Unilateral Cleft Lip

A unilateral cleft lip is a congenital deformity that includes a deformity of the lip as well as alveolus and nose. Children born with this condition require multiple surgeries. No worldwide surgical agreement has been obtained as to timing and technique of unilateral cleft lip surgery which indicates that there are several treatment options for this deformity’s definitive repair.

Unilateral cleft lip:

In cleft lip, the baby’s lip does not join properly and leaves an open space called cleft. This condition can happen on both sides of the face (bilateral) or on one side (unilateral). The exact cause of this congenital condition remain unknown, however, it is considered that genetic factors are responsible for a small number of cases.

The baby’s mouth develops in two halves late in the first month of pregnancy. Somewhere around the forth months of pregnancy, the two halves of the hard palate join together and figure the mouth roof. Then, the fusing develops forward and backward to seal the lips and uvula. By the end of forth month, the mouth and nose are fully formed. However, in children with a cleft lip or cleft palate (or both) the two halves of the lip or palate do not join normally. These conditions vary in severity and extent.

Different types of cleft lip

Unilateral cleft lip affects more commonly Asians and Americans. One out of 690 born children is affected by this facial defect. The various types include:

Microform

The discontinuity of the vermilion cutaneous junction is less than 3 mm. other characteristics may include:

variable muscular indent along the philtral line
Subtle nasal asymmetry
Variable deficiency of vermilion medial to cleft
Variable alveolar defect

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Minor form

The subnasal difference to Cupid’s bow peak distance between sides is more than 3 mm. Other characteristics may include:

The orbicularis oris is interrupted
The philtral line depression is prominent
The nasal asymmetry is more
Posteroinferior is dislocated of the piriform aperture (in cleft lip side)
Alveolar cleft

Incomplete

Full-thickness disjunction of the upper lip occurs. In this type of unilateral cleft lip the upper lip, nasal sill, and floor are continuous though depressed.

Complete

The full-thickness disjunction of the lip extends into the nasal cavity and the alveolus is discontinued.

Cleft lip repair surgery

Cleft repair operation involves fusing the tissues that are separated. There are several different techniques performed by the surgeon, therefore the surgical procedures may also vary. The most prevalent type of this surgery is a rotation advancement repair.

Unilateral cleft lip surgery is done by a plastic or ENT surgeon. He/she makes an incision on each side of the cleft that extends from the lip to the nostril. Then, the surgeon uses tissues from the area to reshape the lip and suture two sides of it together. Further, the muscles of the upper lip are realigned to accelerate suckling and provide normal lip function.

Prior to lip repair, a nasal repair is often performed. In nasal repair surgery the surgeon releases some nasal elements and changes them to a more normal form using stents and sutures. After the operation, the surgeon often uses nasoalveolar molding to preserve the correction.

Cleft lip repair surgery is usually performed between 3 _6 months of age. Children born with this condition are monitored closely for enough nutrition and weight gain to assure that they have no problem associated with breathing while eating.

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