Update in Unilateral Cleft Lip Surgery | Journal CME Article-Journal CME Article: Update in Unilateral Cleft Lip Surgery Article

Journal CME Article: Update in Unilateral Cleft Lip Surgery Article

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The article discusses the condition of unilateral cleft lip, a common birth defect with varying incidence among different ethnic groups. The cleft lip, often accompanied by cleft palate, affects a range of populations, with Asians and Native Americans experiencing the highest rates. The paper outlines various risk factors, including genetic predispositions and environmental influences such as maternal smoking, age, and malnutrition during pregnancy. It also highlights the role of specific genetic mutations contributing to cleft lip conditions, with Van der Woude syndrome being one of the more common associated syndromes.<br /><br />The article emphasizes the importance of a multidisciplinary approach to the care of unilateral cleft lip patients, which should include prenatal consultation and education, as well as postsurgical support. Key members of this care team include cleft orthodontists who play a pivotal role in presurgical infant orthopedics, which helps optimize surgical outcomes. Techniques such as lip taping, Latham devices, and nasoalveolar molding are employed to manipulate cleft segments for improved presurgical alignment and symmetry.<br /><br />The surgical repair of unilateral cleft lip has evolved significantly, categorized into rotation-advancement techniques, such as the Millard repair, and straight-line methods like the Fisher anatomical subunit approximation technique. Both approaches focus on aligning and restoring the normal anatomy of the lip and nose, though they propose slightly different methods of addressing the deformity's mechanics.<br /><br />Unilateral cleft lip repair also includes considerations for cleft nose deformity, a complex issue involving both structural displacement and potential inherent deficiencies in nasal cartilage. The article highlights different opinions on the timing and methods of nasal surgery, from aggressive primaries to minimal intervention strategies, with the aim of optimizing nasal symmetry without hindering growth.<br /><br />Postoperative management includes scar care, pain management, and nasal stenting, with a comprehensive strategy to ensure successful healing and optimal aesthetic outcomes. The document reflects the ongoing search for perfection in cleft lip repair, balancing historical insights with modern advancements.

Keywords

unilateral cleft lip

birth defect

ethnic incidence

genetic predispositions

multidisciplinary care

presurgical orthopedics

surgical techniques

nasal deformity

postoperative management

Van der Woude syndrome