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Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique

BACKGROUND: Millard’s rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed sur...

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Autores principales: Han, Kihwan, Park, Jeongseob, Lee, Seongwon, Jeong, Woonhyeok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cleft Palate-Craniofacial Association 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894548/
https://www.ncbi.nlm.nih.gov/pubmed/29609427
http://dx.doi.org/10.7181/acfs.2018.19.1.3
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author Han, Kihwan
Park, Jeongseob
Lee, Seongwon
Jeong, Woonhyeok
author_facet Han, Kihwan
Park, Jeongseob
Lee, Seongwon
Jeong, Woonhyeok
author_sort Han, Kihwan
collection PubMed
description BACKGROUND: Millard’s rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. METHODS: We retrospectively reviewed 82 patients’ medical records and presented surgical technique and outcomes. The main features of the authors’ strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients’ nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen’s kappa statistics. RESULTS: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. CONCLUSION: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure.
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spelling pubmed-58945482018-04-25 Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique Han, Kihwan Park, Jeongseob Lee, Seongwon Jeong, Woonhyeok Arch Craniofac Surg Original Article BACKGROUND: Millard’s rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. METHODS: We retrospectively reviewed 82 patients’ medical records and presented surgical technique and outcomes. The main features of the authors’ strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients’ nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen’s kappa statistics. RESULTS: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. CONCLUSION: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure. Korean Cleft Palate-Craniofacial Association 2018-03 2018-03-20 /pmc/articles/PMC5894548/ /pubmed/29609427 http://dx.doi.org/10.7181/acfs.2018.19.1.3 Text en Copyright © 2018 The Korean Cleft Palate-Craniofacial Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Han, Kihwan
Park, Jeongseob
Lee, Seongwon
Jeong, Woonhyeok
Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title_full Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title_fullStr Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title_full_unstemmed Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title_short Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique
title_sort personal technique for definite repair of complete unilateral cleft lip: modified millard technique
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894548/
https://www.ncbi.nlm.nih.gov/pubmed/29609427
http://dx.doi.org/10.7181/acfs.2018.19.1.3
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