Immediate postoperative outcomes after unilateral cleft lip repair do not differ by laterality: Results of the multiethnic smile index study

Abstract

In addition to their lower prevalence, right-sided unilateral cleft lips are held by some surgeons to be more morphologically severe than left-sided unilateral cleft lips. These differences may impact surgical performance and outcomes of right- versus left-sided cleft repairs. The authors compared outcomes of left- and right-sided unilateral cleft repairs using a prospectively collected international dataset. Prospectively collected pre- and postoperative anthropometric measurements including columellar angle, cleft width, nostril widths, vertical lip heights, and horizontal vermillion lengths were compared between right- and left-sided unilateral cleft lip patients in Morocco, Bolivia, Vietnam, and Madagascar. Based on previous sociologic and cleft outcome studies, “unacceptable” postoperative outcomes were defined as those with a cleft-side/non–cleft-side vertical lip height discrepancy greater than 3 mm. Sixty-one percent of the 143 study patients had left-sided clefts. Mean preoperative cleft width ratios and the proportion of “severe” (cleft width ratio >= 0.5) clefts did not differ between right- and left-sided cleft lip patients. No differences were noted in postoperative lip vertical height ratios or the proportion of “acceptable” and “unacceptable” repair results between right- and left-sided cleft lips. Finally, no differences were noted in operative time between right- and left-sided cleft lips. In summary, using a prospectively collected international dataset, no significant differences were noted between left- and right-sided unilateral cleft lips in terms of severity, operative times, or ultimate outcomes.