Unilateral Incomplete Cleft Lip Aesthetics With Fisher Repair Compared To Modified Mohler Repair

Purpose:Evaluating subjectively and objectively the appearance of children at different time periods after surgery to explore the postoperative effects of Fisher repair comparing to modified Mohler repair in repairing incomplete unilateral cleft lip.It provides valuable reference for clinical treatment.Methods:a retrospective study was conducted on the patients with incomplete unilateral cleft lip who underwent surgery in the Department of Stomatology of Shenzhen Children’s Hospital from 2017.Jan.to 2019.June.A total of 55 patients were included in the study.25 patients underwent modified Mohler repair and 30patients underwent Fisher repair.Two groups were evaluated objectively and subjectively.The data of lip length,lip height,width of nasal floor,height of nasal columella and height of philtrum crest were obtained.The appearance of white lip,red lip,scar and symmetry of nostril were also observed.The data of the two groups at 1 week and 1 year after operation were compared.Results:Objective evaluation parameters were tested by two-sample t-test and subjective evaluation parameters were tested byχ~2test.One week after operation,in the objective evaluation,two groups were significant difference in the nasal floor width difference of healthy and affected sides(P<0.05).In subjective evaluation,in terms of white lips and red lips,the two groups mainly evaluated"good"(>60%).In terms of nostril symmetry,Fisher repair group was superior to the modified Mohler repair group(P<0.05).One year after operation,Two groups were significant difference in the lip height difference,nasal floor width,and height difference of philtrum crest between healthy and affected sides(P<0.05).In Fisher repair group,lip appearance is better in the height of lip,width of nasal floor and height of philtrum crest.In observation subjectively,There were no significant differences in red lip,scar appearance and nostril symmetry between the two groups(P>0.05).The"good"ratio of scar appearance and red lip in the two groups was increased compared with that in the first week after surgery.Compared with modified Mohler repair group,Fisher repair group was superior in white lip(P<0.05)Conclusion:Both methods can significantly improve the appearance of children with cleft lip.The modified Mohler repair is accepted by clinicians because of its clear design.However,there are still some problems such as insufficient decrease of lip height,which require lip revision in future.Compared with modified Mohler repair,Fisher repair has improved outcomes of lip height and nasal deformity,even though we also observed that some children have over normal length of lip height in clinic.whether Fisher repair has result in better aesthetic outcomes than modified Mohler repair or so still needs long time follow-up study.