Modifications to the WHISTLE Flap Procedure for Correction of Secondary Cleft Lip Deformities.

Autor:	Collar Yagas L; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Bautista CH; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Chen J; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Tausinga TL; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Kim EN; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Johns DN; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah., Gociman BR; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, Utah.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 May 28; Vol. 12 (5), pp. e5848. Date of Electronic Publication: 2024 May 28 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005848
Abstrakt:	Background: The whistle deformity, a deficiency of tissue in the central upper lip, is a consequential outcome of primary cleft lip repair. Among multiple described reconstructive options, the wide-hinged island swing transposition labial enhancement (WHISTLE) flap procedure by Grewal et al has been shown to be a reliable technique that restores the continuity of the orbicularis oris muscle and creates a more natural appearing tubercle and central lip element. This article aims to refine the WHISTLE flap procedure with the addition of tailored mucomuscular flaps and an upper lip-lengthening mucosal Z-plasty. Methods: A total of 11 patients with a whistle deformity were examined. All underwent the WHISTLE flap procedure with tailored mucomuscular flaps and a mucosal Z-plasty. The patients were followed for a period of from 6 to 51.5 months. Pre- and postoperative photographs were used for objective outcome comparison. Results: From 2018 to 2023, a total of 11 patients with a whistle deformity were included in the final cohort, comprised four bilateral and seven unilateral cleft lips. Ten cases (90.1%) resulted in satisfactory postoperative cosmetic appearance and did not require further interventions. A single patient with a significant preoperative discrepancy between the upper and lower lip volumes had a postoperative residual deformity. None of the patients demonstrated any functional deficits associated with the procedure. Conclusions: The WHISTLE flap procedure with the proposed individual tailoring of the mucomuscular flap and Z-plasty for mucosal scar lengthening has excellent cosmetic outcomes and can be considered as the primary treatment modality in most patients with a whistle deformity. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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