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This study aimed to evaluate the effect of orbicularis oris muscle z-plasty modification of modified Millard technique on the esthetic outcome and length of the repaired lip
forty patients with a unilateral cleft lip will be enrolled in this randomized comparative study. The patients will be divided into two groups, the control (group A) who treated with the modified Millard technique and the study group who repaired by orbicularis oris muscle Zplasty modification of modified Millard technique (group B).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| study arm | Experimental | 20 patients with a unilateral cleft lip will be repaired with orbicularis oris muscle Z-plasty modification of modified Millard technique |
|
| controlled arm | Active Comparator | 20 patients with a unilateral cleft lip will be repaired with modified Millard technique |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| orbicularis oris muscle Z- plasty modification of modified millard technique | Procedure | After orbicularis oris muscle had been released from the overlying skin, the previously marked points using methylene blue for designing the z-plasty were shown to be followed by back-cut incisions including the OOM and inner mucosa in both medial and lateral elements without involving the overlying skin. This procedure resulted in two triangular flaps in both segments |
| Measure | Description | Time Frame |
|---|---|---|
| lip legth | evaluate the lip length of the cleft side changes from preoperative at immediate postoperative | immediate postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Philtral ridge length symmetry index assessment | Philtral ridge symmetry index was calculated as follow:- (philtral ridge length by mm at cleft side)/(philtral ridge length by mm at non-clefted side)×100 | 6months |
| Scar width assessment by photograph |
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Inclusion Criteria:
Exclusion Criteria
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| Name | Affiliation | Role |
|---|---|---|
| shaimaa refahee, phd | Fayoum University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fayoum University | Al Fayyum | Egypt |
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| modified millard technique | Procedure | no z-plasty modification |
|
Standard photography was taken; objective measurements were obtained from the photographs using the ruler as a control reference.
One standard surgical ruler was placed over the lower lip and a frontally orientated photograph of the patient was taken at 6m follow up to assess scar width using the Image J1.5i0R program. The first point was 1mm above the white roll and the second point was 1mm below the C-flap suture line . Scar width will be measured by two assessors and the mean score of two assessors was calculated
| 6months |
| scar width by ultrasound | scar width will be quantified by ultrasound. The transducer placement with its upper border touching the columella-philtral junction, upper lip imaging obtained and the scar width will be measured. | 6months |
| scar elascitity | Scar elasticity will be quantified by ultrasound. The transducer, coupled with several millimeters of ultrasound gel, was smoothly placed in the longitudinal section and perpendicular to the skin without compressing the tissue. Compare scar stiffness in relation to adjacent normal tissue | 6months |
| ID | Term |
|---|---|
| D002971 | Cleft Lip |
| ID | Term |
|---|---|
| D008047 | Lip Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D009056 | Mouth Abnormalities |
| D018640 | Stomatognathic System Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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