Clinical Presentation
The case study highlights bilateral macrostomia, a condition manifesting as extensive lateral clefts on both sides of the oral fissure, emphasizing its clinical presentation [PMID:29916981].
The study identifies these three features—shallow upper buccal sulcus, vertical shortness, and limited mobility of the median part of the upper lip—as common postoperative deformities collectively termed tethered upper lip deformity [PMID:21467914].
Management
The authors present a modified Kaplan technique characterized by the creation of a single Z-plasty with the central limb transposed into the nasogenian crease for treating bilateral macrostomia in a newborn, offering a potential advancement in surgical management [PMID:29916981].
Over a 4-year period, the new technique was applied to 9 pediatric patients (aged 1-3 years) with tethered upper lip deformity post-bilateral cleft lip repair, resulting in uneventful healing and satisfactory outcomes with well-contoured lips and functional oral sphincter [PMID:21467914].
Complications
While not explicitly detailing complications, the introduction of a refined surgical technique suggests an effort to mitigate potential issues associated with conventional methods for correcting macrostomia [PMID:29916981].
Prognosis & Follow-up
With a mean follow-up period of 18 months, all patients exhibited well-contoured upper lips, adequate oral function, and nearly invisible mucosal scars following the surgical intervention [PMID:21467914].
References
1 Wong RG, Carrillo TE, Sánchez PYX. Surgical Alternative for Repair of Bilateral Macrostomia. The Journal of craniofacial surgery 2018. link 2 Mutaf M, Günal E, Türkmen A, Sunay M. Correction of tethered upper lip deformity following bilateral cleft lip repair. Annals of plastic surgery 2011. link
2 papers cited of 3 indexed.