Assistant Professor of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Ibb University, Ibb, Yemen.
Professor of Pediatric Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Oral Maxillofac Surg. 2024 Aug;82(8):944-952. doi: 10.1016/j.joms.2024.04.006. Epub 2024 Apr 16.
Since the primary goal of cleft lip repair is to achieve a symmetrical, aesthetic lip, several surgical techniques have been utilized. Accordingly, in this study, a unilateral cleft lip was surgically repaired using two techniques: modified Millard's and Fisher's techniques.
This study was designed to compare the vermillion symmetry and scar quality in the surgical management of patients with unilateral incomplete cleft lip using the modified Millard's and Fisher's techniques.
STUDY DESIGN, SETTING, AND SAMPLE: We conducted a prospective randomized controlled clinical study. The study involved 20 patients selected from the Department of Plastic Pediatric Surgery at the Specialized Pediatric Hospital, Faculty of Medicine, Cairo University. The patients included in the study were aged between 2 and 6 months old, had a primary nonsyndromic unilateral incomplete cleft lip, and had no other associated anomalies.
The predictor variable was operative management of the cleft lip, and subjects were randomly assigned to either the modified Millard or Fisher techniques.
The primary outcome, vermillion symmetry, was evaluated by computerized photogrammetric lip analysis with Image J software. Additionally, scar quality, considered a secondary outcome, was assessed with the Vancouver Scar Scale and the Image J software. Every measurement was meticulously recorded in millimeters.
Age, sex, and cleft side were considered.
Descriptive and analytic statistics were computed. Statistical significance was set at P < .05.
The study comprised 20 children (12 males and 8 females), with a mean age of 140.5 ± 23.7 days in the Fisher's group and 137.4 ± 25.6 days in the modified Millard's group (P = .8). No statistically significant differences (P = .6) were found in vermillion height and width between both groups at 1 week, 3 months, and 6 months. Similarly, there were no statistically significant differences (P = .4) between both groups in terms of scar length and width at the 3- and 6-month follow-up periods.
This study found no statistically significant differences in vermillion symmetry and scar quality between the two cleft lip repair techniques. Notably, one patient in the modified Millard group exhibited a notch on the vermillion border, which was not statistically significant.
由于唇裂修复的主要目标是实现对称、美观的嘴唇，因此已经采用了几种手术技术。因此，在这项研究中，我们使用改良的 Millard 法和 Fisher 法对单侧唇裂进行了手术修复。
本研究旨在比较改良的 Millard 法和 Fisher 法在单侧不完全性唇裂患者手术治疗中的唇红对称性和瘢痕质量。
研究设计、地点和样本：我们进行了一项前瞻性随机对照临床试验。该研究纳入了来自开罗大学医学院特种儿童医院整形外科的 20 名单侧不完全性唇裂患者。纳入研究的患者年龄在 2 至 6 个月之间，患有原发性非综合征性单侧不完全性唇裂，且无其他相关畸形。
预测变量为唇裂的手术治疗，受试者被随机分配至改良 Millard 法或 Fisher 法组。
使用 Image J 软件的计算机摄影测量唇分析评估唇红对称性，这是主要结局变量。此外，使用温哥华瘢痕量表和 Image J 软件评估瘢痕质量，这是次要结局变量。每一个测量值都以毫米为单位进行了仔细的记录。
考虑了年龄、性别和裂侧。
计算了描述性和分析性统计数据。统计学意义设为 P<0.05。
该研究共纳入 20 名儿童（男 12 名，女 8 名），Fisher 组的平均年龄为 140.5±23.7 天，改良 Millard 组的平均年龄为 137.4±25.6 天（P=0.8）。两组在术后 1 周、3 个月和 6 个月时，唇红高度和宽度均无统计学差异（P=0.6）。同样，两组在 3 个月和 6 个月的随访期间，瘢痕长度和宽度也无统计学差异（P=0.4）。
本研究发现，两种唇裂修复技术在唇红对称性和瘢痕质量方面无统计学差异。值得注意的是，改良 Millard 组中有 1 名患者的唇红边缘出现切迹，但无统计学意义。
