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Philtrum Reconstruction Using a Triangular-Frame Conchae Cartilage Graft in Secondary Cleft Lip Deformities.

BACKGROUND
The philtrum represents an essential feature in the architecture of the upper lip and over all facial appearance. A missing philtral ridge and dimple after cleft lip repair is associated with aesthetic impairment. The authors therefore developed a novel strategy for philtrum reconstruction using a triangular-frame conchae cartilage. The authors herein describe the surgical procedure and evaluate the postoperative outcomes.


METHOD
In this study, 32 patients with a deficiency of the philtrum due to unilateral or bilateral cleft lip underwent reconstructive surgery based on a triangular-frame conchae cartilage graft. Preoperative and postoperative assessment of the convexity of the philtral ridge and dimpling was performed at rest and while puckering by standard patient photography and video technology. Postoperative outcome and complications were recorded during follow-up including a patient satisfaction survey.


RESULTS
The follow-up period after philtrum reconstruction ranged from 6 months to 5.3 years. Postoperative evaluation showed satisfactory and stable results with an aesthetic philtral ridge and dimpling, even in the long term. The vast majority (31 patients) were satisfied with the postoperative outcome. Complications included acute infection (1 case), temporary stiffness of smile (1 case), and reddening of the scar (1 case). No systemic complications occurred.


CONCLUSION
The authors here propose a simple, effective, and reliable surgical technique for secondary philtrum reconstruction in cleft lip deformity patients using a triangular-frame auricular cartilage graft.


LEVEL OF EVIDENCE
4.