Qualitative Assessment of Surgical Repair of Three Types of Unilateral Cleft Lip

Authors

  • Adekunle M. Adetayo
  • Abdurazzak Olanrewaju Taiwo
  • Modupe Olusola Adetayo
  • Moses A. Akinola
  • Wasiu Lanre Adeyemo

Keywords:

Congenital Abnormalities, Stomatognathic System Abnormalities, Cleft Palate

Abstract

Objective: To assess the effect of the three types of unilateral cleft lip (UCL) [cleft lip only, cleft lip and alveolus, and cleft lip alveolus and palate] on the outcome of the repair. Material and Methods: This study was a case series of effect of types of UCL on the outcome of the repair. Fifteen subjects each were in three UCL phenotypes groups. Evaluation of the scar, lip, and nose was done qualitatively by both parents/guardians and professionals using a modified form of the criteria described by Christofides et al. (2006). Results: In the assessment of the surgical scar, the parents found a difference between the three types of cleft in terms of texture, shape, and width of the scar and presence of columella deviation. The professional assessors, however, only found the three types of cleft to be different in the presence of alar flattening. Conclusion: Differences truly exist in the outcome of surgical repair of the three types of unilateral cleft lip, especially in the aesthetics of the nose and in the width and shape of the residual lip scar. Thus, it is important to consider this in the assessment of UCL repair because putting the subtypes together might have a negative impact on the assessment.

References

Marcusson A, Paulin G, Ostrup L. Facial appearance in adults who had cleft lip and palate treated in childhood. Scand J Plast Reconstr Surg Hand Surg 2002; 36(1):16-23. https://doi.org/10.1080/028443102753478327

Onasanya PO. Unpublished work. Cleft Lip and Palate: A Prospective Study of Cases Seen and Treated at the University of Benin Teaching Hospital Over a 3 Years Period. A Part II Dissertation for the Partial Fulfillment of the Award of Fellowship of the Postgraduate Medical College of Nigeria; 2008.

Christofides E, Potgieter A, Chait L. A long-term subjective and objective assessment of the scar in unilateral cleft lip repairs using the Millard technique without revisional surgery. J Plast Reconstr Aesthet Surg 2006; 59(4):380-6. https://doi.org/10.1016/j.bjps.2005.04.037

Kappen Bittermann D, Janssen L, Gerhard KP, Chantal B, Sarah H, Hester W. Long-term follow-up study of young adults treated for unilateral complete cleft lip, alveolus, and palate by a treatment protocol including two-stage palatoplasty: Speech outcomes Arch Plast Surg 2017; 44(3):202-9. https://doi.org/10.5999/aps.2017.44.3.202

Campbell A, Restrepo C, Deshpande G, Tredway C, Bernstein SM, Patzer R, et al. Validation of a unilateral cleft lip surgical outcomes evaluation scale for surgeons and laypersons. Plast Reconstr Surg Glob Open 2017; 5(9):e1472. https://doi.org/10.1097/GOX.0000000000001472

Allori AC, Kelley T, Meara JG, Albert A, Bonanthaya K, Chapman K, et al. A standard set of outcome measures for the comprehensive appraisal of cleft care. Cleft Palate Craniofac J 2017; 54(5):54054. https://doi.org/10.1597/15-292

Suzuki A, Mukai Y, Ohishi M, Miyanoshita Y, Tashiro H. Relationship between cleft severity and dentocraniofacial morphology in Japanese subjects with isolated cleft palate and complete unilateral cleft lip and palate. Cleft Palate Craniofac J 1993; 30(2):175-81. https://doi.org/10.1597/1545-1569_1993_030_0175_rbcsad_2.3.co_2

Bishara SE. Variation in cleft width and its effect on facial and dental anomalies. Int J Oral Surg 1973; 2(5):179-84.

Campbell A, Restrepo C, Park E, Navas G, Deshpande G, Swanson J, et al. Influence of severity on aesthetic outcomes of unilateral cleft lip repair in 1,823 patients. Plast Reconstr Surg Glob Open 2019; 7(1):e2083. https://doi.org/10.1097/GOX.0000000000002083

Asher-McDade C, Roberts C, Shaw WC, Gallager C. Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate. Cleft Palate-Craniofac J 1991; 28(4):385-391. https://doi.org/10.1597/1545-1569_1991_028_0385_doamfr_2.3.co_2

Nicola P, Jonathan S. An aesthetic index for evaluation of cleft repair. Eur J Orthodont 2003; 25(3):243-9. https://doi.org/10.1093/ejo/25.3.243

Trotman CA, Phillips C, Essick GK, Faraway JJ, Barlow SM, Losken HW, et al. Functional outcomes of cleft lip surgery. Part I: Study design and surgeons ratings of lip disability and need for lip revision. Cleft Palate Craniofac J 2007; 44(6):598-606. https://doi.org/10.1597/06-124.1

Nollet PJ, Kuijpers-Jagtman AM, Chatzigianni A, Semb G, Shaw WC, Bronkhorst EM, et al. Nasolabial appearance in unilateral cleft lip, alveolus and palate: a comparison with Eurocleft. J Craniomaxillofac Surg 2007; 35(6-7):278-86. https://doi.org/10.1016/j.jcms.2007.04.011

Schlesselman JJ. Sample size requirements in cohort and case-control studies of disease. Am J Epidemiol 1974; 99(6):9-11. https://doi.org/10.1093/oxfordjournals.aje.a121625

Christofides EA. Evaluation of unilateral cleft lip repairs and the evolution of a new technique based on experience and research. 2010. PhD Thesis.

Adetayo AM, Adetayo MO, Adeyemo WL, James OO, MO Adeyemi. Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assess-ment. J Korean Assoc Oral Maxillofac Surg 2019; 45(3):141-51. https://doi.org/10.5125/jkaoms.2019.45.3.141

Son D, Harijan A. Overview of surgical scar prevention and management. J Korean Med Sci 2014; 29(6):751-7. https://doi.org/10.3346/jkms.2014.29.6.751

Adenwalla HS, Narayanan PV. Primary unilateral cleft lip repair. Indian J Plast Surg 2009; 42 Suppl(Suppl):S62-70. https://doi.org/10.4103/0970-0358.57189

Bilwatsch S, Kramer M, Haeusler G, Schuster M, Wurm J, Vairaktaris E, et al. Nasolabial symmetry following Tennison-Randall lip repair: A three-dimensional approach in 10-year old patients with unilateral clefts of lip, alveolus and palate. J Craniomaxillofac Surg 2006; 34(5):253-62. https://doi.org/10.1016/j.jcms.2006.03.001

Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician 2009; 80(3):253-60.

Hood CA, Hosey MT, Bock M, White J, Ray A, Ayoub AF. Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique. Cleft Palate Craniofac J 2004; 41(1):27-35. https://doi.org/10.1597/02-143

Hoh EY, Sulaiman WA. Analysis of preoperative measurements in unilateral cleft lip patients toward the outcome of secondary cleft deformities. J Cleft Lip Palate Craniofac Anomal 2019; 6(2):93-8. https://doi.org/10.4103/jclpca.jclpca_1_19

Abdurrazaq TO, Micheal AO, Lanre AW, Olugbenga OM, Akin LL. Surgical outcome and complications following cleft lip and palate repair in a teaching hospital in Nigeria. Afr J Paediatr Surg 2013; 10(4):345-57. https://doi.org/10.4103/0189-6725.125447

Gundlach KK, Schmidtz R, Maerker R, Bull HG. Late results following different methods of cleft lip repair. Cleft Palate J 1982; 19(3):167-71.

Honda Y, Suzuki A, Nakamura N, Ohishi M. Relationship between primary palatal form and maxillofacial growth in Japanese children with unilateral cleft lip and palate: infancy to adolescence. Cleft Palate Craniofac J 2002; 39(5):527-34. https://doi.org/10.1597/1545-1569_2002_039_0527_rbppfa_2.0.co_2

Gosman AA. Cleft lip and palate part 1: Embryology, anatomy, epidemiology, and clinical assessment. SRPS 2007; 10(16):1-51.

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Published

2022-06-10

How to Cite

Adetayo, A. M. ., Taiwo, A. O. ., Adetayo, M. O. ., Akinola, M. A. ., & Adeyemo, W. L. . (2022). Qualitative Assessment of Surgical Repair of Three Types of Unilateral Cleft Lip. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e210085. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1269

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Original Articles