The Effect of Botulinum Toxin Injection in Cleft Lip Repair

Abstract

Background & Objectives: Cleft lip and palate are common congenital anomalies that require precise management with main component of repairing lip is the aesthetic outcome. Using botulinum toxin is new method to optimize the resultant scar. The aim of this study is to evaluate the effect of botulinum toxin type A following cleft lip repair on resultant quality of scar. Methods: This is a comparative study conducted in Rizgary teaching hospital and private hospitals in Erbil – Kurdistan region/Iraq between July 2018 and April 2021. A total of 38 patients with cleft lip were included; bilateral and unilateral, complete and incomplete, isolated cleft lip and cleft lip and palate, 20 of them received botulinum toxin injection. Preoperative and postoperative photos were documented. Scars were analysed one year following repair. Results: Among 38 patients, in comparison of outcome of using botulinum toxin (31.6%) following cleft lip repair to patients did not receive the injection (68.4%), the scar quality was better; linear scar in botox group 100%, non-botox group 80.8%, complications were less; early complications in botox group 8.3%, non-botox group 11.5% and late complications in botox group 0% non-botox 7.7% and satisfaction was better; parents of botox group were 100% highly satisfied while for those of non-botox group 84.6% highly satisfied, 7.7% satisfied and 7.7% unsatisfied. There was significant difference between the two groups but statistically not significant. Conclusion: Botulinum toxin injections into the subjacent orbicularis oris muscle following cleft lip repair produced better appearing and narrower cheiloplasty scars.