Double-Advance Technique for the Closure of Inferior Cleft Lip
The Objective is present a case of a medial cleft of the lower lip with associated ankyloglossia and a proposal for a double-advance local flap technique for its closure who attended the Oral and Maxillofacial Surgery Service of the Madre Rafols Hospital, Venezuela. A 4-month-old female patient, presenting a medial cleft of the lower lip with an associated aberrant frenulum of the tongue causing ankyloglossia (Tessier 30). Lingual frenectomy and primary cheiloplasty were performed with a double-advance local flap technique to close the lower labial cleft. A wedge-shaped incision along the labial cleft, with lateral extensions towards the mentolabial sulcus extending bilaterally were performed in order to advance both flaps and place the wound at the limit of the esthetic subunit, as well as a Z-plasty in the vermilion of the lower lip. Postoperative follow-ups did not reveal local complications or tissue dehiscence. Due to the rarity of this entity, relevant surgical techniques for this type of anomaly have not been established or evaluated. The technique presented here proved its usefulness, achieving harmonious and favorable functional and aesthetic results in our patient.
Clefts of the lower lip are a rare condition. Abnormal or incomplete development of structures derived from the lower half of the first branchial arch is extremely rare. Until now, only 75 to 80 documented cases have been reported in recent years.2 This condition varies in severity. On the mildest form, it can present as a notch in the submucosa of the lower lip and in the most severe form it can involve the lower lip as a whole, as well as ankyloglossia or bifid tongue, cleft of the alveolar process, mandible, floor of the mouth and even some structures of the neck.
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