[논문]Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods

Al-Zajrawee, Mustafa Zahi; Aljodah, Mohammed Abd-Alhussein; Hassan, Qays Ahmed

doi:10.5999/aps.2018.00332

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods 원문보기

Archives of plastic surgery : APS, v.46 no.2, 2019년, pp.114 - 121

Al-Zajrawee, Mustafa Zahi (Department of Surgery, University of Kufa College of Medicine) , Aljodah, Mohammed Abd-Alhussein (Department of Surgery, University of Baghdad Al-Kindy College of Medicine) , Hassan, Qays Ahmed (Department of Surgery, University of Baghdad Al-Kindy College of Medicine)

Abstract ▼ AI-Helper

Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle. Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a modification of the Millard and Manchester techniques. Patients with a very wide cleft lip and protruded or rotated premaxilla were excluded from this study. We analyzed 30 normal children for a comparison with our patients in terms of anthropometric measurements. Results By the end of the follow-up period (between 9 and 19 months), all our patients had obtained a full central segment with adequate white roll in the central segment and a deep gingivolabial sulcus, and we obtained nearly normal anthropometric measurements in comparison with age-matched normal children. Conclusions We recommend this modified technique for the treatment of bilateral cleft lip deformity.

주제어

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

In this study we aimed to evaluate the surgical outcomes of a modification of the two aforementioned methods (the Millard and Manchester techniques) for bilateral cleft lip repair; this technique was developed by Byrd on the basis of over 25 years of surgical experience dealing with bilateral cleft lip [12].

제안 방법

A general evaluation of the medical status of all patients was performed, with an assessment of any associated congenital anomalies. All patients’ weight was measured.
All operations were undertaken under general anesthesia. The patients were placed in the supine position, and the face was prepared and draped.
None of our patients had any other associated congenital anomalies. At the time of presentation, we instructed our patients to use rubber band traction over the premaxilla and palatal acrylic plate in order to facilitate the repair and to prevent lateral maxillary collapse.
In our study, three anthropometric measurements were made: upper lip height (sn-sto), cutaneous lip height (sn-ls), and vermilion mucosal height (ls-sto). The growth of the upper lip was analyzed by comparing the patients’ anthropometric measurements to age-matched normal children preoperatively and at 1 year postoperatively.
Statistical analyses were performed for the intraoperative and postoperative measurements. Continuous variables were expressed as mean±standard deviation.
The patients were divided by age, and measurements were taken of every patient both intraoperatively and at 1 year postoperatively. The labial anthropometric measurements included the following: upper lip height (subnasale-stomion; sn-sto), cutaneous upper lip height (subnasale-labial superioris; sn-ls), and vermilion mucosal height (labial superioris-stomion; ls-sto).

대상 데이터

Routine preoperative investigations were done, including hemoglobin levels, prothrombin time, partial thromboplastin time, and a virology screening. Frontal and lateral photographs were taken of all patients.

데이터처리

Continuous variables were expressed as mean±standard deviation. The paired t-test was used to analyze continuous variables. P-values less than 0.

성능/효과

In conclusion, using a U-shaped prolabial dry vermilion flap that was augmented by lateral lip vermilion flaps (without skin or white roll) could improve central vermilion fullness without sacrificing the lateral lip segment and while avoiding a tight upper lip. We recommend this procedure for the treatment of bilateral cleft lip, but suggest that the follow-up period should be extended for at least 5 years postoperatively.

참고문헌 (18)

1 Giele H Cassele O Plastic and reconstructive surgery (Oxford specialist handbook in surgery) New York Oxford University Press 2008
2 Olasoji HO Ukiri OE Yahaya A Incidence and aetiology of oral clefts: a review Afr J Med Med Sci 2005 34 1 7 15971547
3 Gorlin RJ Cohen MM Hennekam RC Syndromes of the head and neck New York Oxford University Press 2003
4 Mulliken JB Primary repair of bilateral cleft lip and nasal deformity Plast Reconstr Surg 2001 108 181 94 11420522

상세보기
5 Spritz RA The genetics and epigenetics of orofacial clefts Curr Opin Pediatr 2001 13 556 60 11753106

상세보기
6 Vieira AR Orioli IM Candidate genes for nonsyndromic cleft lip and palate ASDC J Dent Child 2001 68 272 9 11862881

상세보기
7 Hopper RA Cutting C Grayson B Cleft lip and palate Thorne CH Bartlett SP Beasley RW Grabb and Smith’s plastic surgery 6th ed Philadelphia Lippincott Williams & Wilkins 2007 201 25
8 Yuzuriha S Oh AK Mulliken JB Asymmetrical bilateral cleft lip: complete or incomplete and contralateral lesser defect (minor-form, microform, or mini-microform) Plast Reconstr Surg 2008 122 1494 504 18971734

상세보기
9 El-Hadidy AM Eldeen AM Elbassiony LE An improved technique for repair of bilateral cleft lip deformities through extensive muscle dissection in one stage sugery Egypt J Plast Reconstr Surg 2006 30 131 7
10 Mulliken JB Repair of bilateral cleft lip and its variants Indian J Plast Surg 2009 42 Suppl S79 90 19884685
11 Millard DR Jr Closure of bilateral cleft lip and elongation of columella by two operations in infancy Plast Reconstr Surg 1971 47 324 31 5549423
12 Byrd HS Ha RY Khosla RK Bilateral cleft lip and nasal repair Plast Reconstr Surg 2008 122 1181 90 18827654

상세보기
13 Mulliken JB Burvin R Farkas LG Repair of bilateral complete cleft lip: intraoperative nasolabial anthropometry Plast Reconstr Surg 2001 107 307 14 11214042

상세보기
14 Gundlach KK Schmitz R Maerker R Late results following different methods of cleft lip repair Cleft Palate J 1982 19 167 71 6956459

상세보기
15 Fillies T Homann C Meyer U Perioperative complications in infant cleft repair Head Face Med 2007 3 9 17280602

상세보기
16 Mulliken JB Wu JK Padwa BL Repair of bilateral cleft lip: review, revisions, and reflections J Craniofac Surg 2003 14 609 20 14501318

상세보기
17 Jackson IT Fasching MC Secondary deformities in cleft lip and palate McCarthy JG Plastic surgery 2nd ed Philadelphia Saunders 1990 2796
18 Kim SK Lee JH Lee KC Mulliken method of bilateral cleft lip repair: anthropometric evaluation Plast Reconstr Surg 2005 116 1243 51 16217463

상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods 원문보기

Abstract ▼ AI-Helper

주제어

AI 본문요약
AI-Helper

문제 정의

제안 방법

대상 데이터

데이터처리

성능/효과

참고문헌 (18)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트

연합인증

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods 원문보기

Abstract ▼ AI-Helper

주제어

AI 본문요약 엑셀 다운로드 AI-Helper

문제 정의

제안 방법

대상 데이터

데이터처리

성능/효과

참고문헌 (18)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트

AI 본문요약
AI-Helper