J Korean Assoc Oral Maxillofac Surg.  2012 Dec;38(6):360-365. 10.5125/jkaoms.2012.38.6.360.

Repair of bilateral cleft lip and nose by the Mulliken method: a case report

• Lim JS
• Lee GT
• Jung YS

• KMID: 2136973
• DOI: http://doi.org/10.5125/jkaoms.2012.38.6.360

Abstract

The simultaneous surgical correction of bilateral cleft lip and nasal deformity has become a more common surgical technique that has greatly changed conventional strategies for secondary nasal correction. Mulliken has been known as one of the earliest proponents for the synchronous repair of bilateral cleft lip and nasal deformity, and he emphasized the responsibility of the treating surgeon to evaluate nasolabial growth by comparing anthropometric measurements with age-matched normal patients. Good outcomes from this surgical method have been reported in clinical cases worldwide. Herein, we describe the management of two cases of bilateral cleft repair, following the principles and methods established by Mulliken. We also provide a relevant review of the literature.

Keyword

Bilateral cleft lip; Nasolabial growth; Four-dimensional change; Synchronous repair

MeSH Terms

Cleft Lip
Congenital Abnormalities
Humans
Nose

Figure

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  Fig. 1 Preoperative clinical photograph. A. 18 months child with protrusive premaxilla. B. 6 months child without protrusive premaxilla.

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  Fig. 2 Intraoperative clinical photograph (18 months child). A. Osteotome was applied to posterior of epiphysial line. B. Premaxillary osteotomy was done.

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  Fig. 3 Surgical repositioning of premaxilla (18 months child). A. Protrusive premaxilla was observed. B. Premaxilla was moved backward.

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  Fig. 4 Marking. A. 18 months child. B. 6 months child.

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  Fig. 5 Dissection of the orbicularis oris muscle and elevation of flap.

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  Fig. 6 Narrowing interalar dimension with cinch suture.

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  Fig. 7 Inferior view after suturing. A. 18 months child. Cymal trim was done at superior edge of lateral labial flap. B. 6 months child.

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  Fig. 8 Frontal view after suturing. A. 18 months child. B. 6 months child.

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