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Complete cleft lip or cleft palate is a common congenital pathology in children. Cleft lip changes the anatomical structure, seriously affects the aesthetics of the face, causes functional disorders in eating, breathing, pronunciation of children, has a very heavy impact on psychology. of the patient and family, so cleft lip surgery is very necessary. One-sided congenital cleft lip surgery is a method widely performed in many medical facilities with high efficiency for children.
1. What is a unilateral cleft lip?
Nasal cleft, also known collectively as a complete cleft lip, manifests as a disruption of the anatomical structure of the upper lip and the base of the nose.
Classification of cleft lip - palate : There are many ways to classify cleft lip - palate. However, the most common classification is the anatomical classification. Accordingly, people divide the degrees of cleft lip including:
One-sided cleft lip grade I: Cleft lip is only found in red lips. Grade II: Small cleft lip and partial lip height. Grade III: Simple total lip cleft communicates to the base of the nostrils. Grade IV: Total cleft lip combined with cleft palate and palate. Cleft upper lip on both sides is that there are 2 slits in the same upper lip. Grading the degree is similar to that of a unilateral cleft lip. The two clearances may be of the same or different extent. Cleft palate
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2. Time of total congenital one-sided cleft lip plastic surgery
Cleft nose and lips can be operated at any age, even after the child has just been born. However, in practice, the choice of time for surgery depends on many factors, so the following conditions must be met: The child is at least 10 weeks old, has enough weight, and is not anemic If the patient has congenital heart disease accompanied: cardiovascular examination, preparation of prophylactic antibiotics, examination of other specialties when required, pre-anesthesia examination.
3. Necessary standards to be achieved when shaping cleft lip and nose
With lip contouring guaranteed: Return the correct anatomical position and function of the lip sphincter, create a balanced lip V and nuclei, preserve the length of the white lips, the lip contour is continuous, the lips regular, proportional red, reestablishing the correct relationship between wet and dry lips. With rhinoplasty: Create symmetry of the nostrils, reconstruct the floor of the nose, put the nasal cartilage in the right position, adjust the balance of the alar wings, repair the arch of the nose, make the two sides of the nasal column straight and equal together. Must meet aesthetic requirements: The scar must be as small as possible, avoid creating a straight scar that causes contraction, and the scar coincides with the natural grooves.
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4. Total congenital cleft palate surgery method
4.1. One-sided cleft lip contouring by straight incision is a method of using skin flap to create one-sided cleft lip by straight incision. The disadvantage of this method is that the straight scar line is easy to pull up the Cupidon arc and shorten the lip skin height.
4.2. One-sided cleft lip reconstruction by quadrangular flap is a method that uses the outer quadrangular flap of skin and mucosa in combination with Cupidon's arc border to insert into the quadrilateral skin defect in the middle of the nucleus pulposus. The disadvantage of this method is that there is a scar in the middle of the nucleus pulposus and it is necessary to cut away many tissues outside the lips, causing deviation and shortening of the lip length.
4.3. Create a unilateral cleft lip by creating a triangular flap Create a unilateral cleft lip according to Tennison. It is a relatively widely applied method in maxillofacial and plastic surgery establishments throughout the country. Indications: Applied to surgery of cleft lip grade I, II. Advantages and disadvantages of the method: Easy to restore the lip skin height, less scarring of Cupidon's bow after surgery. One-sided cleft lip contouring by rotating flap according to Millard D.R This is the most preferred method by surgeons today. Millard took an anterior triangular fascia flap outside the base of the rotator cuff and pushed it outwards and inserted it into the skin defect in the front of the lateral nostril with the cleft, while the large flap of the lateral border of the cleft was rotated and pushed inward. Applies to cleft lip grade III, IV. This method is easy to narrow the base of the nose on the side of the cleft, revealing in the recovery of the lip sphincter better, the scar is more beautiful, the technique is simple and easy to perform, creating a relatively complete lip shape. The choice of lip shaping method depends a lot on the preferences, experience and habits of the surgeon. If the surgeon prefers any surgical method, it will be performed flexibly and creatively to get the best shaping results.
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