Quantifying Sagittal Lip Changes in Patients with Bilateral Cleft Lip Post Abbe Flap Reconstruction

Cleft Palate Craniofac J. 2024 Jun 4:10556656241255478. doi: 10.1177/10556656241255478. Online ahead of print.

Abstract

Objectives: To objectively quantify results of sagittal lip changes following Abbe flap reconstruction in patients with bilateral cleft lip.

Design: Retrospective, observational study.

Setting: Single institution, 8-year retrospective review.

Patients/participants: In total, 17 patients with bilateral cleft lip that underwent Abbe flap reconstruction were included in this study.

Intervention: Patients had lateral photographs taken prior to Abbe flap reconstruction and at least 8 months post-Abbe flap.

Main outcome measurements: Vegter's index, Sushner's S2 line and Burstone's B line reference lines were used for evaluation of sagittal lip changes. Wilcoxon signed rank tests were used in analysis.

Results: The mean pre-Abbe flap upper to lower lip ratio, defined as Vegter's Lip Index, was 0.906 compared to a mean of 0.946 following Abbe flap reconstruction. The mean upper to lower lip ratio for Sushner's S2 and Burstone's B line exhibited an increase in upper lip sagittal projection from -0.164 to 1.459 and 0.259 to 0.957, respectively (P < 0.001).

Conclusions: This study quantifies sagittal changes to upper and lower lip position after Abbe flap reconstruction. These findings may aid in operative planning and patient/caregiver expectations during counseling.