Objective Study of Surgical Outcome of Unilateral Cleft Lip Repair

Objective: The objective of study was to perform an objective assessment of postoperative aesthetic outcomes in patients undergoing unilateral cleft lip repair using Millard rotation advancement technique in patients who were operated in year 2016-2023.Methods: In this study we evaluated surgical outcome of unilateral cleft lip repair of patients that undergone surgery from 2016-2023, at Al-Mustafa Medical center, Karachi. All patients in the study were operated by single surgeon to obtain consistent results. We included patients who had unilateral cleft lip requiring surgery and excluded patients with any syndromic and bilateral cleft of lip. Descriptive statistics applied for demographic variables. Photographic record of patients obtained and analyzed by two examiners with regard to lip height from alar base to white roll, white roll symmetry, red line symmetry, notching of vermillion border and nasal symmetry. Inter-rater reliability between examiners was assessed using weighted Cohen’s kappa coefficientResults: A total of 44 patients, of which 24 (54.5%) male and 20 (45.5%) female were evaluated. Results of surgery were evaluated at 1st post-operative, 2nd post-operative day and 8th day post-operative day by two examiners. Preoperatively unilateral cleft was graded as incomplete cleft lip 19 (43.18%), complete cleft lip and alveolus 8 (18.18%) and complete cleft lip, alveolus and palate (38.63%). Post operatively all parameters were marked as 0, 1 and 2 as poor, fair and good outcomes respectively, on day 1, day 2 & on day 8th. Statistically we did not find significant difference among the observers regarding symmetry of Cupid ’s bow, white roll, vermillion border and red line, but there was a significant difference observed in the nasal symmetry.Conclusion: This qualitative objective assessment of surgical outcome of unilateral cleft lip repair stresses us on to modify techniques which focus on the improvement of nasal symmetry simultaneously with lip repair.