Use of levator labii superioris muscle flap in the muscle repair of cleft lips

Summary

In order to facilitate and improve muscle repair in wide cleft lips, a levator labii superioris muscle flap has been used to augment the orbicularis oris muscle. The neurovascular pedicle of this muscle flap can be preserved to eliminate the possibility of ischemic muscle fibrosis and atrophy. Eleven patients between the ages of 4 months and 24 years having wide cleft lips underwent this procedure. Seven had a unilateral and 4 had a bilateral cleft lip deformity. In one patient who had a bilateral complete cleft lip, the levator labii superioris muscle was directly approximated to the contralateral muscle. In the other three patients with bilateral cleft lips, the levator labii superioris muscle flaps were approximated to the contralateral orbicularis oris muscles. In all 7 of the unilateral cases, the levator labii superioris muscle flaps were used to obtain a tension free closure and for filling out the defect below the nostril sill. None of the patients had wound infection, wound dehiscence or scar widening. The functional loss resulting from the transposition of the flap is compensated for by the remaining synergistic muscle, the zygomaticus minor. This method of muscle repair seems to be completely benign, and the muscle flap dissection can be performed easily and safely.