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KMID : 0952820150180010025
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Journal of Korean Cleft Lip & Palate Association
2015 Volume.18 No. 1 p.25 ~ p.32
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Secondary Cleft Lip Repair - Report of Cases
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Kim Jung-Hyun
Kim Hui-Young
Song In-Seok
Seo Byoung-Moo
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Abstract
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Cleft lip is one of the most common congenital malformations, and consequent secondary deformities after primary lip repair are also frequently seen in children born with cleft lip and palate. Owing to the related researches and continuous improvement in the surgical techniques for the repair of primary cleft lip and palate, incidence and severity of secondary cleft lip deformities have been decreased. Factors that lead to such improvement include team approach with various specialists, simultaneous primary cheilorhinoplasty, pre surgical orthopedic treatment, and application of gingivoperiosteoplasty. Nevertheless, secondary cleft lip deformities still remains as the most challenging task to cleft surgeons in terms of post surgical scar formation, distortion of anatomical landmarks, and shortage of available tissue volume. Deformities after primary surgery include cleft lip scar, long or short lip, tight lip, distortions in philtrum, asymmetric Cupid’s bow and white roll, vermilion notch, and abnormality of orbicularis oris muscle. Whistle deformity is one of the challenging sequelae to be repaired. Intrinsic deficiency of tissue in the prolabium, and failure in reconstructing the orbicularis oris muscle contribute to this deformity. Therefore, functional realignment of the orbicularis oris muscle is the most important component in the correction of secondary cleft lip deformities. In addition, ideal scar distribution, correction of wide philtrum, and elongation of short columella are also indispensable components for the accurate correction of secondary cleft lip deformity. In this report, the revision surgery of cleft lip deformities were reported with literature review. Four patients underwent excision of unfavorable scar, realignment of orbicularis oris muscle, and reconstruction of the normal anatomical structures and landmarks with satisfactory results.
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KEYWORD
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Cleft lip and palate, Lip revision
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