Anatomy of the Upper Lip and Nose Muscular Bundle Tendon and Its Application During Unilateral Cleft Lip Repair.

Abstract

Background: While several authors have previously described the anatomy of the nasolabial muscles in patients with unilateral cleft lip, some personal intraoperative findings may provide additional information on this topic. The aim of this study is to describe the anatomy and histopathology of the tendon of the upper lip and nose muscle bundle on the cleft side and the role of myrtiform muscles during primary repair of the unilateral cleft lip.

Methods: The anatomy of this structure has been described during primary cleft lip repair, and small pieces of the muscle and tendon of the upper lip muscular bundle were excised and embedded in paraffin for histopathologic study. In addition, a retrospective cross-sectional study was performed to evaluate the utility of this anatomic structure in cleft lip and nose repair. The outcomes were anthropometric measurements of the repaired lip and nose at the age of 5 years.

Results: The anatomic descriptions during cleft lip repair and the histopathologic study confirm the existence of this tendon structure in all the studied cases. A well-defined tendon was detected at the base of the nasal ala on the cleft side. There was no statistically significant difference between cleft and noncleft alar base positions on the operated side in patients who underwent the described muscular repair.

Conclusions: A tendon structure has been documented and demonstrated in operated patients with unilateral cleft lip and palate nose deformity; it has not been previously described in the literature. The observed outcomes after primary cleft lip repair using this structure support its utility and underscore the importance of the myrtiform muscles during unilateral cleft lip repair.