Modified design of Cupid's bow in the repair of unilateral microform cleft lip: in case of deficient distance between the midline and the cleft side Cupid's bow peak.J Craniofac Surg 2009; 20(5):1367-9JC
In unilateral microform cleft lip repair, when the distance from the cleft side peak of Cupid's bow to the midline is shorter than on the noncleft side, conventional cheiloplasty design results in asymmetric Cupid's bow with unnatural philtrum that is hard to correct. We modified the design of the cleft side Cupid's bow to avoid causing this secondary deformity. Twelve patients with a unilateral microform cleft lip who had a shorter cleft side from the midline to the peak of Cupid's bow distance were treated using a modified cheiloplasty design between January 1998 and December 2007. The point for the peak of Cupid's bow of the lateral segment was shifted medially to compensate for the short medial segment. The mean age of patients at the time of surgery was 48 months (range, 3 mo to 24 yr), and the follow-up period ranged from 10 to 100 months, with a mean of 33 months. A symmetric Cupid's bow with a natural-looking philtrum was achieved and maintained throughout the follow-up period in all the patients. In patients with a unilateral microform cleft lip with a shorter cleft side from the midline to the peak of Cupid's bow distance, the point for the peak of Cupid's bow of the lateral segment was shifted medially to achieve symmetric Cupid's bow. The resulting scar was more medial than in a conventional design, but the philtrum looked more natural. Longer follow-up would be required to verify the long-term results.