Correcting the secondary bilateral cleft lip deformities using an innovative partial-thickness musculomucosal pedicle cross-lip flap

Abstract

Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip. We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap. Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities. The central defects usually occurred in these patients. The defects were reconstructed partially or completely according to the severities of the defects. The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided. Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect. Results All 98 musculomucosal pedicle flaps were viable. The upper lips were reconstructed according to the severities. Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity. It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities. Key words: Bilateral clefit lip; Secondary deformity cleft lip; Cross-lip flap; Upper lip deformity