Force Balance Reconstruction of the Orbicularis Oris in Secondary Unilateral Cleft Lip Deformity

• Published in: Aesthetic plastic surgery 2024-07, Vol.48 (13), p.2382-2388
• Main Authors: Chen, Yu, Zhang, Chong, Yao, Meilin, Tsauo, Chialing, Shi, Bing, Low, David W., Li, Chenghao
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Cleft Lip - surgery; Cohort Studies; Esthetics; Facial Muscles - surgery; Female; Humans; Imaging, Three-Dimensional; Male; Medicine; Medicine & Public Health; Original Articles; Otorhinolaryngology; Patient Satisfaction; Plastic Surgery; Plastic Surgery Procedures - methods; Retrospective Studies; Risk Assessment; Treatment Outcome
• ISSN: 0364-216X; 1432-5241; 1432-5241
• DOI: 10.1007/s00266-024-04110-1

Background Secondary unilateral cleft lip deformities are commonly observed in patients with cleft lip and traditional surgical methods can’t completely tackle this problem. The purpose of this study was to evaluate the outcomes of a novel surgical technique using force balance reconstruction of the orbicularis oris. Methods 53 patients with secondary unilateral cleft lip deformity were included in this study, in which the orbicularis oris muscle was reconstructed symmetrically to achieve optimal force balance. Photometric 2d indexes were employed to evaluate the outcome of 27 patients, and 3d indexes for the remaining 26 patients. Aesthetic evaluation and parent-patient satisfaction surveys were also recorded. Results Significant differences were found in the following: (1) LH (the lip height), LW (the lip width), D1(the vertical distance from the white roll to the vermilion bottom at the christa philtra points) and D2(the vertical distance from the christa philtra points to the facial midline) when comparing preoperative and postoperative 2D images; (2) LH, LW, D1 and D2 when comparing preoperative and follow-up 2D images; (3) RMS (root mean of square) when comparing preoperative and postoperative 3D images. Aesthetic evaluation in the follow-up period was a mean of 4.29, while parent-patient satisfaction of the overall appearance was a mean of 4.41. Conclusions The results suggest this new muscle reconstruction technique can significantly improve the surgical outcome of secondary unilateral cleft lip deformities. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .”