J Korean Assoc Oral Maxillofac Surg.  2019 Jun;45(3):141-151. 10.5125/jkaoms.2019.45.3.141.

Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment

• Adetayo AM
• Adetayo MO
• Adeyemo WL
• James OO
• Adeyemi MO

• KMID: 2451321
• DOI: http://doi.org/10.5125/jkaoms.2019.45.3.141

Abstract

OBJECTIVES
The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments.
MATERIALS AND METHODS
This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues.
RESULTS
Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups.
CONCLUSION
Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

Keyword

Unilateral cleft lip; Repair techniques; Evaluation of surgical outcome

MeSH Terms

Cicatrix
Cleft Lip*
Evaluation Studies as Topic
Female
Hospitals, Teaching
Humans
Lip
Male
Nose
Prospective Studies
Strikes, Employee
Treatment Outcome*

Figure

• 

  Fig. 1 A 4-month-old female with right unilateral cleft lip and alveolus, preoperative picture (A) and postoperative picture (B) showing a repair with the Millard technique that the guardian judged to be satisfactory. A 4-month-old female with right unilateral cleft lip alveolus and palate, preoperative picture (C) and postoperative picture (D) showing a repair with the Tennison–Randall technique that the guardian judged to be satisfactory.

• 

  Fig. 2 A. Postoperative clinical picture of a 6-month-old male following Millard repair showing scar transgression of the philtral ridge (arrow). B. Postoperative clinical picture of a 6-month-old female following Tennison–Randall repair showing scar transgression of the philtral ridge (arrow).

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