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Abstract
Unilateral cleft lip is a condition that is associated with significant deformity even when the cleft is minor or incomplete.(1) The cleft-side will display features including shortness of the normal side of the lip (1, 2) as well as a deficiency of skin, muscle, mucosa, and vermillion. Despite of the presence of the cupid’s bow on the cleft side it is rotated upward in cephalad direction (1,3). A number of studies described the abnormal arrangement of the muscle fibers on the cleft side that tend to run parallel to the cleft instead of traversing across the lip (4,5) .
The nasal deformity in both complete and incomplete UCL is complex, affecting the nasal tip, collumella, alar cartilage, lower lateral cartilage and the nasal septum .There is displacement of the lower lateral cartilage laterally and inferiorly on the cleft side. The nasal dome is flattened and turned or slumped in a downward position. In addition; the alar cartilage on the cleft side is flat and gives an apparent or false lengthening (27,28). These deformities are characteristic and hence referred to as the nasal stigmata of UCL.
These abnormalities also influence the muco-cutaneous tissues resulting in a group of well-defined characteristics. These include the displacement of the nostril skin towards the upper part of the lip, labial skin retraction and tissue abnormalities on either side of the muco-cutaneous junction hence affecting both the white roll and mucosa (6).
The literature is rich with scientific articles presenting different techniques, maneuvers, and protocols for management of UCL and its associated deformities. The present study reviewed the literature to critically analyze the surgical techniques of UCL repair as well as to answer a very common question ”which surgical technique should be used for which case?”
A comprehensive search of the international scientific literature using the search engines: Pubmed, Ovid Medline, and Science direct was performed. The keywords: ”unilateral cleft lip” and ”unilateral cleft lip repair” were used for the conducted search. The search was confined to publications in English up to January 2009. The automated search was then augmented by a manual search. The manual augmentation consisted of a search through the available relevant journals using the Egyptian medical library index for full articles that were not available online.