Raposo-Amaral Cassio Eduardo, Giancolli André Pecci, Denadai Rafael, Somensi Renato Salazar, Raposo-Amaral Cesar Augusto
From the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
J Craniofac Surg. 2014 Jan;25(1):308-13. doi: 10.1097/SCS.0000000000000521.
Characterizing the cutaneous upper lip height changes after unilateral cleft lip repair is very important to plan the surgical maneuvers, anticipate the need for overcorrection of the vertical dimension of the lips, and instruct the family on the postoperative outcomes. The aim of this study was to objectively analyze the asymmetry of upper lip height in patients with unilateral incomplete cleft lip who underwent Cutting extended Mohler repair.
A prospective study of consecutive patients with unilateral incomplete cleft lip who underwent primary lip repair without facial orthopedics was performed. Fifty children without craniofacial abnormalities were used as a control. Frontal view photographs taken at the preoperative (T0) period and early (3-5 months; T1) and late (12-14 months; T2) postoperative periods were used to measure the cutaneous upper lip height. A comparative analysis between affected and unaffected lip heights (control group: right and left sides, respectively) was accomplished using a computerized photogrammetric evaluation.
The patients with cleft lip (n = 9) showed a significant (P < 0.01) progressive reduction in lip asymmetry within the studied period (T0 > T1 > T2). The lip asymmetry was higher (P < 0.01) in the cleft lip group (n = 9) than in the control group (n = 50), except in the T2 period (P > 0.05). The average improvement of lip height during the first year after surgery was 9%.
There is a progressive reduction in lip asymmetry following primary lip repair. Patients with unilateral incomplete cleft lip presented lip height average similar to children with noncleft lip in the late postoperative period.
描述单侧唇裂修复术后上唇皮肤高度的变化对于规划手术操作、预测唇部垂直维度过度矫正的需求以及向家属说明术后结果非常重要。本研究的目的是客观分析接受Cutting改良Mohler修复术的单侧不完全性唇裂患者上唇高度的不对称性。
对连续接受一期唇裂修复且未进行面部正畸的单侧不完全性唇裂患者进行前瞻性研究。选取50名无颅面畸形的儿童作为对照。使用术前（T0）、术后早期（3 - 5个月；T1）和晚期（12 - 14个月；T2）拍摄的正位照片测量上唇皮肤高度。通过计算机摄影测量评估对患侧和未患侧唇高（对照组：分别为右侧和左侧）进行对比分析。
唇裂患者（n = 9）在研究期间（T0 > T1 > T2）唇不对称性有显著（P < 0.01）的逐渐降低。除T2期外（P > 0.05），唇裂组（n = 9）的唇不对称性高于对照组（n = 50）（P < 0.01）。术后第一年唇部高度的平均改善率为9%。
一期唇裂修复术后唇不对称性逐渐降低。单侧不完全性唇裂患者在术后晚期的唇高平均值与非唇裂儿童相似。
