Abstract:
Background: The Millard method of unilateral cleft
lip repair has been associated with a short lip and a
flattened nose on the cleft side. The aim of this study
was to determine the need for revision surgery following
repair of unilateral cleft lip repair at the Komfo
Anokye Teaching Hospital
Method: Satisfaction with facial appearance (upper lip,
nose and general facial appearance) was assessed quantitatively
by means of a Visual Analogue Scale (VAS),
where 0cm indicates totally unsatisfied or “highly unattractive”
and 10cm indicates totally satisfied or “highly
attractive”. Three assessors - parents, surgeon and layperson
- were purposively selected to score their level
of satisfaction with repair of complete and incomplete
unilateral cleft lip. The assessors also indicated the
need for any revision.
Results: The total sample size was 120, of which
40.0% were male and 60.0% were female. There were
79 cases of repaired complete unilateral cleft lip and 41
incomplete unilateral cleft lip. Average scores of satisfaction
of parents were 6.6, 6.8 and 7.2 for nose, lip
and general facial appearance (GFA) respectively. Satisfaction
scores for surgeon were 6.1(nose), 6.0(lip)
and 6.5(GFA), while those of the lay-assessor were
5.2(nose), 5.4 (lip) and 6.0(GFA). Concerning the need
for revision, parents indicated 30.2% as needing revision,
surgeon 33%; and lay-assessor 40%. Of the cases
that needed revision, 33.3% were complete cleft lip and
0.1% were incomplete cleft lip.
Conclusion: Parents were more satisfied with unilateral
cleft lip repair using the Millard procedure than
either the surgeon or lay assessor. Those who needed
revision were mostly children who presented with
complete unilateral cleft lip.