Ibrahim, M., Abdel Halim, M., Abdelsalam, A., Mabrouk, A. (2022). A Prospective Comparative Study of ALA Repair between Modified Tajima Suture and Cinch Suture in Unilateral Cleft Lip Patients. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), 313-322. doi: 10.21608/ejprs.2022.254766
Mohamed K. Ibrahim; Mohamed M. Abdel Halim; Ahmed M. Abdelsalam; Amr A. R. Mabrouk. "A Prospective Comparative Study of ALA Repair between Modified Tajima Suture and Cinch Suture in Unilateral Cleft Lip Patients". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 3, 2022, 313-322. doi: 10.21608/ejprs.2022.254766
Ibrahim, M., Abdel Halim, M., Abdelsalam, A., Mabrouk, A. (2022). 'A Prospective Comparative Study of ALA Repair between Modified Tajima Suture and Cinch Suture in Unilateral Cleft Lip Patients', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), pp. 313-322. doi: 10.21608/ejprs.2022.254766
Ibrahim, M., Abdel Halim, M., Abdelsalam, A., Mabrouk, A. A Prospective Comparative Study of ALA Repair between Modified Tajima Suture and Cinch Suture in Unilateral Cleft Lip Patients. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(3): 313-322. doi: 10.21608/ejprs.2022.254766
A Prospective Comparative Study of ALA Repair between Modified Tajima Suture and Cinch Suture in Unilateral Cleft Lip Patients
The Department of Plastic Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Despite previous concerns of growth disturbances, primary correction of the cleft nose deformity is an internationally accepted and approved concept. In the evolution of cleft lip and nose deformity surgery, a move from a protocol without primary nasal reconstruction to a second one, but the patients had to have secondary nasal reconstruction in the growing period due to insufficient primary repair. Aim of the Work: The aim of this work is to assess Cinch suture as technique for ALA repair in unilateral cleft lip < br />regarding aesthetic outcome in comparison with modified Tajima suture. Patients and Methods: Prospective comparative study that was conducted on 20 children at Ain Shams University Hospitals throughout 6 months to assess Cinch suture. Results: From the results presented of the comparison between Cinch group and Tajima group regarding postoperative assessment of the studied patients, there was no statistically significant difference found between Cinch and Tajima regarding assessment of the studied patients except patients with straight on the philtral border was found with higher percentage in Cinch than Tajima with p-value=0.010. In further comparison between Cinch and Tajima regarding nose results among the patients, there was statistically significant difference found between Cinch and Tajima regarding hypoplastic flattened ALA, excessive wrapping of ALA, Narrow sil, large sill and defect of upper rim with pvalue= 0.010, 0.001, 0.003, 0.025 and 0.010 respectively while no statistically significant difference found between both groups regarding septal deviation, insufficient wrapping of ALA, columellar base too wide, low position and high position. In addition, the relation between Mortier score post-operative and the other studied parameters in Tajima, there was no statistically significant relation found between Mortier score post-operative and the other studied parameters in Cinch except only relation with patients with straight on the philtral border with p-value =0.006. Finally, in relation between Mortier score post-operative and the other studied parameters in Cinch, there was no statistically significant relation found between Mortier score post-operative and the other studied parameters in Cinch except only relation with patients with low position with p-value=0.003.
1- Parker S.E., Mai C.T., Canfield M.A., Rickard R., Wang Y., Meyer R.E. and National Birth Defects Prevention Network: Updated national birth prevalence estimates for selected birth defects in the United States, 2004-2006. Birth Defects Research Part A: Clinical and Molecular Teratology, 88 (12): 1008-1016, 2010. 2- James W.H.: Are oral clefts a consequence of maternal hormone imbalance? Evidence from the sex ratios of sibs of probands. Teratology, 62 (5): 342-345, 2000. 322 Vol. 46, No. 3 / ALA Repair by Modified Tajima Suture Vs Cinch Suture 3- Dixon M.J., Marazita M.L., Beaty T.H. and Murray J.C.: Cleft lip and palate: Understanding genetic and environmental influences. Nat. Rev. Genet, 12 (3): 167-78, 2011. 4- Desmedt D.J., Maal T.J. and Kuijpers M.A.: Nasolabial symmetry and esthetics in cleft lip and palate: Analysis of 3D facial images. Clin. Oral Investig., 19: 1833-1842, 2015. 5- Millard T. and Richman L.C.: Different cleft conditions, facial appearance, and speech: Relationship to psychological variables. The Cleft palate-craniofacial journal, 38 (1): 68-75, 2001. 6- Lithovius R.H., Lehtonen V., Autio T.J., Harila V., Anttonen V., Sándor G.K. and Ylikontiola L.P.: The association of cleft severity and cleft palate repair technique on hearing outcomes in children in northern Finland. Journal of Cranio-Maxillofacial Surgery, 43 (9): 1863-1867, 2015. 7- Chow I., Purnell C.A., Hanwright P.J., A.K. J.P. Gosain and R. Surgery: "Evaluating the rule of 10s in cleft lip repair: do data support dogma?" 138 (3): 670-679, 2016. 8- Mossey P.A., Little J., Munger R.G., Dixon M.J. and W.C. J.T.L.: "Cleft lip and palate", 374 (9703): 1773-1785, 2009. 9- Tajima S.A.D.A.O. and Maruyama M.A.S.A.R.U.: Reverse- U incision for secondary repair of cleft lip nose. Plastic and Reconstructive Surgery, 60 (2): 256-261, 1977. 10- Millard D.R.: The alar cinch in the flat, flaring nose. Plastic and Reconstructive Surgery, 65 (5): 669-672, 1980. 11- Collins P.C. and Epker B.N.: The alar base cinch: A technique for prevention of alar base flaring secondary to maxillary surgery. Oral Surgery, Oral Medicine, Oral Pathology, 53 (6): 549-553, 1982. 12- Mortier P.B., Martinot V.L., Anastassov Y., Kulik J.F., Duhamel A. and Pellerin P.N.: Evaluation of the results of cleft lip and palate surgical treatment: Preliminary report. The Cleft palate-craniofacial journal, 34 (3): 247- 255, 1997. 13- Allam E., Windsor L. and Stone C.: Cleft lip and palate: Etiology, epidemiology, preventive and intervention strategies. Anat. Physiol., 4 (3): 1-6, 2014. 14- Ammar H., Elprince N.H., Khalil A.A.F. and Sweedan A.O.: Comparison of rotation-advancement and straight-line methods for repairing of unilateral cleft lip (a randomized controlled clinical trial). Alexandria Dental Journal, 2022. 15- Losee J.E., Kirschner R.E., Smith D.M., Straub A.E. and Lawrence C. (Eds.): Comprehensive Cleft Care: Family Edition. CRC Press/Taylor & Francis Group, 2015. 16- Jackson I., Michael L. Bentz, Bruce S. Bauer, Ronald M. Zuker (Eds): Principles and practice of pediatric plastic surgery, 2008. 17- Marc C.S. and David M.F.: Cleft lip. In: Ross Farhadieh, Neil Bulstrode, Sabrina Cugno (ed) Plastic and Reconstructive Surgery: Approaches and Techniques, 1st ed. Pondicherry, India Wiley Blackwell, 2015. 18- Kuna S.K., Srinath N., Naveen B.S. and Hasan K.: Comparison of outcome of modified Millard's incision and Delaire's functional method in primary repair of unilateral cleft lip: A prospective study. Journal of maxillofacial and oral surgery, 15 (2): 221-228, 2016. 19- Reddy S.G., Reddy R.R., Bronkhorst E.M., Prasad R., Jagtman A.M.K. and Bergé S.: Comparison of three incisions to repair complete unilateral cleft lip. Plastic and Reconstructive Surgery, 125 (4): 1208-1216, 2010. 20- Roussel L.O., Myers R.P. and Girotto J.A.: The Millard rotation-advancement cleft lip repair: 50 years of modification. The Cleft Palate-Craniofacial Journal, 52 (6): 188- 195, 2015. 21- Mbuyi-Musanzayi S., Katombe F.T., Tshilobo P.L., Kayamba P.K.M., Devriendt K. and Reychler H.: Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique. International Journal of Oral and Maxillofacial Surgery, 46 (10): 1338-1345, 2017. 22- Funayama E., Yamamoto Y., Furukawa H., Murao N., Shichinohe R., Hayashi T. and Oyama A.: A new primary cleft lip repair technique tailored for Asian patients that combines three surgical concepts: Comparison with rotation- advancement and straight-line methods. Journal of Cranio-Maxillofacial Surgery, 44 (1): 27-33, 2016. 23- Patel T.A. and Patel K.G.: Comparison of the Fisher anatomical subunit and modified Millard rotationadvancement cleft lip repairs. Plastic and Reconstructive Surgery, 144 (2): 238e-245e, 2019. 24- Othman S.A., Majawit L.P., Wan Hassan W.N., Wey M.C. and Mohd Razi R.: Anthropometric study of threedimensional facial morphology in Malay adults. PloS one, 11 (10): e0164180, 2016. 25- Zreaqat M., Hassan R. and Halim A.S.: Facial dimensions of Malay children with repaired unilateral cleft lip and palate: A three dimensional analysis. International journal of oral and maxillofacial surgery, 41 (6): 783- 788, 2012.
View on SCiNiTO
Top