Primary Repair of Unilateral Complete Cleft Lip and Nose Deformities

Primary repair of unilateral cleft lip with primary rhinoplasty.

Repair of lip defects and associated congenital cleft nasal deformity

Surgery should be delayed or staged if there are significant medical comorbidities

11 blade or 30 degree ophthalmic blade
15 Blade
4-0 vicryl
5-0 Chromic
5-0 PDS
5-0 vicryl
6-0 fast absorbing plain gut
converse scissors
dermabond
fine and wide double prong skin hooks
Fine forceps
fine marking pen
fine needle driver
iris scissors

Standard soft tissue instrumentation and simple towels and drapes. An oral RAE tube should be used for intubation.

The author does not perform any further imaging or work up beyond what was deemed medically appropriate for evaluating this child in infancy after the diagnosis of cleft lip was made. If syndromic features are present, and echocardiogram may be prudent.

An understanding of the aberrant muscular attachments and cartilaginous positioning will improve the surgeon's understanding of the primary unilateral cleft lip and nose deformity and therefore the optimal steps to correct these problems.

Bleeding, infection, breakdown of flap, soft tissue nasal stenosis, hypertrophic scarring, need for additional procedures

None

Mohler LR. Unilateral cleft lip repair. Plast Reconstr Surg 1987, 80(4):511-516
Fisher D.M. Unilateral cleft lip repair: an anatomical subunit approximation technique. Plast Reconstr Surg 2005; 116(1): 61-71.
Tse R. Unilateral Cleft Lip: Principles and Practice of Surgical Management. Semin Plast Surg. 2012 Nov; 26(4): 145–155.