%0 Journal Article
%T Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique
%A Cassio Eduardo Raposo-Amaral
%A Andr¨Ļ Pecci Giancolli
%A Rafael Denadai
%A Frederico Figueiredo Marques
%A Renato Salazar Somensi
%A Cesar Augusto Raposo-Amaral
%A Nivaldo Alonso
%J Plastic Surgery International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/206481
%X Objective. To compare the cutaneous lip height at early and late postoperative periods and to objectively determine the average amount of lip height improvement during the first year of unilateral complete cleft lip repair using Cutting extended Mohler technique. Methods. In this prospective cohort study, 26 unilateral complete cleft patients and 50 noncleft subjects were included. Photographs were taken between 12 and 16 weeks (T1) and also taken between 12 and 13 months after surgery (T2). The cutaneous lip height distance (photogrammetric lip analysis) obtained in these two periods of time were measured and statistically analyzed. Results. The average lip heights were in T1 and in T2 ( ). The average lip height asymmetry in the noncleft individuals was . Conclusion. Since all principles to obtain a symmetrical CupidĄ¯s bow were performed, the postoperative pull-up of CupidĄ¯s bow is probably owed to the scar contracture, which improves by 2 times during the first year after surgery. 1. Introduction Ralph Millard revolutionized the treatment of cleft lip by describing the innovative principles to repair a unilateral cleft lip, that allows surgeons around the globe to treat patients with different racial characteristics [1¨C4]. Consequently, his principles remain as a foundation to the development of surgical strategies and tactics to improve the results in the cleft lip repair worldwide [5¨C7]. Mohler [8] used MillardĄ¯s principles to develop his own technique, that adds a more vertical incision in the cleft philtrum column, creating a final faint scar that represent a mirror image of the contralateral philtrum column. In the Mohler technique [8], the MillardĄ¯s C-flap is used to fill the gap created by the downward rotation of the cleft lip segment, instead of the lateral advancement segment as proposed by Millard [5]. Thus, a short lip height may be produced as a consequence of these maneuvers (straight-line scar and absence of the lateral advancement segment fulfilling the medial gap after the back-cut incision). CuttingĄ¯s modifications of the Mohler technique are the following: (1) an extension of the medial incision toward the columella, (2) the MillardĄ¯s back-cut incision never passes the noncleft philtral column, (3) a more vertical incision than that described by Millard, that creates a, and (4) wider C-flap that fills the medial rotation defect [9]. Cutting and Dayan [9] subsequently analyzed cleft patients who underwent a cheiloplasty, using the Cutting extend Mohler technique, in order to respond whether this technique produces a short lip height
%U http://www.hindawi.com/journals/psi/2012/206481/