Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study
Background: Cleft lip and palate, which affects 0.5–1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap)...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2024;volume=21;issue=1;spage=18;epage=27;aulast=Mabrouk |
| _version_ | 1797225913232916480 |
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| author | Mohamed M Mabrouk Khaled Salah Abdullateef Ayman Hussein Abdelsattar Mohamed Elbarbary Sherif Kaddah Wesam Mohamed |
| author_facet | Mohamed M Mabrouk Khaled Salah Abdullateef Ayman Hussein Abdelsattar Mohamed Elbarbary Sherif Kaddah Wesam Mohamed |
| author_sort | Mohamed M Mabrouk |
| collection | DOAJ |
| description | Background: Cleft lip and palate, which affects 0.5–1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap) from the lateral lip element were employed by Mishra to modify Millard's technique to create the vermilion and white roll on the medial lip segment. This study aimed to use the anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with WRV flap technique in unilateral cleft lip (UCL) repair. Materials and Methods: Prospective, randomised controlled study recruited infants scheduled for UCL repair. Infants aged 3–6 months, either complete or incomplete deformity. A total of 42 patients were randomized in 1:1 ratio to undergo either WRV flap technique (group A) or modified Millard technique (group B) and another control included 21 age-matched healthy children. We compared WRV flap procedure to Modified Millard's procedure in terms of both qualitative (another surgeon's opinion) and quantitative (anthropometric) evaluation. Results: Vertical lip length and philtral lip height significantly longer in Millard group (B) than WRV flap group (A) in immediate postoperative assessment and nasal width was significantly wider in WRV flap group (A) than Millard group (B) in 3-month post-operative assessment. The lip shape, the vermilion shape was better in Millard technique than WRV flap technique; however, this was statistically insignificant. However, no major difference in the overall results between the WRV flap and Millard rotation-advancement repairs. Conclusion: Anthropometric measurement of surgical outcome evaluates the surgical technique used and helps to compare between cleft and non-cleft side showing the degree of deformity and we used subjective assessment to analyse facial aesthetics. Overall results demonstrate no significant differences between modified Millard technique and WRV flap technique. |
| first_indexed | 2024-03-07T21:36:55Z |
| format | Article |
| id | doaj.art-bf33fee7ceab48bb9da5cd0538c59989 |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-04-24T14:16:34Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-bf33fee7ceab48bb9da5cd0538c599892024-04-03T08:45:17ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252024-01-01211182710.4103/ajps.ajps_20_23Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled studyMohamed M MabroukKhaled Salah AbdullateefAyman Hussein AbdelsattarMohamed ElbarbarySherif KaddahWesam MohamedBackground: Cleft lip and palate, which affects 0.5–1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap) from the lateral lip element were employed by Mishra to modify Millard's technique to create the vermilion and white roll on the medial lip segment. This study aimed to use the anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with WRV flap technique in unilateral cleft lip (UCL) repair. Materials and Methods: Prospective, randomised controlled study recruited infants scheduled for UCL repair. Infants aged 3–6 months, either complete or incomplete deformity. A total of 42 patients were randomized in 1:1 ratio to undergo either WRV flap technique (group A) or modified Millard technique (group B) and another control included 21 age-matched healthy children. We compared WRV flap procedure to Modified Millard's procedure in terms of both qualitative (another surgeon's opinion) and quantitative (anthropometric) evaluation. Results: Vertical lip length and philtral lip height significantly longer in Millard group (B) than WRV flap group (A) in immediate postoperative assessment and nasal width was significantly wider in WRV flap group (A) than Millard group (B) in 3-month post-operative assessment. The lip shape, the vermilion shape was better in Millard technique than WRV flap technique; however, this was statistically insignificant. However, no major difference in the overall results between the WRV flap and Millard rotation-advancement repairs. Conclusion: Anthropometric measurement of surgical outcome evaluates the surgical technique used and helps to compare between cleft and non-cleft side showing the degree of deformity and we used subjective assessment to analyse facial aesthetics. Overall results demonstrate no significant differences between modified Millard technique and WRV flap technique.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2024;volume=21;issue=1;spage=18;epage=27;aulast=Mabroukmillard techniqueunilateral cleft lipwhite roll vermilion turn down flap technique |
| spellingShingle | Mohamed M Mabrouk Khaled Salah Abdullateef Ayman Hussein Abdelsattar Mohamed Elbarbary Sherif Kaddah Wesam Mohamed Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study African Journal of Paediatric Surgery millard technique unilateral cleft lip white roll vermilion turn down flap technique |
| title | Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study |
| title_full | Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study |
| title_fullStr | Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study |
| title_full_unstemmed | Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study |
| title_short | Comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair: A randomised controlled study |
| title_sort | comparative study between modified millard and white roll vermilion flap techniques in unilateral lip repair a randomised controlled study |
| topic | millard technique unilateral cleft lip white roll vermilion turn down flap technique |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2024;volume=21;issue=1;spage=18;epage=27;aulast=Mabrouk |
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