Early and one stage repair of bilateral cleft lip and nose.Keio J Med 1998; 47(4):212-8KJ
In bilateral cleft lip repair numerous complicated problems still remain. In our opinion, it is better to begin treatment soon after birth. We start nonsurgical correction of a nasal deformity using a nose retainer and preoperative orthodontics using a palatal plate. Surgical repair of the lip is done within one month of birth, by which time the nose alveolus and projecting prolabium can be adequately changed into the desired form. Primary lip repair is performed in one stage which includes restoration of the muscle union, labial sulcus reconstruction and nasal correction. We use a two straight parallel suture line method for symmetric bilateral cleft lip repair. The distance between the two cupid's peaks is 4 mm. The central tubercle is reconstructed using bilateral cutaneo-mucosal flaps. The tissue volume of both sides is not the same in asymmetric cases so we have refined our method in order to achieve symmetry.