Upper double-rotation advancement method for unilateral cleft lip repair of severe forms: Classification and surgical technique

Background: The purpose of this study was to evaluate the symmetry in lip height and lip width after double-rotation advancement unilateral cleft lip repair. Study Desing: This was a retrospective audit of 1 surgeon's outcome of 72 consecutively performed unilateral cleft lip with short lateral segment. Two hundred fifty patients with unilateral cleft lip were operated on using the upper double-rotation advancement technique since 2007. Of those patients, 72 met the study criterion of having anthropometric measurements performed at least 1 year postoperatively. Data Collection: Measurement of lip height, lip width, vermilion height, and alar base width was performed at the cleft and noncleft side under general anesthesia, immediately before the lip (preoperative) and palate (postoperative) surgery. The lip measurements were obtained using calipers. The matched-pair t-test analyses were performed when the assumptions required were met. When the normality assumption was not met, a nonparametric test was used, the Wilcoxon signed rank test, to assess the statistical significance of differences between the cleft side and the noncleft side. Results: The study found no statistically significant differences between cleft-side and noncleft-side lip height (P = 0.058), lip width (P = 0.295), and vermilion height (P = 0.237) after lip repair. Conclusions: The findings suggest that the upper double-rotation and advancement technique is a good alternative to repair short lateral segment and severe forms of unilateral cleft lip.