Comparison of surgical effects between the modified West China method and Millard method in repairing unila-teral cleft lip

doi:10.7518/hxkq.2022.03.010

Abstract

Abstract: Objective

The purpose of this study is to compare the surgical effects of the modified West China method and Millard methods for repairing unilateral cleft lip.

Methods

A total of 34 cases of unilateral cleft lip were analyzed, composed of 16 cases in the experimental group subjected to the modified West China method and 18 cases in the control group, which was subjected to the Millard method. Photographs before and after operation were compared, and SPSS 21.0 was used in statistical analysis.

Results

After operation, no significant difference in symmetry between the healthy and affected sides of the nasal alar foot (sba), nasal alar point (al), lip peak point (cph), and mouth angle point (ch) in the experimental group (P>0.05), but no significant difference in symmetry was found between healthy and affected sides of cph and ch in the control group (P>0.05). No significant differences in the symmetry rates of the sba, cph, ch and the nasal columella regression rates were found between the experimental and control groups (P>0.05). The symmetry rates of the al in the experimental group were higher (P<0.05).

Conclusion

For unilateral cleft lip repair, two methods had better effects on lip repair, but the nasal symmetry showed greater improvement when the modified West China me-thod was used than when the Millard method was used.

Key words: unilateral cleft lip, modified West China method, surgical effect

CLC Number:

R 782.2⁺1

Liu Xiaolin, Wang Yu, Feng Xiaowei, Liu Wenjing, Li Xiangjun.. Comparison of surgical effects between the modified West China method and Millard method in repairing unila-teral cleft lip[J]. West China Journal of Stomatology, 2022, 40(3): 309-313.

Figures/Tables 8

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Tab 1

Tab 2

Tab 3

References 15

1	Fan D, Wu S, Liu L,et al. Prevalence of non-syndromic orofacial clefts: based on 15,094,978 Chinese perinatal infants[J]. Oncotarget, 2018, 9(17): 13981-13990.
2	Millard DR Jr. The primary camouflage of the unilateral hare-look[C]//Transactions of the International Society of Plastic Surgeons. Stockholm: First Congress, 1957: 160-166.
3	石冰, 王晴. 个体化单侧唇裂修复术式的设计[J]. 华西口腔医学杂志, 1999, 17(3): 257-260.
	Shi B, Wang Q. A study of individual operation designs for unilateral cleft lip repair[J]. West Chin J Stomatol, 1999, 17(3): 257-260.
4	石冰, 王晴. 单侧唇裂手术设计的几何学解析[J]. 华西口腔医学杂志, 2000, 18(1): 30-33.
	Shi B, Wang Q. Geometrical analysis of operative designs in unilateral cleft liprepair[J]. West Chin J Stomatol, 2000, 18(1): 30-33.
5	石冰. 单侧唇裂的个体化整复[J]. 国际口腔医学杂志, 2015, 42(5): 497-502.
	Shi B. Individualized surgical management of unilateral cleft lip repair[J]. Int J Stomatol, 2015, 42(5): 497-502.
6	Ettorre G, Weber M, Schaaf H, et al. Standards for digital photography in cranio-maxillo-facial surgery-PartⅠ: basic views and guidelines[J]. J Craniomaxillofac Surg, 2005, 34(2): 65-73.
7	Farkas LG. Anthropometry of the head and face[M]. New York: Raven Press, 1994.
8	张睿, 张玲阁, 李喜红, 等. 梯度旋转下降法治疗单侧完全性唇裂效果评价[J]. 上海口腔医学, 2020, 29(1): 51-54.
	Zhang R, Zhang LG, Li XH, et al. Evaluation of the symmetry in nasolabial area of unilateral complete cleft lip with the method of rotation descent step by step[J]. Shanghai J Stomatol, 2020, 29(1): 51-54.
9	张睿, 郑谦, 石冰, 等. 唇裂术后鼻部对称性的变化及其影响因素[J]. 华西口腔医学杂志, 2011, 29(1): 31-35.
	Zhang R, Zheng Q, Shi B, et al. Evaluation of the symmetry rate of nasal floor width and the influencing factor after primary repair[J]. West Chin J Stomatol, 2011, 29(1): 31-35.
10	石冰, 李承浩. 唇鼻裂畸形整复石冰2017观点[M]. 北京: 科学技术文献出版社, 2017.
	Shi B, Li CH. Shi Bing’s 2017 viewpoint on cleft lip and nose deformity[M]. Beijing: Science and Technology Literature Publisher, 2017.
11	Millard DR Jr. Cleft Craft.vol 1: the unilateral deformity[M]. Boston: Little Brown & Company, 1976: 421-433.
12	He X, Shi B, Li S, et al. A geometrically justified rotation advancement technique for the repair of completeunilateral cleft lip[J]. J Plast Reconstr Aesthet Surg, 2009, 62(9): 1154-1160.
13	Xing H, Bing S, Kamdar M, et al. Changes in lip 1 year after modified Millard repair[J]. Int J Oral Maxillofac Surg, 2008, 37(2): 117-122.
14	Zhang R, Li J, Zheng Q, et al. Symmetry in nasolabial area of UCCL patients one year after primary lip repair with modified Millard technique[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(5 ): S11-S18.
15	Xu Y, Li J, Zhao S, et al. Four-dimensional changes ofnasolabial positions in unilateral cleft lip and palate[J]. J Craniofac Surg, 2013, 24(2): 473-478.

项目	术前			术后
项目	健侧	患侧	P值	健侧	患侧	P值
sba-VML	0.881 5±0.144 5	0.754 7±0.161 4	0.005	0.654 8±0.099 3	0.594 2±0.141 9	0.082
al-VML	1.129 5±0.159 0	1.011 8±0.189 0	0.005	0.970 6±0.111 8	0.924 5±0.125 8	0.141
cph-VML	0.493 1±0.113 4	0.627 9±0.182 3	0.010	0.274 0±0.093 5	0.302 2±0.093 1	0.444
ch-VML	1.103 1±0.165 8	1.170 3±0.186 6	0.073	1.046 1±0.142 9	1.038 0±0.197 7	0.900

项目		术前			术后
项目	健侧	患侧	P值	健侧	患侧	P值
sba-VML	0.873 0±0.139 7	0.777 2±0.105 0	0.000	0.743 0±0.127 0	0.623 9±0.092 1	0.001
al-VML	1.104 8±0.114 2	0.960 4±0.188 1	0.000	1.012 4±0.110 7	0.869 0±0.087 7	0.000
cph-VML	0.403 0±0.145 0	0.610 9±0.105 0	0.000	0.246 5±0.090 2	0.276 1±0.065 3	0.391
ch-VML	0.973 4±0.169 1	1.100 1±0.127 1	0.012	0.981 6±0.167 5	0.928 2±0.147 6	0.168

项目	试验组/%	对照组/%	P值
sba	82.91±12.29	84.37±12.64	0.736
al	90.91±8.25	61.88±8.08	0.000
cph	71.76±23.02	62.98±18.70	0.286
ch	85.52±10.87	87.08±8.55	0.644
sn回归率	34.71±98.87	51.14±25.27	0.527

[1]	Wei Mianxing, Zhang Chong, Shi Bing, Li Chenghao.. One-year clinical observation of muscular force balance reconstruction technique for the correction of secondary nasal malformation after cleft lip surgery [J]. West China Journal of Stomatology, 2023, 41(5): 563-567.
[2]	Chen Yu, Liu Yingmeng, Zhang Bihe, Zheng Qian, Shi Bing, Li Chenghao. Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity [J]. West China Journal of Stomatology, 2021, 39(6): 698-702.
[3]	Liu Yingmeng, Chen Yu, Zhang Bihe, Shi Bing, Li Chenghao. Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique [J]. West China Journal of Stomatology, 2021, 39(5): 560-565.
[4]	Li Hongyi, Kuang Hai, Wang Xiaomeng, Li Dongshuang. Three-dimensional analysis of alveolar changes of complete unilateral cleft lip patients after presurgical nasoalveolar molding treatment [J]. West China Journal of Stomatology, 2016, 34(4): 375-380.
[5]	Zhong Yuxiang, Li Wanshan, Li Yuangui, Chen Mengwei, Liao Lishu, Liang Li, Zuo Ding. Effective evaluation of presurgical nasoalveolar molding devices in the treatment of complete unilateral cleft lip and palate patients [J]. West China Journal of Stomatology, 2014, 32(2): 145-149.
[6]	LI Fang, WANG Jian-guo. Measurement of tooth length of upper canines in complete unilateral cleft lip and palate patients with conebeam computed tomography [J]. West China Journal of Stomatology, 2011, 29(02): 161-163.
[7]	Fang Bojun, Zhao Yongkang. Effects of Unilateral Cleft Lip and Palate Prothesis on the Development of Maxillary and Facial Soft Tissue [J]. West China Journal of Stomatology, 2001, 19(04): 225-228.