Correction of tethered upper lip deformity following bilateral cleft lip repair.

Abstract

Shallow upper buccal sulcus, vertical shortness (whistling deformity), and limited mobility of the median part of the upper lip are among the most common secondary deformities following surgical repair of wide bilateral cleft lip. They are often encountered together as a triad of postoperative deformities with a common etiology. To date, there has been no surgical procedure to correct these 3 associated deformities in 1 stage. In this article, we describe the triad above-mentioned 3 associated postoperative deformities as a single clinical entity, namely the tethered upper lip (TUL) deformity. Moreover, a new procedure for simultaneous correction of these 3 postoperative deformities in 1 stage is presented. Over 4 years, this new technique was used in 9 patients, 7 males and 2 females, with the TUL deformity following bilateral cleft lip repair. The patients were aged from 1 to 3 years. All patients healed uneventfully. A mean follow-up of 18 months revealed a well-contoured upper lip with a sufficient depth of the upper buccal sulcus, an adequate oral sphincter function, and mobility in all patients. The scars placed on the mucosal surface were almost invisible. Our technique seems to be useful for 1-stage correction of all 3 components of the TUL deformity including shallow upper buccal sulcus, vertical shortness of the median part of vermilion, and limited upper lip mobility following surgical repair of the bilateral cleft lips.