Quantitative preliminary indication criteria and clinical outcomes of Abbe Flap repair for secondary cleft lip deformities.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42247777.
- Also identified by DOI 10.1016/j.bjps.2026.05.050.
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Abstract
Secondary nasolabial deformities are common after primary cleft lip repair, yet objective preliminary quantitative indication criteria for Abbe flap repair remain lacking. This study aimed to establish preliminary quantitative indication thresholds for Abbe flap repair, evaluate its clinical efficacy, and explore preoperative predictors for optimal postoperative outcomes. This STROBE-compliant retrospective cohort study enrolled 102 patients with secondary cleft lip deformities (21 in Abbe flap group, 81 in non-Abbe flap group) and 36 healthy controls. Standardized anthropometric measurements, phenotypic stratification via cluster analysis, and ROC curve analysis for diagnostic efficacy were conducted. The Abbe flap group showed significant postoperative improvements in all core morphological parameters (all P < 0.05), while conventional non-Abbe repair yielded minimal improvement in patients with significant upper lip tissue deficiency. The optimal preliminary cut-off values for Abbe flap indication were upper-to-lower lip projection ratio (ULR) ≤0.700 (sensitivity 100%, specificity 97.26%) and nasolabial angle (NLA) ≥108° (sensitivity 95.24%, specificity 93.15%). Stratified analysis confirmed the therapeutic superiority of Abbe flap was independent of initial cleft type, and preoperative lip height index (LHI) and intercanthal width to medial upper lip height ratio (IMWH) were independent predictors for optimal postoperative outcomes. Preoperative ULR ≤0.700 and NLA ≥108° can be used as preliminary objective quantitative reference criteria for Abbe flap selection in secondary cleft lip deformity patients, with prospective multi-center validation required for further clinical generalization. The Abbe flap can achieve significant correction of morphological abnormalities caused by upper lip tissue deficiency, and preoperative LHI and IMWH can assist in prognostic evaluation for surgical candidates.