Secondary Cleft Lip Reconstruction and the Use of Pedicled, Deepithelialized Scar Tissue.
BACKGROUND
The optimal time to create symmetry in a cleft lip is during primary repair; a secondary effort later is more difficult due to potential scarring and possible tissue deficiency of the repaired cleft lip. A plethora of methods for secondary correction have been described that have the goal of constructing the philtral column, ameliorating bad scar results, and augmenting lip volume, for example. Nevertheless, there is no single procedure that yields completely satisfactory results. In addition, the appropriate timing for secondary surgical corrections of the cleft lip is still under debate.


METHODS
We present a new technique for secondary lip reconstruction of unilateral and bilateral cleft patients using pedicled, de-epithelialized cleft scar tissue as an autologous graft to obtain sustainable lip volume. Our results were evaluated by physicians and patient-parent satisfaction surveys.


RESULTS
The esthetic outcomes of 29 patients were assessed using a patient satisfaction questionnaire and a physician survey based on the preoperative and postoperative clinical images. The success of the procedure was evaluated using a 5-point scale. The total scores of both the physician and patient assessments were high, although no correlation was found between the scores.


CONCLUSIONS
Cleft lip reconstruction using pedicled, deepithelialized scar tissue leads to excellent physician and patient satisfaction scores; this technique can be executed at any patient age and as a secondary repair for any given primary type of cleft disorder.
Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital/AZ MONICA Antwerp, Antwerp, Belgium; Faculty of Medicine & Health Sciences, Oral and Maxillofacial Surgery Research Group, University of Antwerp, Antwerp, Belgium; Maxillofacial Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Maxillofacial Surgery Unit, Bufalini Hospital, Cesena, Italy; and All for Research vzw, Antwerp, Belgium.
Nasser
N
Nadjmi
Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital/AZ MONICA Antwerp, Antwerp, Belgium; Faculty of Medicine & Health Sciences, Oral and Maxillofacial Surgery Research Group, University of Antwerp, Antwerp, Belgium; Maxillofacial Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Maxillofacial Surgery Unit, Bufalini Hospital, Cesena, Italy; and All for Research vzw, Antwerp, Belgium.
Sara
S
Amadori
Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital/AZ MONICA Antwerp, Antwerp, Belgium; Faculty of Medicine & Health Sciences, Oral and Maxillofacial Surgery Research Group, University of Antwerp, Antwerp, Belgium; Maxillofacial Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Maxillofacial Surgery Unit, Bufalini Hospital, Cesena, Italy; and All for Research vzw, Antwerp, Belgium.
Elke
E
Van de Casteele