Update in Unilateral Cleft Lip Surgery | Journal CME Article-Journal CME Article: Update in Unilateral Cleft Lip Surgery V1

Video Transcription

To mark the modified alard cleft lip repair, first the midline of the face and the nose, then the alar bases are outlined, the midline and the base of the collimella are marked.  Then the nadir of Cupid's bow is identified. Sometimes identifying the frenulum can assist in precisely marking the nadir of Cupid's bow. Two marks are made, one at the junction  of the red and white lip, and one mark is made above the white roll. Then the peak of Cupid's bow is identified on the non-cleft side.  That distance is then transposed to identify peak of Cupid's bow on the cleft side. Attention is then turned to the lesser lip segment, and Nordoff's point is identified  where you start to lose definition of the white roll. Again, this is marked using two points. The red line is then marked on both sides, and the discrepancy of the height noted.  The height of the lip is then measured on the non-cleft side, and this gives an idea of the relative discrepancy between the cleft and non-cleft lip heights.  Rotation flap is then marked, taking care not to cross the filtral column, and then the C flap is marked as well. The advancement flap is checked and marked,  and then the point on the lesser segment to be used is marked. The M flap is marked.  L flap is drawn for later use for closure of the nose, and the back cut is marked within the upper buccal sulcus, and all points are tattooed using the quill and methylene blue.

Video Summary

The modified Alard cleft lip repair marking process involves precise identification and marking of several key facial and lip features. First, the midline of the face, nose, and alar bases are outlined, along with the midline and base of the columella. Cupid's bow nadir is identified, often aided by locating the frenulum. Marks are made at the red-white lip junction and above the white roll. Cupids's bow peak on the non-cleft side is mirrored to the cleft side. Key points and flaps—Nordoff's point, rotation, C, advancement, M, and L flaps—are then marked, noting any height discrepancies, and tattooed for surgery.

Asset Subtitle

Surgical marking. Video 1 from "Update in Unilateral Cleft Lip Surgery" 148 (2) CME

Keywords

Alard cleft lip repair

facial marking

Cupid's bow

Nordoff's point

surgical tattooing