Philtrum Reconstruction in Primary Unilateral Cleft Lip Repair：Surgical Technique of Orbicularis Oris Muscle Splitting and the Short-term Outcome

Abstract

　　Reconstruction of the natural lip appearance in the treatment of cleft lip remains challenging. The purpose of this report was to describe the short-term outcome of a surgical technique for philtrum reconstruction that we developed. The study population included 26 patients with unilateral cleft lip who underwent primary unilateral cleft lip repair at Kyoto University Hospital between May 2015 and June 2018. A philtrum-like structure was made by splitting the orbicularis oris muscle on the non-cleft side followed by the insertion of the muscular stump on the cleft side into the split. Photographs taken at six months after surgery were used for evaluation. Two morphological parameters, philtrum column height and nasal floor width, were defined. For each parameter, the ratio of the value on the cleft side to that on the non-cleft side was used for comparison between groups of different types of cleft lip. Among patients without cleft palate, a higher philtrum column height ratio and higher nasal floor width ratio were found in the complete-type group. In contrast, these parameters were comparable in patients with cleft palate, regardless of the type of cleft lip. Thus, this technique may be a useful option for philtrum reconstruction when performing unilateral cleft lip repair.