title: Median cleft of the upper lip: A new classification to guide treatment decisions.
abstract: Median cleft of the upper lip (MCL) is a specific and rare entity on the spectrum of facial clefts. MCL have different clinical expressions and can be either isolated or part of multiple malformations. Confusion still exists regarding the explanation and classification of MCL; some cases have been reported in the literature, but no studies carried out a complete review of the literature. This study reviewed cases of MCL in 2 French units and conducted a systematic review of the literature, in order to derive a new classification. Fourteen patients with MCL in the 2 units and 195 cases in the literature were reviewed. They involved complete (42%), incomplete (49%), and minor forms (9%). Epidemiological and clinical data were collected, from which a classification was derived, based on the type of cleft and its belonging to other syndrome(s). Three main groups were distinguished, namely, isolated MCL, MCL within craniofacial malformations, and MCL with extrafacial malformations. Each group and subgroup was associated with a prognosis and led to specific management. This study reviewed all of the various forms of MCL and their associated anomalies, in order to have a global view of MCL and to derive a useful classification scheme to guide management of care.
authors.affiliation: Department of Oral, Maxillo-facial and Plastic Surgery, CHRU Montpellier, Gui De Chauliac University Hospital, 80 avenue augustin Fliche, 34295 Montpellier cedex 5, France. Electronic address: madeboutray@hotmail.com.
authors.forename: Marie
authors.initials: M
authors.lastname: de Boutray
authors.affiliation: Maxillo-facial Surgery Unit, Groupement Hospitalier Lyon Nord, 103 grand rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Beziat
authors.affiliation: Department of Oral, Maxillo-facial and Plastic Surgery, CHRU Montpellier, Gui De Chauliac University Hospital, 80 avenue augustin Fliche, 34295 Montpellier cedex 5, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Yachouh
authors.affiliation: Department of Plastic Pediatric and Craniofacial Surgery, CHRU Montpellier, Hôpital Lapeyronie, 325 avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Bigorre
authors.affiliation: Maxillo-facial Surgery Unit, Groupement Hospitalier Lyon Nord, 103 grand rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gleizal
authors.affiliation: Department of Plastic Pediatric and Craniofacial Surgery, CHRU Montpellier, Hôpital Lapeyronie, 325 avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Captier
mesh_terms: D002971:Cleft Lip / Q000145:classification* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008046:Lip / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D008297:Male
keywords: Frontonasal dysplasia; Holoprosencephaly; Median cleft lip; Midline cleft