Facial and Nasolabial Aesthetics of Complete UCLP Submitted to 2-Stage Palate Repair With Vomer Flap

Cleft Palate Craniofac J. 2018 Oct;55(9):1211-1217. doi: 10.1177/1055665618767418. Epub 2018 Apr 13.

Abstract

Objective: To evaluate the aesthetics of nasolabial appearance and facial profile of children with unilateral cleft lip and palate (UCLP) submitted to 2-stage palate repair with vomerine flap.

Design: Retrospective.

Setting: Single center.

Patients: Forty patients with UCLP, mean age of 7.81 years of both sexes, rehabilitated at a single center by 1 plastic surgeon.

Interventions: Lip and anterior palate repair with nasal alar repositioning was performed at 3 to 6 months of age by Millard technique and vomer flap, respectively. Posterior palate was repaired at 18 months by Von Langenbeck technique.

Main outcome measure(s): Four cropped digital facial photographs of each patient were evaluated by 3 orthodontists to score the nasolabial aesthetics and profile. Frequencies of each score as well means and medians were calculated. Kappa test was used for evaluating inter- and intrarater reproducibility.

Results: The nasal form and deviation was scored as good/very good in 70%, fair in 22.5%, and poor in 7.5% of the sample. The nasal-subnasal aesthetic was considered good/very good in 55%, fair in 30%, and poor in 15% of the sample. The lip vermilion border and the white part of surgical scar aesthetics were good/very good in 77.5% and 80%, fair in 17.5% for both categories, and poor in 5% and 2.5% of the cases, respectively. In all, 67.5% showed convex facial profile, 20% was straight, and 12.5% was concave profile.

Conclusions: Two-stage palatoplasty presented an adequate aesthetical results for the majority of patients with UCLP in the mixed dentition.

Keywords: UCLP; aesthetics; vomerine flap.

MeSH terms

  • Child
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Esthetics*
  • Female
  • Humans
  • Male
  • Nose / abnormalities
  • Nose / surgery*
  • Photography
  • Reproducibility of Results
  • Retrospective Studies
  • Surgical Flaps*
  • Treatment Outcome
  • Vomer / surgery*