A CASE REPORT: UNILATERAL COMPLETE CLEFT LIP RECONSTRUCTION USING THE MODIFICATION MILLARD TECHNIQUE
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Highlights:
- The modified Millard technique, including the Tennison triangular flap, is effective in preventing vermillion notching and reducing scar complications in cleft lip repairs.
- The technique addresses concerns related to compromised lip tissue and nostril deformities, leading to improved appearance and functionality.
- Scar thinning techniques and separate nasoraphy contribute to enhanced aesthetics and optimal healing in cleft lip repairs.
Abstract:
Introduction: With 1 in 700 live births worldwide, cleft lip with or without cleft palate is the most prevalent congenital craniomaxillofacial birth condition. More people have a unilateral cleft lip than a bilateral cleft lip. With the exception of vision, it can influence the morphology and nearly all facial functions. The purpose of this study is to give an overview and learn more about the management of lip repair using the modified Millard approach, which can prevent straight line closure and vermilion notching.
Case Illustration: We present a case of a 4-month-old male who underwent a modified Millard procedure and had a unilateral full cleft lip. The findings revealed no vermillion notch, acceptable columellar and alar lengths, symmetrical Cupid's bow, lip height, lip width, and philtrum angle.
Discussion: The modified Millard technique, including the Tennison triangular flap, improves the repair of cleft lips by preventing vermillion notching and reducing scar complications. It also addresses concerns related to lip tissue compromise and nostril deformities. Scar thinning techniques and separate nasoraphy contribute to enhanced aesthetics and optimal healing. These modifications aim to achieve improved appearance and functionality in cleft lip repairs.
Conclusion: The modified Millard technique can be considered as a viable option for treating unilateral cleft lip due to its ability to create a balanced Cupid's bow, maintain appropriate lip height and width, and achieve satisfactory aesthetic results in the nasal area without vermillion notching.
Yılmaz HN, Özbilen EÖ, & Üstün T. The prevalence of cleft lip and palate patients: a single-center experience for 17 years. Turkish Journal of Orthodontics. 2019 Sep;32(3):139.
Auslander A, Cowdin RM, Brindopke F, et al. The role of smoke from cooking indoors over an open flame and parental smoking on the risk of cleft lip and palate: A case-control study in 7 low-resource countries. Journal of Global Health. 2020;10(2):1-9.
Gani AB & Josh F. Perbandingan Estetika Post Labioplasty Unilateral antara Teknik Millard dengan Teknik Tennison. UMI Medical Journal. 2022;7(1):1-9.
Zaleckas L, Linkeviciene L, Olekas J, & Kutra N. The Comparison of Different Surgical Techniques Used for Repair of Complete Unilateral Cleft Lip. Medicina (Kaunas). 2011;47(2):85-90.
ElMaghraby MF, Ghozlan NA, Ashry MH, Abouarab MH, & Farouk A. Comparative study between fisher anatomical subunit approximation technique and millard rotation-advancement technique in unilateral cleft lip repair. Alexandria Journal of Medicine. 2021;57(1):92-102.
Adetayo AM, Adetayo MO, Adeyemo WL, James OO, Adeyemi MO. Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment. Journal Korean Assoc Oral Maxillofac Surg. 2019;45:141-51.
Knezevic P, Grgurević L, Uglešić V, & Grgurević J. Modified Millard's technique in operations for unilateral cleft lip. J Plast Surg Hand Surg. 2012;46(5):326-9.
Han K, Park J, Lee S, & Jeong W. Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique. Arch Craniofac Surg. 2018;19(1): 3–12.
Sharma, RK. Triangular flap technique for unilateral cleft lip deformity. Journal of Cleft Lip Palate and Craniofacial Anomalies. 2021;8(2):163-8.
Shi Bing & Sommerlad Brian.Cleft Lip and Palate Primary Repair. In: Bing Shi (ed): Geometric Analysis of Classic Cheiloplasty. Zhejiang University Press: Springer, 2013;43-50.
Alkebsi K, Li C, Aonan X, Zeyu H, Shi B, Li Y, Sakran KA, Al-Watary MQ, Abotaleb BM, &Almoraissi E. Cupid's Bow Leveling and Preservation of Lip Height and Width: A Modified rotation-advancement Technique. Plastic and Reconstructive Surgery. 2023;24:10-97.
Adetayo AM, James O, Adeyemo WL, Ogunlewe MO, & Butali A. Unilateral cleft lip repair: a comparison of treatment outcome with two surgical techniques using quantitative (anthropometry) assessment. J Korean Assoc Oral Maxillofac Surg 2018;44:3-11.
Elayah SA, Sakran KA, Alkebsi K, Younis H, Yang M, Liang X, Alkhutari AS, Li Y, & Shi B. Primary unilateral incomplete cleft lip repair by a modified rotational advancement technique. Journal of Stomatology, Oral and Maxillofacial Surgery. 2022;3:101325.
Tse R. Unilateral cleft lip: principles and practice of surgical management. Thieme Medical Publishers. In Seminars in plastic surgery. 2012;26(4):145-55.
Malek Rene & Martin Dunitz. Cleft Lip and Palate Primary Repair. In: Renan Ernest (ed): The Lip and The Nose : Primary Treatment. CRC Press: Taylor & Francis Group, 2000;51-89.
Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, Husein A, Ahmad WMAW, Eusufzai SZ, Prasadh S, Subramaniyan V, Fuloria NK, Fuloria S, Sekar M, & Selvaraj S. Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate”A Systematic Review. International Journal of Environmental Research and Public Health. 2022; 19(17):10860. DOI: 10.3390/ijerph191710860
Aljancic L, Rougier G, Neiva-Vaz C, Vazquez MP, Picard A, & Kadlub N. Millard's modified technique in the reconstruction of bilateral cleft lip: Objective and subjective assessment. Journal of Stomatology, Oral and Maxillofacial Surgery.2022;123(5):532-537.
Karina K, Fransisca F, & Suryadinata, KL.Analyzing Parental Age to Determine Types of Cleft in Hayandra Peduli Foundation Patient, Indonesia. Jurnal Profesi Medika : Jurnal Kedokteran Dan Kesehatan, 2020,14(2).
Khamila N, Agus Nurwiadh A, Putri FA.Characteristic Of Cleft Lip And Palate At Cleft Center Of Padjadjaran University Dental Hospital: 2 Years Retrospective Study.Jurnal Pendidikan Tambusai.2022,6(1):1058-1064
Ningrum, L.P., saputro, I.D. and Zarasade, L. CORELATION OF PARENTS' PROFILE OF CHILDREN WITH LATE CLEFT REPAIR IN SURABAYA CLEFT LIP AND PALATE CENTRE (JANUARY 2015 – DECEMBER 2017). Jurnal Rekonstruksi dan Estetik. 2020;5(1):18–23.
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