Correction of secondary cleft lip deformity: The whistle flap procedure

Navanjun S. Grewal, Henry K. Kawamoto, Anand R. Kumar, Bryan Correa, Arthur E. Desrosiers, James P. Bradley

Research output: Contribution to journalArticle

Abstract

Background: The Kapetansky flap was described to repair a whistle deformity or central vermilion defect following a primary bilateral cleft lip repair. The authors studied a modification of this technique, called the Whistle (wide-hinged island swing transposition labial enhancement) flap, to correct a wide array of secondary cleft lip deformities. Methods: Patients with secondary cleft lip deformity who underwent the Whistle flap correction were studied (n = 21). Vertical lip height, lateral lip projections, and three-dimensional volumetric measurements were recorded along with physician and parent-patient satisfaction surveys. Results: From 1994 to 2006, 23 Whistle flap procedures were performed on 21 cleft lip patients (bilateral, n = 13; unilateral, n = 8). The average age at surgery was 15.4 years (range, 13 to 21 years). The average follow-up was 27.6 months. The vertical height of the cleft side Cupid's bow to vermilion bottom had a mean increase of 164 percent. Lateral projection of the upper lip showed a mean increase of 117 percent. Preoperatively, patients exhibited mean volumetric asymmetry of 29.4 percent, and this was reduced following treatment to approximately 3.1 percent. Physician satisfaction using a modified Whitaker classification (categories I through IV) demonstrated that 56 percent of patients were category I (no refinements necessary) and 44 percent were category II (minor revisions are advisable). Parent-patient satisfaction in the follow-up period was a mean of 3.5 as measured using a five-point scale ranging from 0 to 4. There were minimal perioperative complications. Conclusion: The Whistle flap procedure provided a versatile and reliable option for the correction of vermilion defects from secondary cleft lip deformities.

Original languageEnglish (US)
Pages (from-to)1590-1598
Number of pages9
JournalPlastic and Reconstructive Surgery
Volume124
Issue number5
DOIs
Publication statusPublished - 2009
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Grewal, N. S., Kawamoto, H. K., Kumar, A. R., Correa, B., Desrosiers, A. E., & Bradley, J. P. (2009). Correction of secondary cleft lip deformity: The whistle flap procedure. Plastic and Reconstructive Surgery, 124(5), 1590-1598. https://doi.org/10.1097/PRS.0b013e3181b99e2e