Our Summary

This research studied whether a two-stage method of repairing cleft lip contributed to better facial symmetry and facilitated more definitive repairs of the lip, nose, and palate. The study looked at the records and photographs of patients who had undergone a two-step repair. The first step was a straight-line repair and the second step was a modified Millard repair. All the surgeries were performed by one surgeon. The research found that the width of the area of the C flap (a part of the lip) increased by 19% after the first stage of the repair. After the second stage, the width of the nostril on the cleft side decreased to 1.2 times the width of the other nostril. The length of the upper lip on the cleft side was 92% of the length of the other side after the second stage. The study concluded that the two-stage repair produced good results both functionally and aesthetically, and could be an alternative to pre-surgical nasoalveolar molding.

FAQs

  1. What was the main purpose of the research study regarding cleft lip repair?
  2. What did the two-stage repair method of cleft lip involve and what were the results?
  3. How did the two-stage cleft lip repair affect the size and symmetry of the nostril and lip on the cleft side?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft lip repair is to follow all post-operative care instructions closely to ensure proper healing and optimal results. This may include keeping the surgical site clean, avoiding certain foods or activities that could disrupt healing, and attending follow-up appointments as scheduled. Additionally, it is important to communicate any concerns or changes in symptoms to the medical team promptly.

Suitable For

Patients with cleft lip and/or palate are typically recommended for cleft lip repair surgery. This includes infants, children, and adults who have a cleft lip deformity that affects their appearance and/or function. The two-stage repair method discussed in the research may be recommended for patients who require a more extensive and complex repair of their cleft lip, nose, and palate. This method may be especially beneficial for patients who have a wide cleft lip and/or nostril asymmetry that requires additional surgical interventions to achieve better facial symmetry and function.

Timeline

Before cleft lip repair:

  • Patient is born with a cleft lip
  • Consultation with a surgeon to discuss treatment options
  • Pre-operative appointments and evaluations
  • Nasoalveolar molding (if recommended by the surgeon)
  • First stage of cleft lip repair surgery (straight-line repair)
  • Post-operative care and follow-up appointments

After cleft lip repair:

  • Healing and recovery period after the first stage of surgery
  • Evaluation for readiness for second stage of surgery
  • Second stage of cleft lip repair surgery (modified Millard repair)
  • Continued post-operative care and follow-up appointments
  • Monitoring of facial symmetry and function
  • Long-term follow-up to assess outcomes and potential need for additional surgeries or interventions.

What to Ask Your Doctor

  1. What is the success rate of the two-stage method of cleft lip repair compared to other methods?
  2. What are the potential risks and complications associated with this type of surgery?
  3. How long is the recovery process after each stage of the repair?
  4. Will additional surgeries be needed in the future to address any issues that may arise from the initial repair?
  5. How soon after birth can the cleft lip repair surgery be performed?
  6. What type of anesthesia will be used during the surgery?
  7. Will there be any scarring or visible marks after the surgery?
  8. How soon after the surgery can the patient resume normal activities and feeding?
  9. Are there any specific post-operative care instructions that need to be followed to ensure proper healing?
  10. What long-term effects, if any, can be expected after the cleft lip repair surgery?

Reference

Authors: Grewal JS, Yanik SC, Strohl-Bryan AM, Tatum SA. Journal: Am J Otolaryngol. 2021 May-Jun;42(3):102908. doi: 10.1016/j.amjoto.2021.102908. Epub 2021 Jan 13. PMID: 33508593