Changes in the length over time to the triangular flap in the Cronin method

Abstract

ObjectiveIn initial cheiloplasty, inserting a triangular flap into the lower third of the upper lip is effective in reliably pulling down the cleft in Cupid’s bow. Measuring the length and designing the triangular flap are easier with the Cronin method than with other surgical techniques, and this method may be seen as a technique with which relatively stable results can be obtained with less dependence on the skill and experience of the surgeon. As the patient grows, however, the prepared flap increases in size. This study measured the shape of the triangular flap prepared with the Cronin method and separately investigated changes in size over time. MethodsThe subjects were 65 patients who underwent initial surgery for unilateral cleft lip using the Cronin method. The length of each side of the triangular flap was measured on the most recent outpatient visit, and changes in the length of each side over time were investigated separately in males and females. The ratio of the triangular flap to the total length of the philtrum was also investigated. ResultsIncreases on all sides of the triangular flap were seen over time, with the length approximately doubling by the period of adolescence. The increase was not only in the vertical direction, but also in the horizontal direction, so that the flap occupied approximately 40% of the skin of the upper lip. ConclusionThe triangular flap stretches with growth, and becomes conspicuous in some patients as a scar.