Etiology: Research shows that it may be divided into genetic and environmental factors, and is related to nutrition, genetics, infection, endocrine and other factors.
Classification: There are various ways to classify cleft lip, which can be divided into unilateral cleft lip (including incomplete and complete type), bilateral cleft lip (including incomplete, complete and mixed type), median cleft (extremely rare) and occult cleft (often unilateral or one side of bilateral cleft lip).
Clinical manifestations: In unilateral cleft lip, the cleft can range from a small notch in the red part of the lip to a complete cleft of the entire upper lip, up to a complete cleft of the nasal base and a cleft of the alveolar ridge on that side. In incomplete clefts, there is often more deformity than meets the eye.
Unilateral cleft lip is usually accompanied by deformities of the ipsilateral nasal wing, nasal floor, and nasal column. In general, the degree of nasal deformity is proportional to the size of the cleft. There are often varying degrees of deformity of the nasal septum, nasal wings, nasal tip, nasal tip, and nasal columella. Correction of this series of lip and nose deformities is not an easy task and varies from patient to patient, making it one of the difficult points in plastic surgery.
In bilateral cleft lip, especially in bilateral complete cleft lip, both sides of the nose are balanced in shape, the anterior lip and premaxilla at the front of the nasal septum are close together and arched forward and upward, and the nasal column is very short or almost missing.
Treatment: 1. Timing of surgery: Generally, surgery is appropriate for unilateral cleft lip in about three to six months, while bilateral cleft lip is slightly delayed. The basic conditions for a child to be adapted for surgery are: good general health, no upper respiratory tract infection, and no infection in the local and surrounding tissues. In common clinical cases, stage I surgery is often timely, but as the child grows and develops, new lip and nose deformities of varying degrees usually appear, and some deformities need to be stabilized only after the patient’s development has ceased, so the vast majority of adult cleft lip patients have nasal deformities that often require stage II surgical repair. Generally, after the age of 16, when the patient has basically matured and the nasal cartilage is dense and elastic, is a favorable period for second-stage surgery. Nowadays, with the improvement of living standards, people have higher and higher requirements for correcting deformities, and patients often do not care about the number of surgeries, but only want to achieve a normal shape. However, since cleft lip is a complex embryonic developmental deformity that involves not only skin, muscle and mucosa, but also bone and cartilage development, the difficulty of surgery is self-evident, and patients and their families should be fully prepared.
The basic steps of cleft lip repair surgery are design, incision, repositioning of the cleft muscles and reconstruction of continuity, and suturing of the skin.