Study on the effects of modified Millard′s method in the reconstruction of unilateral degree Ⅲ cleft lip evaluated by geometric principles

ObjectiveTo evaluate the improvement and stability of the modified Millard′s method in the reconstruction of lip-nasal deformity after unilateral degree Ⅲ cleft lip surgery.

Methods Forty children with unilateral degree Ⅲ cleft lip treated with the modified Millard′s method from October 2018 to July 2020 were investigated.According to the same standard, the photos were collected before surgery, after 1 week and 1 year of operation.The coordinate system was constructed according to the same standard for the photos collected, the alar point(A), alar base point(B), lip peak point(C) and front cut point(D) of the healthy and affected sides were measured, and the coordinate area and symmetry rate of each measuring point were calculated.The difference analysis was made by comparing the area of healthy and affected sides at each time point, the overall change of symmetry rate over time was evaluated and the changes of symmetry rate between two time points were analyzed to assess the surgical improvement and stability.

ResultsThe differences of the coordinate area at A, B, C and D points between the healthy side and affected side before operation were statistically significant(P < 0.01).After the modified Millard′s method surgery, the differences of the A, C and D points between the healthy side and affected side after 1 week of operation were statistically significant(P < 0.01), and the difference of which in B point was not statistically significant(P>0.05).After 1 year of operation, the difference of the coordinate area at A point between the healthy side and affected side was statistically significant(P < 0.01), but the differences of which at B, C and D points were not statistically significant(P>0.05).The symmetry rate of each measurement point after 1 week and 1 year of operation was higher than that before surgery(P < 0.01), and the symmetry rates of A and D points after 1 year of operation were higher than that after 1 week of operation(P < 0.01).

ConclusionsThe modified Millard′s method in the reconstruction of unilateral degree Ⅲ cleft lip can significantly improve the lip-nasal deformity, and make the symmetry and stability better.