An Anatomical Study And Clinical Research Of Repair Of Unilateral Cleft Lip And Its Secondary Deformities

According to the published data of the nationwide survey of the birth rate of congenital deformities in China in 1989, each year, our country has 200,000 new born babies affected with cleft lip or palate. Together with the already existed deformed children and adults, the total number of cleft lip and palate patients must be over one million. This is really alarming. An anatomical study and clinical research aiming to better the repair of unilateral cleft lip and its secondary deformity is therefor very valuable.Currently, the popular methods for unilateral cleft lip repair are the Tennison's Triangular Flap technique and the Millard's Rotation-Advancement operation, both of which produce satisfactory results. However, the former technique is based on the theory that the deformity is caused by a deficiency of tissue at the lower part of the lip, so, a triangular flap is transposed to the lower part of the deformed lip, whereas the later operation is based on the theory that the deformity is caused by an upward displacement of the upper lip, so, a curved incision is made at the naso labial junction to rotate down the upwardly displaced lip segment . Thus, basically, they are two different measures.After Tennison had published his technique in 1952, Marcks, Trevaskis, Dacosta, Cronin, Buauer, Randall, and many other expert valuable improvements. Nevertheless, after Millard published his operation in 1955, only he himsellf made improvements on the operation in 1960, 1968, 1987 and 1990. We believe the later also needs improvement.In the past, in improving the Tennison's technique, plastic surgeons used to try to change the formation and transportation of the triangular flap. At the present, we use a different way. We carried out an anatomical research and clinical study to find out the material basis of the normal and the deformed form and function of the nose and upper lip. We have found, two new findings and developed two improved methods as follows,1.The "M.Levator Septi Nasi". This is a new muscle that we found during our gross anatomical dissection and histological examination on the nose and upper lip of 18 cadaver specimens. This muscle is the antagonist of the known Depressor Septi Nasi muscle. Similar to the later, Levator Septi Nasi muscle is also both a nasal muscle and a component of the Orbicularis Oris muscle. In unilateral cleft lip, since the M. Depressor Septi Nasi is wearened by the cleft and the M. Levator Septi Nasi becomes stronger than normal, the medial segment of the upper lip is drawn upward. Hence, a curved incision at the nasolabial junction is needed to lower down the upwardly displaced upper lip.2. The improve Millard I and Millard II operation. In this new or...