A long-term appraisal of the unilateral complete cleft lip repair: one surgeon's experience

The authors reviewed 85 patients with unilateral complete cleft lip repaired with a low triangular flap technique. Clefts were classified into four categories, depending on the degree of deformity. The clinical results, as evidenced in standardized slides, were assessed by a professional panel using a weighted formula adapted from that devised by Williams. The Farkas-Lindsay anthropometric technique was also used to measure all dimensions of the lip and nose, with the results calculated as a ratio of the cleft to normal side. The findings demonstrated that the method of classification was consistent and reliable. As expected, the panel gave the postoperative results of the Simonart's and mild-degree clefts the highest ratings, with the severe clefts having the lowest. The consultant surgeons awarded the highest marks and the clinical fellows, the lowest. The residual nasal deformity continues to be the challenge rather than the lip defect, as evidenced by an average of 1.7 revisionary procedures on the nose compared with 0.7 on the lip. A combination of subjective and objective methods of evaluation has been incorporated into a critical clinical review of these patients.