A Prospective Comparative Study of ALA Repair by Modified Tajima Suture with Cinch Suture in Unilateral Cleft LIP Patients

Abstract

D espite previous concerns of growth disturbances, primary correction of the cleft nose deformity is now an internationally accepted and approved concept. In the evolution of cleft lip and nose deformity surgery in many institutions, a move from a protocol without primary nasal reconstruction to a second one in which the nose was addressed, but the patients had to have secondary nasal reconstruction in the growing period due to insufficient primary repair. This study was conducted on 20 patients admitted, of which were 6 females and 14 males with age ranging from 4 to 11 months. From the results presented there was a statistically significant decrease in postoperative Mortier score than preoperative in follow up of Mortier score preoperative and post-operative among the studied patients in both groups. Detailed analysis of the preoperative state compared with the postoperative results using the described scoring system has its benefits. It enables comparisons between the results obtained in cases of equally severe clefts, i.e., a more precise assessment of the therapeutic benefits. It makes it possible to define every single defect of any nasal deformity, and to determine its frequency and etiology; it will reveal errors and show whether the aim of the operation has been achieved. The treatment of the unilateral cleft lip and palate deformity is not only a concern of the oral but also the nasal region. Because primary nasal correction by the time of lip repair has been incorporated into the treatment approach, many patients have benefited from this combined procedure. In comparison between Cinch group and Tajima group regarding demographic data and characteristics of the studied patients there was no statistically significant difference found between Cinch group and Tajima group regarding age, sex and side with p-value = 0.616, 0.329 and 1.000 while there was statistically significant difference found between both groups regarding palate with p-value = 0.010. It is said that success or failure of a surgical procedure depends on the degree of palatal deformity at the time of surgery as well as surgical skills and surgical procedure utilized. This fact has been considered in this rating scale in assessment of pre-operative deformity. Depressed alar base indicates a failure to mobilize the ala and bring it forward.