Presurgical Unilateral Cleft Lip Anthropometrics: Implications for the Choice of Repair Technique

Background: It has been stated that height of the lateral lip is difficult to obtain with the rotation advancement repair only when the lateral lip is short in both its vertical and horizontal dimensions. The authors studied preoperative cleft lip anthropometry to determine the frequency of the “geometrically unfavorable lateral lip”—short in both vertical and transverse dimensions. Methods: Direct caliper measurements were taken by a single observer of the heights and of the transverse lengths in 100 consecutive patients (age ≥3 months and <6 months) with unilateral cleft lip (51 complete and 49 incomplete) who were under general anesthesia just before cleft lip repair. Results: In 75 patients, the height of the lateral lip was less than that of the noncleft side; on average, 2.1 mm less than (or 82 percent of) the noncleft side (range, 50 to 133 percent). In 86 patients, the lateral lip transverse length was less than on the noncleft side; on average, 2.7 mm less than (or 86 percent of) the noncleft side (range, 66 to 114 percent). Of the 75 patients with height deficiency, 63 patients also had transverse length deficiency. There were 19 patients who exhibited vertical height deficiency of 4 mm or more (>1 SD from the mean), and 79 percent of these patients with extreme height deficiency also exhibited transverse length deficiency. Conclusions: The lateral lip is frequently short in both vertical and transverse dimensions. These findings warrant consideration for the use of repairs other than rotation advancement (and its variations) in the setting of lateral lip deficiency.