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KMID : 0358819870140010091
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1987 Volume.14 No. 1 p.91 ~ p.97
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THE COMBINATION OF TRIANGULAR FLAP METHOD AND MILLARD’S METHOD FOR THE REPAIR OF CLEFT LIP
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Kim Duk-Rae
Kang Dong-Hoon
Chun Kun-Soo
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Abstract
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There are several well established methods of primary cleftlip repair. Nowadays, traingular flap method and rotation advancement flap method are most widely used and regarded as a method of choice for the repair of cleft lip. However, in cases with severe vertical height difference between cleft side and non cleft side, both methods have some problems.
With the Millard`s method for the repair in these cases, the incision of rotation flap must be extended to the philtral column on the noncleft side. This induces a break in the upper part of philtrum and it is not always easy to achieve smooth continuity of the Cupid`s bow. With the triangular flap method for the repair in these cases, large traingular flap has to be designed for lengthening. It produces fairly noticeable scar on the philtrum and divides the philtrum into two parts. Onizuka reported a method in which a small triangular flap was added together with that of Millard in 1966. Y, Nishimura modified Onizuka method in 1978.
We performed a method in which triangular flap was put on the end of vermilion ridge with Millard`s method for the repair of cleft lip in cases which vertical hight differences are severe, usually more than 5mm in length in the infant. The result of this method is proved to be very successful and eliminates or reduces the problems previously described.
―Advantages of this method―
1. Permit lengthening even in severe forms without making large z-plasty scar in the philtrum.
2. Preserve philtral dimple and column better than triangular flap method.
3. Natural appearence of the upper part of philtrum.
4. Better correction of nasal deformties than triangular flap method.
5. Good muscle anatomic realignment.
6. In the Second stage operation of bilateral cleft lip, expected lengthening can be achieved without making protrusion of the lower margin of the prolabium.
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KEYWORD
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