Median cleft of the upper lip: report of cases

Background : Median cleft of upper lip is an uncommon facial anomaly and the severe form of it rarely survives infancy because of the associated brain tissue (corpus callosum agenesis) deformity. Surgical correction can be challenging especially when it is associated with premaxilla agenesis and absence of columella and nasal septum. Materials/Method : A review of presentation and management of five patients with median cleft of upper lip and the discussion of relevant literature. Result : Four of the cases were adult. Repair of defects were carried out by Burrow’s procedure, inverted V excision technique combined with sub-periosteal undermining at labio-buccal sulci. Effective mobilization of labial flaps on both sides ensured good apposition, but the absence of columella and nasal septum remains a major challenge in reconstruction of the defect. Conclusion : Late presentation, attributed to ignorance and poverty remains a concern in management; apart from ignorance and poverty, shortage of specialists and facilities for craniofacial surgery in Northern Nigeria may also contribute to their late presentation. Multiple surgical interventions are also not usually attractive to the patients hence result of repair are modest.