Experience of Unilateral Cleft Lip Repair using the Anatomical Subunit Technique in an Omani Population over a Five-Year Period

Abstract

Objectives: This study aimed to report the authors’ experience with the anatomical subunit technique for unilateral cleft lip repair, which has gained popularity worldwide. Methods: From July 2015 to April 2020, 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon. The demographic data, severity and type of the cleft lip, surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon. The rate of revision surgery was collected from the Al-Shifa® - 3Plus healthcare information system (Ministry of Health, Oman). Parents’ satisfaction regarding scar quality and lip and nose appearance was collected and all data were statistically analysed. Results: A total of 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. Among these, 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. Additionally, 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects (response rate: 48.8%) which showed 85% satisfaction rate with the postoperative scar and 77.5% satisfaction with the aesthetic appearance of the nose. Conclusion: The anatomical subunit technique resulted in a predictable outcome indicating a high rate of patient satisfaction with scar quality and nasal and lip symmetry in children with varying severity of cleft lip. The high percentage of consanguinity (52%) in this study highlights the need for more targeted national campaigns involving premarital counselling in the Omani population.

Keywords: Cleft Lips; Congenital Abnormalities; Cleft lip/Surgery; Reconstructive Surgical Procedures; Treatment Outcome; Surgical Diagnostic Technique; Consanguinity; Oman.