title: Intraoperative vascular anatomy, arterial blood flow velocity, and microcirculation in unilateral and bilateral cleft lip repair.
abstract: BACKGROUND
  Cleft lip repair aims to normalize the disturbed anatomy and function. The authors determined whether normalization of blood circulation is achieved.
  
  
  METHODS
  The authors measured the microcirculatory flow, oxygen saturation, and hemoglobin level in the lip and nose of controls (n = 22) and in patients with unilateral and bilateral cleft lip-cleft palate. The authors measured these parameters before lip repair (n = 29 and n = 11, respectively), at the end of lip repair (n = 27 and 10, respectively), and in the late postoperative period (n = 33 and n = 20, respectively). The arterial flow velocity was measured in unilateral groups at the same time points (n = 13, n = 11, and n = 12, respectively). Statistical differences were determined using analysis of variance.
  
  
  RESULTS
  Before surgery, the arterial flow velocities and microcirculation values were similar on each side of the face and between groups. The microcirculatory flow was significantly higher in the prolabium of bilateral patients than in the philtrum of controls. All circulation values in unilateral and bilateral patients in the late postoperative period were within the range of controls and of those before surgery. Intraoperatively, the authors consistently found a perforating artery on the superficial side of the transverse nasalis muscle.
  
  
  CONCLUSIONS
  There appears to be no intrinsic circulatory deficit in unilateral and bilateral cleft lip-cleft palate patients. The increased flow in the prolabium indicates a strong hemodynamic need in this territory, compelling its vascular preservation. Whether surgical preservation of the nasalis perforator artery is of long-term benefit should be addressed in future studies.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Basel and Zurich, Switzerland; and Saidabad, Hyderabad, India From Craniomaxillofacial Surgery, University Hospital Basel; the Hightech Research Center of Craniomaxillofacial Surgery, University of Basel; the G. S. R. Institute of Craniomaxillofacial and Facial Plastic Surgery; the Anatomical Institute, Macroanatomy and Muskuloskeletal Anatomy, Laboratory for Functional Macromorphology; and Cleft-Children International CCI.
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Mueller
authors.forename: Dieter
authors.initials: D
authors.lastname: Schumann
authors.forename: Rajgopal R
authors.initials: RR
authors.lastname: Reddy
authors.forename: Katja
authors.initials: K
authors.lastname: Schwenzer-Zimmerer
authors.forename: Magdalena
authors.initials: M
authors.lastname: Mueller-Gerbl
authors.forename: Hans-Florian
authors.initials: HF
authors.lastname: Zeilhofer
authors.forename: Hermann F
authors.initials: HF
authors.lastname: Sailer
authors.forename: Srinivas Gosla
authors.initials: SG
authors.lastname: Reddy
mesh_terms: D001783:Blood Flow Velocity; D002971:Cleft Lip / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D002972:Cleft Palate / Q000097:blood / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007432:Intraoperative Period; D008046:Lip / Q000098:blood supply* / Q000502:physiology*; D008833:Microcirculation / Q000502:physiology; D009666:Nose / Q000098:blood supply* / Q000502:physiology*
chemical_list: D006454:Hemoglobins