Novel Reconstruction of Orbicularis Oris in Unilateral Complete Cleft Lip Repair

Background: Orbicularis oris muscle repair is key to successful unilateral cleft lip repair. Objective: To measure the lip symmetry after repair of the lip muscles in the midline compared with traditional repair on the cleft side. Methods: A retrospective review and photographic analysis of patients with complete cleft lip treated with the modified approach were carried out. Anthropometric analysis was done at pre-, immediate, and 1-year postoperatively, and at 1-year follow-up. Four upper lip and six nostril landmarks were measured. Results: Fourteen patients met inclusion criteria. Immediate postoperatively, the horizontal lip length on the cleft side was shorter than that on the noncleft side, but the discrepancy decreased as facial development progressed over the course of a year. Lip measurements at the 1-year follow-up were approximately symmetrical in vertical lip height, philtral height, and lateral lip height. Small changes in the nasal correction occurred at 1 year. Conclusion: A modified technique in the unilateral complete cleft lip repair seeks to balance the perinasal and perioral muscles and improve symmetric outcomes.