Dynamic reconstruction of the philtrum using coronal muscle splitting technique in microform cleft lip.
OBJECTIVE
The philtral column and dimple are especially important in patients with cleft lip. Recently, we have found that, at maximal puckering, the appearance of the philtrum worsens although the philtral column is well formed at rest. In this study, we explore the effectiveness of the coronal muscle splitting technique in a microform cleft lip through comparative analysis of the postoperative results between the control group (patients without coronal muscle splitting) and the study group (patients with coronal muscle splitting).


METHODS
Philtral reconstruction was performed in 24 patients with microform cleft lip between March 2006 and March 2010. The philtrum was reconstructed in 12 patients using the coronal muscle splitting technique and in the other 12 patients without this technique. The convexity of the philtral column and the dimpling of the philtrum were evaluated at rest and at maximal puckering through digital photographs and videos taken preoperatively and postoperatively. In addition, we compared the postoperative results between the 2 groups using the paired t-test.


RESULTS
Postoperative evaluation was done at 6 to 48 months (mean, 25 mo). There was no statistically significant difference in the shape of the philtral column and the philtral dimple between the 2 groups preoperatively (P > 0.05). Reconstruction of the philtral column in the study group rendered better results than in the control group at both rest and maximal puckering (P < 0.001 and P < 0.001). Reconstruction of the philtral dimple in the study group rendered better results than in the control group at both rest and maximal puckering (P = 0.018 and 0.035).


CONCLUSIONS
The coronal muscle splitting technique offers more esthetic and functional results in the formation of the philtral column and dimple both at rest and at maximal puckering than in the control group in cases of philtral reconstruction of the microform cleft lip.
From the *Department of Plastic and Reconstructive Surgery, Institute of Human-Environment Interface Biology, Seoul National University College of Medicine, Seoul, Republic of Korea; and †Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.
Sukwha
S
Kim
Juyong
J
Kwon
Geun-Yong
GY
Kwon
Tae Hyun
TH
Choi
D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D004954:Esthetics; D005149:Facial Expression; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000601:surgery*; D008297:Male; D010781:Photography / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D014741:Video Recording / Q000379:methods