers looked at previous studies published up until the end of 2020, focusing on patients who had surgery before their first birthday. They were particularly interested in how these surgeries affected the symmetry of the patient’s nose and any complications that arose.

The researchers reviewed nearly 20,000 records and selected 17 specific studies to analyze further. They used established tools and criteria to evaluate the quality and reliability of these studies. The majority of the studies they reviewed compared two techniques: the triangular repair and the rotation advancement (RA) methods. In general, these studies preferred the RA technique or modifications of it.

However, when it came to the symmetry of the patient’s nose, a technique known as the Fisher repair was found to be better than the RA method. The RA technique and a method called straight line repair were found to be equally effective. Another technique, known as the Delaire method, might be a better choice than the modified RA. The researchers also found that performing lip and nose repair at the same time produced satisfactory results.

However, the authors caution that there was a lot of variation between the studies they reviewed in terms of the surgical techniques used, how they measured nasal symmetry, and how long they followed up with patients after surgery. This means that the evidence they gathered isn’t of the highest quality and should be interpreted carefully. They recommend that future research should involve larger, randomized controlled trials and follow patients for an appropriate length of time after surgery. They also suggest that the surgeries should ideally be performed by a single experienced surgeon.

FAQs

  1. What surgical techniques were reviewed in this research for cleft lip repair?
  2. Which technique was found to be most effective in maintaining the symmetry of the patient’s nose after cleft lip repair?
  3. What are the researchers’ recommendations for future studies on cleft lip repair techniques?

Doctor’s Tip

Overall, a doctor might advise a patient undergoing cleft lip repair to discuss with their surgeon the specific technique being used and what to expect in terms of nasal symmetry post-surgery. They may also recommend seeking out a surgeon with experience in cleft lip repair and ensuring proper follow-up care to monitor the results of the surgery. Additionally, the patient should be aware that there may be variations in techniques and outcomes, so it’s important to have open communication with their healthcare provider throughout the process.

Suitable For

Overall, patients who are recommended cleft lip repair surgery are typically infants or young children with a cleft lip that affects the symmetry of their nose. The surgery is usually performed before the child’s first birthday to achieve the best results. The choice of surgical technique may vary depending on the individual patient’s needs and the surgeon’s expertise. Patients with a cleft lip may also have other associated conditions that need to be considered when planning for surgery. It is important to consult with a healthcare provider or a specialized cleft lip and palate team to determine the most appropriate treatment plan for each patient.

Timeline

Before cleft lip repair:

  • Patient is diagnosed with a cleft lip either prenatally or shortly after birth
  • Consultation with a team of specialists including a plastic surgeon, speech therapist, and pediatrician
  • Preoperative assessments and evaluations to determine the best surgical technique
  • Anesthesia consultation for the surgery
  • Preoperative instructions and preparation for the surgery

After cleft lip repair:

  • Surgery is performed, typically before the patient’s first birthday
  • Postoperative care and monitoring in the hospital
  • Follow-up appointments with the surgical team to monitor healing and address any complications
  • Speech therapy and other interventions as needed to address any speech or feeding issues
  • Long-term follow-up to monitor growth and development of the repaired area
  • Potential additional surgeries or interventions as the patient grows and develops

Overall, the goal of cleft lip repair is to improve the patient’s appearance, speech, and ability to eat and drink normally. With proper care and follow-up, patients can achieve excellent outcomes and lead healthy, happy lives.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft lip repair include:

  1. What specific surgical technique do you recommend for my cleft lip repair?
  2. How will the chosen technique affect the symmetry of my nose?
  3. What are the potential complications associated with the surgery?
  4. How long is the recovery process after cleft lip repair?
  5. What are the expected outcomes of the surgery in terms of appearance and function?
  6. How many surgeries will I need to undergo for complete cleft lip repair?
  7. Are there any alternative treatments or techniques available for cleft lip repair?
  8. What experience do you have in performing cleft lip repair surgeries?
  9. Can you provide before and after photos of previous patients who have undergone cleft lip repair with similar techniques?
  10. What post-operative care and follow-up appointments are necessary for the best results?

Reference

Authors: Bansal A, Reddy SG, Chug A, Markus AF, Kuijpers-Jagtman AM. Journal: J Craniomaxillofac Surg. 2022 Dec;50(12):894-909. doi: 10.1016/j.jcms.2022.12.006. Epub 2023 Jan 5. PMID: 36635151