Comparison of the Millard and Fisher technique for closure of the unilateral cleft lip

Objective: The goal of cleft lip repair is to restore normal function and form while achieving the best cosmetic appearance. The Fisher technique utilizes the anatomical subunits of the lip and nose, the scar has been placed in the “ideal line of repair”. In this study, we compare the esthetics of unilateral cleft lip repair using two methods, the rotation advancement flap (Millard) and the Fisher flap.

Participants: Twenty non-syndromic patients with unilateral cleft lip, with or without cleft palate were operated by the same surgeon. Prior to 2006 all repairs were conducted using the Millard technique. After 2006, all clefts were repaired using the Fisher technique.

Method: The average age of repair was three months. Patients from both groups were followed for approximately 2.5 years. The criteria for evaluation of the esthetics were symmetry of Cupid’s bow, nasal symmetry, symmetry of the free vermillion border, wet and dry vermillion relationship, hypertrophy/discoloration of scar and spreading of suture mark.

Results: There were small difference between the techniques in notching of the vermillion border favoring the Fisher closure. There are no scars in the nares, allowing for an improved nasal form with the Fisher technique compared to the rotation advancement flap. In the other areas of evaluation of the closure, there were no significant differences, although the Fisher technique appeared to have an overall more pleasing appearance.

Conclusion: We have found the Fisher technique to be superior. This might be due to the anatomical difference inherent to the technique.

Conflict of interest : None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Comparison of the Millard and Fisher technique for closure of the unilateral cleft lip
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