Our Summary

This research paper is about how to train surgeons on cleft surgery. It highlights the importance of not only learning the technical aspects but also mastering the techniques based on modern principles of repairing cleft lip and nose deformities simultaneously. The paper describes a method used for repairing a complete cleft lip using these principles, and includes a new approach to the composition of mucosal flaps (which are tissue flaps used in surgery) for the nasal floor and inside the mouth. These include different types of flaps like the prolabial mucosal flap, C-flap mucosal flap, inferior turbinate mucosal flap, and lateral nasal mucosal flap. The paper also includes a four-part video series showing each step of this alternative technique.

FAQs

  1. What are the modern principles of bilateral cleft lip repair with synchronous reconstruction of cleft nose deformity?
  2. What is the role of the different types of mucosal flaps in cleft lip repair?
  3. How does the step-by-step video series assist in learning the alternative technique for cleft lip repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft lip repair is to follow the post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the surgical area clean, avoiding certain foods that may irritate the incision site, and attending follow-up appointments as scheduled. It’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for cleft lip repair include those with bilateral complete cleft lip deformities, particularly those with synchronous reconstruction of cleft nose deformity. Surgeons-in-training should be proficient in performing these procedures and should be knowledgeable about the modern principles and techniques involved in cleft lip repair.

Timeline

Before cleft lip repair:

  1. Diagnosis of cleft lip during prenatal ultrasound or after birth
  2. Consultation with a cleft lip and palate team to discuss treatment options
  3. Preoperative evaluations and assessments to ensure the patient is healthy for surgery
  4. Discussion of the surgical procedure, expected outcomes, and potential risks with the patient and their family

After cleft lip repair:

  1. Surgery typically takes place when the patient is around 3-6 months old
  2. Postoperative care includes monitoring for any signs of infection or complications
  3. Follow-up appointments with the surgical team to ensure proper healing and address any concerns
  4. Speech and feeding therapy may be recommended to help the patient adjust to the repaired lip
  5. Long-term follow-up to monitor growth and development and address any potential issues related to the cleft lip repair.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with cleft lip repair surgery?

  2. How long is the recovery period after cleft lip repair surgery and what can I expect during this time?

  3. Will there be scarring after the surgery and are there any options for scar revision if needed?

  4. How many surgeries may be needed to fully repair the cleft lip and what is the timeline for these procedures?

  5. What type of follow-up care will be necessary after the surgery and how often will I need to see the doctor?

  6. Are there any specific dietary or lifestyle changes I should make before or after the surgery to aid in the healing process?

  7. Can you provide me with before and after photos of previous cleft lip repair surgeries you have performed?

  8. Are there any alternative treatments or techniques that could be considered for cleft lip repair in my case?

  9. How experienced are you in performing cleft lip repair surgeries and what is your success rate with this procedure?

  10. Are there any support groups or resources available for patients undergoing cleft lip repair surgery to help with emotional and psychological aspects of the process?

Reference

Authors: Denadai R, Pai BCJ, Sato N, Lonic D, Chou PY, Lo LJ. Journal: Plast Reconstr Surg. 2020 Dec;146(6):1352-1356. doi: 10.1097/PRS.0000000000007398. PMID: 33234968