Minor modification of Millard's surgical technique for correction of complete unilateral cleft lip

• Main Author: Coen Pramono D (Author)
• Format: Book
• Published: Universitas Airlangga, 2010-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>A surgical technique for correction of complete unilateral cleft lip was done using a minor modification of Millard's </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>surgical technique. The purpose of this modification is to achieve a good anatomical form of columelia, nostril cill and the position of </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>nasal tip. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>This article presents the correction of the complete cleft lip which was done initially by correction of the slanted </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>columella followed by correction of the nostril sill which was done before the sequence of closing the lip crevice. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Correction of </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>a case with complete unilateral cleft lip on a fifteen year old girl using modification of Millard's surgical technique is presented. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case </strong><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Management: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Rotation incision in the philtrum region was made as introduced by Millard to make a triangular flap. The triangular </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>flap was contralaterally rotated and pulled into the direction of cleft to achieve a normal position of the columella and nasal tip. The </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>lateral side of the ala was incised in circular form down to the alar base and straight through to the direction of cleft formed an alar </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>flap which consisted of ala, clefted and slanted nasal base tissue. The tip of the triangular flap was trimmed and approximated to the </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>alar flap to form a new the nostril sill. Adjustment of the size of the nostrill sill size was achieved during the approximation of those </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>two flaps. The nasal base was built during approximation of the lateral and the medial segment flap or philtrum region and the base </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of new nostril sill. Surgical correction of the complete unilateral cleft lip including correction of the nostrill sill using approximation </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of triangular flap and the alar flap was achieved. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>This surgical technique with minor modification of Millard's surgical </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>technique can be used for correction of the complete unilateral cleft lip with extremely slanted columella and nasal tip to form the</em><br /><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>nostril sill.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Latar belakang: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Koreksi celah bibir komplit satu sisi telah dilakukan menggunakan metode operasi Millard yang dimodifikasi.
</em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Modifikasi dimaksudkan untuk memperoleh bentuk anatomis yang baik dari columella, nostril dan letak ujung hidung yang baik. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tujuan</strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Melaporkan koreksi suatu celah bibir komplit satu sisi menggunakan metode operasi Millard yang dimodifikasi yang dimulai dengan </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>melakukan perbaikan pada columella yang miring pada bentuk nostril sebelum tahapan penutupan celah bibir dilakukan. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kasus: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Dilaporkan satu kasus koreksi celah bibir komplit satu sisi pada pasien wanita usia 15 tahun menggunakan metode operasi Millard </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang dimodifikasi. </em><span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tatalaksana kasus: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Dilakukan insisi berbentuk rotasi di regio seperti pada metode Millard untuk membuat flap </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>berbentuk trianguler. Flap trianguler dirotasikan ke arah kontra lateral dan ditarik menuju arah celah bibir untuk memperoleh posisi </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>columella yang normal, bentuk nostril yang simetris dan letak ujung hidung yang baik. Dilakukan insisi sirkuler ke bawah ke arah dasar </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>ala pada regio lateral ala menuju ke bagian celah bibir, selanjutnya akan diperoleh bentuk flap yang disebut alar flap yang terdiri </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>atas bagian ala nasi, bagian dari jaringan yang berada pada sisi celah dan bagian dari dasar hidung di sisi celah bibir. Bagian ujung </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>dari trianguler flap dipotong dan selanjutnya ditautkan pada flap alar untuk membentuk bentukan nostril baru. Penyesuaian ukuran </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>nostril dilakukan pada tahap penautan kedua flap tersebut. Bagian dari dasar hidung dibentuk pada saat tahapan penautan antara </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>flap segmen lateral dan medial atau bagian dari philtrum dan bagian dasar dari nostril atau cuping hidung. Koreksi bedah suatu </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>celah bibir komplit satu sisi termasuk koreksi pada bentuk nostril diperoleh dengan menautkan antara flap trianguler dan flap alar.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: Tribune-Bold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kesimpulan: </strong><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Teknik bedah Millard dengan modifikasi kecil dapat dipakai untuk melakukan koreksi pada kasus celah bibir komplit </em><span style="font-family: Tribune-Italic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>satu sisi yang disertai kemiringan columella dan ujung hidung yang ekstrim.</em></span></span></span><br /></em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>

Item Description

1978-3728
2442-9740
10.20473/j.djmkg.v43.i4.p172-175