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Dependence of columella development on the technique used for primary cleft lip closure

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Abstract

Objective

Primary cleft lip closure can be achieved by use of different types of surgery. The procedures of Millard, Veau, and Delaire are among the techniques most frequently performed worldwide. The factors which affect development of the columella have not been studied, however.

Setting

University Hospital of Leipzig, Germany, Department of Oral, Craniomaxillofacial and Facial Plastic Surgery.

Patients, participants

In a comparative, retrospective, non-randomised study, we obtained anthropometric details from photographs of 120 unilateral and bilateral cleft patients after cleft lip closure by use of the techniques of Millard or Veau (n = 60) and Delaire (n = 60). Length and shape of the columella was assessed twice—first at the age of 10 months and again at the age of 10 years. Anthropometric characteristics of columella morphology and development were compared between the two groups.

Results

At the age of 10 months, the ratio of nasal height to width (interalar distance) was significantly different for unilateral and bilateral cases, and results were better for the Delaire groups (p = 0.001 unilateral and p > 0.001 bilateral). This effect was no longer apparent at 10-year follow up. Another index which tended to indicate better results in the Delaire groups was the nasal width index. In the summary of the anthropometric values investigated, however, differences between the Millard or Veau group and the Delaire group were marginal.

Conclusion

Cleft lip closure by the technique of Millard for unilateral cleft lips and of Veau for bilateral cases is neither better nor worse than Delaire cheiloplasty for unilateral and bilateral clefts.

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References

  1. Gundlach KK, Maus C (2006) Epidemiological studies on the frequency of clefts in Europe and world-wide. J Craniomaxillofac Surg 34(Suppl 2):1–2, PMID: 17071381

    PubMed  Google Scholar 

  2. Anastassov Y, Chipkov C (2003) Analysis of nasal and labial deformities in cleft lip, alveolus and palate patients by a new rating scale: preliminary report. J Craniomaxillofac Surg 31:299–303, PMID: 14563331

    Article  CAS  PubMed  Google Scholar 

  3. Tanikawa DY, Alonso N, Rocha DL (2010) Evaluation of primary cleft nose repair: severity of the cleft versus final position of the nose. J Craniofac Surg 21:1519–1524. doi:10.1097/SCS.0b013e3181ec087e

    Article  PubMed  Google Scholar 

  4. Salyer KE, Genecov ER, Genecov DG (2003) Unilateral cleft lip-nose repair: a 33-year experience. J Craniofac Surg 14:549–558, PMID: 12867873

    Article  PubMed  Google Scholar 

  5. Bhattacharya S, Khanna V, Kohli R (2009) Cleft lip: the historical perspective. Indian J Plast Surg 42(Suppl):S4–S8. doi:10.4103/0970-0358.57180

    Article  PubMed Central  PubMed  Google Scholar 

  6. Malgaigne J (1844) Du bec-de-lièvre. J Chir (Paris) 2:1–6

    Google Scholar 

  7. Mirault G (1844) Lettre sur l’operation du bec-de-lièvre. J Chir (Paris) 2:257–265

    Google Scholar 

  8. Bill J, Proff P, Bayerlein T, Weingaertner J, Fanghanel J, Reuther J (2006) Treatment of patients with cleft lip, alveolus and palate—a short outline of history and current interdisciplinary treatment approaches. J Craniomaxillofac Surg 34(Suppl 2):17–21, PMID: 17071385

    Article  PubMed  Google Scholar 

  9. Hoffmann-Axthelm W (1995) Die Geschichte der Mund-Kiefer-Gesichtschirurgie. Quintessenz-Verlag, Berlin Chicago London, pp 27:189–77;225

  10. Millard DR Jr (1958) A radical rotation in single harelip. Am J Surg 95:318–322, PMID: 13487963

    Article  PubMed  Google Scholar 

  11. Delaire J (1978) Theoretical principles and technique of functional closure of the lip and nasal aperture. J Maxillofac Surg 6:109–116, PMID: 276551

    Article  CAS  PubMed  Google Scholar 

  12. Delaire J, Precious D (1986) Influence of the nasal septum on maxillonasal growth in patients with congenital labiomaxillary cleft. Cleft Palate J 23:270–277, PMID: 3464365

    CAS  PubMed  Google Scholar 

  13. Delaire J, Precious DS, Gordeef A (1988) The advantage of wide subperiosteal exposure in primary surgical correction of labial maxillary clefts. Scand J Plast Reconstr Surg Hand Surg 22:147–151, PMID: 3187449

    Article  CAS  PubMed  Google Scholar 

  14. Millard DR Jr (1964) Rotation-advancement principle in cleft lip closure. Cleft Palate J 12:246–252, PMID: 14140821

    PubMed  Google Scholar 

  15. Amaratunga NA (1988) A comparison of Millard’s and LeMesurier’s methods of repair of the complete unilateral cleft lip using a new symmetry index. J Oral Maxillofac Surg 46:353–356, PMID: 3163367

    Article  CAS  PubMed  Google Scholar 

  16. Marcusson A, Paulin G, Ostrup L (2002) Facial appearance in adults who had cleft lip and palate treated in childhood. Scand J Plast Reconstr Surg Hand Surg 36:16–23, PMID: 11925823

    Article  PubMed  Google Scholar 

  17. Meyer-Marcotty P, Stellzig-Eisenhauer A (2009) Dentofacial self-perception and social perception of adults with unilateral cleft lip and palate. J Orofac Orthop 70:224–236. doi:10.1007/s00056-009-8813-9

    Article  PubMed  Google Scholar 

  18. Oosterkamp BC, Dijkstra PU, Remmelink HJ, van Oort RP, Goorhuis-Brouwer SM, Sandham A, de Bont LG (2007) Satisfaction with treatment outcome in bilateral cleft lip and palate patients. Int J Oral Maxillofac Surg 36:890–895, PMID: 17766083

    Article  CAS  PubMed  Google Scholar 

  19. Marcusson A (2001) Adult patients with treated complete cleft lip and palate. Methodological and clinical studies. Swed Dent J Suppl 1–57, PMID: 11400538

  20. Hemprich A (2000) Secondary operations in lip-jaw-palate clefts. Mund Kiefer Gesichtschir 4(Suppl 1):S61–S67, PMID: 10938644

    Article  PubMed  Google Scholar 

  21. Brunner M, Georgopoulou A, Verres R, Komposch G, Mussig E (2004) Psychosocial problems and coping strategies of young patients with cleft lip and palate. Psychother Psychosom Med Psychol 54:423–430, PMID: 15494892

    Article  PubMed  Google Scholar 

  22. Fadeyibi IO, Coker OA, Zacchariah MP, Fasawe A, Ademiluyi SA (2012) Psychosocial effects of cleft lip and palate on Nigerians: the Ikeja-Lagos experience. J Plast Surg Hand Surg 46:13–18. doi:10.3109/2000656X.2011.643027

    Article  PubMed  Google Scholar 

  23. Hunt O, Burden D, Hepper P, Johnston C (2005) The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthod 27:274–285, PMID: 15947228

    Article  PubMed  Google Scholar 

  24. Sinko K, Jagsch R, Prechtl V, Watzinger F, Hollmann K, Baumann A (2005) Evaluation of esthetic, functional, and quality-of-life outcome in adult cleft lip and palate patients. Cleft Palate Craniofac J 42:355–361, PMID: 16001915

    Article  PubMed  Google Scholar 

  25. Andretto AC (2007) The central role of the nose in the face and the psyche: review of the nose and the psyche. Aesthetic Plast Surg 31:406–410, PMID: 17551776

    Article  Google Scholar 

  26. Babuccu O, Latifoglu O, Atabay K, Oral N, Cosan B (2003) Sociological aspects of rhinoplasty. Aesthetic Plast Surg 27:44–49, PMID: 12789458

    Article  PubMed  Google Scholar 

  27. Huffman WC, Lierle DM (1946) Studies on the pathologic anatomy of the unilateral harelip nose. Plast Reconstr Surg 4:225–234, PMID: 18131353

    Article  Google Scholar 

  28. Shaw WC, Semb G, Nelson P, Brattstrom V, Molsted K, Prahl-Andersen B, Gundlach KK (2001) The Eurocleft project 1996–2000: overview. J Craniomaxillofac Surg 29:131–140, PMID: 11465251

    Article  CAS  PubMed  Google Scholar 

  29. Horswell BB, Pospisil OA (1995) Nasal symmetry after primary cleft lip repair: comparison between Delaire cheilorhinoplasty and modified rotation-advancement. J Oral Maxillofac Surg 53:1025–1030, PMID: 7643272

    Article  CAS  PubMed  Google Scholar 

  30. Kohout MP, Aljaro LM, Farkas LG, Mulliken JB (1998) Photogrammetric comparison of two methods for synchronous repair of bilateral cleft lip and nasal deformity. Plast Reconstr Surg 102:1339–1349, PMID: 9773988

    Article  CAS  PubMed  Google Scholar 

  31. Reddy GS, Webb RM, Reddy RR, Reddy LV, Thomas P, Markus AF (2008) Choice of incision for primary repair of unilateral complete cleft lip: a comparative study of outcomes in 796 patients. Plast Reconstr Surg 121:932–940. doi:10.1097/01.prs.0000299282.63111.3f

    Article  CAS  PubMed  Google Scholar 

  32. Reddy SG, Reddy RR, Bronkhorst EM, Prasad R, Kuijpers Jagtman AM, Berge S (2010) Comparison of three incisions to repair complete unilateral cleft lip. Plast Reconstr Surg 125:1208–1216. doi:10.1097/PRS.0b013e3181d45143

    Article  CAS  PubMed  Google Scholar 

  33. Farkas LG, Hajnis K, Posnick JC (1993) Anthropometric and anthroposcopic findings of the nasal and facial region in cleft patients before and after primary lip and palate repair. Cleft Palate Craniofac J 30:1–12, PMID: 8418865

    Article  CAS  PubMed  Google Scholar 

  34. Nagy K, Mommaerts MY (2007) Analysis of the cleft-lip nose in submental-vertical view, part I—reliability of a new measurement instrument. J Craniomaxillofac Surg 35:265–277, PMID: 17870608

    Article  PubMed  Google Scholar 

  35. Farmand M (2002) Lip repair techniques and their influence on the nose. Facial Plast Surg 18:155–164, PMID: 12152134

    Article  PubMed  Google Scholar 

  36. Millard D (1976) Cleft craft: the evolution of its surgery. Little Brown, Boston

    Google Scholar 

  37. Veau V (1938) Bec-de liévre, forms clinique, chirurgie. Editeur Masson, Paris

    Google Scholar 

  38. Ettorre G, Weber M, Schaaf H, Lowry JC, Mommaerts MY, Howaldt HP (2006) Standards for digital photography in cranio-maxillo-facial surgery—part I: basic views and guidelines. J Craniomaxillofac Surg 34:65–73, PMID: 16427297

    Article  PubMed  Google Scholar 

  39. Farkas LG, Posnick JC (1992) Growth and development of regional units in the head and face based on anthropometric measurements. Cleft Palate Craniofac J 29:301–302, PMID: 1643056

    Article  CAS  PubMed  Google Scholar 

  40. Liou EJ, Subramanian M, Chen PK, Huang CS (2004) The progressive changes of nasal symmetry and growth after nasoalveolar molding: a three-year follow-up study. Plast Reconstr Surg 114:858–864, PMID: 15468390

    Article  PubMed  Google Scholar 

  41. Jeong HS, Lee HK, Shin KS (2012) Correction of unilateral secondary cleft lip nose deformity by a modified Tajima’s method and several adjunctive procedures based on severity. Aesthetic Plast Surg 36:406–413. doi:10.1007/s00266-011-9788-7

    Article  PubMed  Google Scholar 

  42. McDaniel JM, Alleyne B, Gosain AK (2013) Secondary cleft nasoplasty at primary school age: quantitative evaluation of the efficacy of resorbable plates. Plast Reconstr Surg 132:933–943. doi:10.1097/PRS.0b013e3182a053f1

    Article  CAS  PubMed  Google Scholar 

  43. Wang TD (2010) Secondary rhinoplasty in unilateral cleft nasal deformity. Clin Plast Surg 37:383–387. doi:10.1016/j.cps.2009.12.013

    Article  PubMed  Google Scholar 

  44. Kim JB, Strike P, Cadier MC (2011) A simple assessment method for auditing multi-centre unilateral cleft lip repairs. J Plast Reconstr Aesthet Surg 64:195–200. doi:10.1016/j.bjps.2010.04.020

    Article  CAS  PubMed  Google Scholar 

  45. Lazarus DD, Hudson DA, van Zyl JE, Fleming AN, Fernandes D (1998) Repair of unilateral cleft lip: a comparison of five techniques. Ann Plast Surg 41:587–594, PMID: 9869130

    Article  CAS  PubMed  Google Scholar 

  46. Zaleckas L, Linkeviciene L, Olekas J, Kutra N (2011) The comparison of different surgical techniques used for repair of complete unilateral cleft lip. Medicina (Kaunas) 47:85–90, PMID: 21734440

    Google Scholar 

  47. Mosmuller DG, Griot JP, Bijnen CL, Niessen FB (2013) Scoring systems of cleft-related facial deformities: a review of literature. Cleft Palate Craniofac J 50:286–296. doi:10.1597/11-207

    Article  CAS  PubMed  Google Scholar 

  48. Olesen OV, Paulsen RR, Hojgaard L, Roed B, Larsen R (2012) Motion tracking for medical imaging: a nonvisible structured light tracking approach. IEEE Trans Med Imaging 31:79–87. doi:10.1109/TMI.2011.2165157

    Article  PubMed  Google Scholar 

  49. Schwenzer-Zimmerer K, Chaitidis D, Berg-Boerner I, Krol Z, Kovacs L, Schwenzer NF, Zimmerer S, Holberg C, Zeilhofer HF (2008) Quantitative 3D soft tissue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). J Craniomaxillofac Surg 36:431–438. doi:10.1016/j.jcms.2008.05.003

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany

    Vedat Yildirim, Julia Kaiser, Alexander Hemprich & Niels Christian Pausch

  2. Translational Centre for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany

    Karsten Winter

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  1. Vedat Yildirim
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  2. Julia Kaiser
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Correspondence to Vedat Yildirim.

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Yildirim, V., Kaiser, J., Hemprich, A. et al. Dependence of columella development on the technique used for primary cleft lip closure. Oral Maxillofac Surg 19, 165–175 (2015). https://doi.org/10.1007/s10006-014-0472-3

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  • DOI: https://doi.org/10.1007/s10006-014-0472-3

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