Comparative study between fisher anatomical subunit approximation technique and millard rotation- advancement technique in unilateral cleft lip repair

Figures & data

Figure 1. Lip markings in Fisher’s technique

Figure 2. Lip markings of Millard’s technique

Figure 3. Anthropometric measurements on the patient (a: lip height), (b: lip width), (c: vermilion height), and (d: alar base width)

Figure 4. Distribution of studied patients according to gender

Figure 5. Distribution of studied patients according to age

Figure 6. Distribution of studied patients according to extent of cleft

Table 1. Distribution of studied patients based on affected side, extent, and surgical technique

Affection	Surgical technique
	Fisher n = 20	Millard n = 20
Side Right Left	7 (35%) 13 (65%)	12 (60%) 8 (40%)
Extent Complete Incomplete	8 (40%) 12 (60%)	10 (50%) 10 (50%)

Table 2. Comparison between two groups according to anthropometric parameters

Measurement	Fisher	Millard	Student t test
Lip height Min-Max Median Mean ± SD	0.93–1.33 1.12 1.1 ± 0.13	0.88–1.2 0.95 0.97 ± 0.09	t = 3.706 p = 0.001*
Lip width Min-Max Median Mean ± SD	0.89–1.14 0.97 1 ± 0.08	0.89–1.3 0.99 1.02 ± 0.1	t = −0.737 p = 0.47
Vermilion height Min-Max Median Mean ± SD	1.03–1.41 1.24 1.23 − 0.12	0.95–1.32 1.03 1.08 ± 0.12	t = 4.087 p˂ 0.001*
Alar base length Min-Max Median Mean ± SD	0.95–1.21 1.04 1.05 ± 0.08	0.87–1.31 0.96 0.99 ± 0.11	t = 2.044 p = 0.048*

*Statistically significant at p ≤ 0.05

Table 3. Comparison between two groups according to the cleft extent and anthropometric measurements

Measurement	Fisher			Millard
	Complete n = 8	Incomplete n = 12	Student t test	Complete n = 10	Incomplete n = 10	Student t test
Lip height	1.06 ± 0.11	1.13 ± 0.14	t = −1.26 p = 0.22	0.98 ± 0.09	0.96 ± 0.09	t = 0.43 p = 0.67
Lip width	0.97 ± 0.06	1.02 ± 0.09	t = −1.57 p = 0.13	1.01 ± 0.12	1.04 ± 0.09	t = −0.67 p = 0.51
Vermilion height	1.23 ± 0.1	1.23 ± 0.13	t = 0.15 p = 0.89	1.1 ± 0.12	1.05 ± 0.12	t = 0.903 p = 0.38
Alar base length	1.06 ± 0.09	1.05 ± 0.08	t = 0.38 p = 0.71	0.99 ± 0.14	0.98 ± 0.07	t = 0.236 p = 0.82

Table 4. Comparison between two groups according to Steffensen grading criteria

Steffensen Criteria	Good		Average		poor
	Fisher	Millard	Fisher	Millard	Fisher	Millard
Cutaneous roll symmetry	18	17	2	2	0	1
Vermilion symmetry	14	9	3	6	3	5
Scar appearance	18	13	2	4	0	2
Cupid’s bow	16	11	3	7	1	2
Lip length	12	12	5	4	3	4
Nostril symmetry	11	10	5	5	4	5
Alar dome	12	8	5	8	3	4
Alar base	10	7	5	5	5	8

Figure 7. A case of Fisher’s group; 4-month-old male, with left-sided unilateral incomplete cleft lip. (a and b) Preoperative frontal and submental views and (c and d) 2 months’ postoperative frontal and submental views

Figure 8. A case of Fisher’s group; 4-month-old male, with left-sided unilateral incomplete cleft lip. (a and b) Preoperative frontal and submental views and (c and d) 3 months’ postoperative frontal and submental views

Figure 9. A case of Fisher’s group; 3-month-old female, with left-sided unilateral incomplete cleft lip. (a and b) Preoperative frontal and submental views and (c and d) 6 months’ postoperative frontal and submental views

Figure 10. A case of Fisher’s group; 6-month-old male, with right-sided unilateral complete cleft lip. (a and b) Preoperative frontal and submental views and (c and d) 5 months’ postoperative frontal and submental views

Figure 11. A case of Millard’s group; 5-month-old male, with left-sided unilateral complete cleft lip. (a and b) Preoperative frontal and submental views and (c and d) 12 months’ postoperative frontal and submental views

Figure 12. A case of Millard’s group; 4-month-old male, with left-sided unilateral incomplete cleft lip. (a and c) Preoperative frontal and submental views and (b and d) 3 months’ postoperative frontal and submental views

Figure 13. A case of Millard’s group; 5-month-old male, with left-sided unilateral incomplete cleft lip. (a and c) Preoperative frontal and submental views and (b and d) 4 months’ postoperative frontal and submental views

Figure 14. A case of Millard’s group; 3-month-old female, with right-sided unilateral incomplete cleft lip. (a and c) Preoperative frontal and submental views and (b and d) 3 months’ postoperative frontal and submental views