Orbicularis Oris Muscle Z-Plasty Modified Millard’s Technique Versus Modified Millard’s Technique For Unilateral Cleft Lip Repair: A Randomized Clinical Trial

Abdulhameed, Mona Mahmoud; Aboulhassan, Mamdouh Ahmed; Ahmed, Mamdouh Sayed; El-Gangehi, Mostafa Talaat

doi:10.21608/asdj.2025.348255.1766

Orbicularis Oris Muscle Z-Plasty Modified Millard’s Technique Versus Modified Millard’s Technique For Unilateral Cleft Lip Repair: A Randomized Clinical Trial

Document Type : Consort randomized clinical trials (RCT)

Authors

¹ Oral and maxillofacial surgery department

² Pediatric Plastic Surgery, Faculty of Medicine, Cairo University. Egypt

³ Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University. Egypt

10.21608/asdj.2025.348255.1766

Abstract

Aim: In a trial to attain the most possible aesthetic result of obtaining a repaired lip with the least sacrificing scar and reasonable lip height at the first operation, in the current study a z-plasty was just incorporated in orbicularis oris muscle to generate the predetermined lip length while maintaining the Millard curvilinear skin incision with no transverse scar.
Materials and Methods: A double blinded, randomized controlled trial in which a group of 30 nonsyndromic unilateral cleft lip patients were randomized into two equal groups. Group A: undergone orbicularis oris muscle z-plasty modified Millard’s technique, Group B: undergone modified Millard’s technique. Six months postoperatively the height of philtral ridge, nostril width and scar width were assessed using computer software, all the measurements were carried out digitally on the taken standardized photographs by blinded assessors. Comparison of mean age and weight values in the two groups was carried out by Student’s t-test. The repeated measures ANOVA test was used for comparison of cleft and non-cleft sides within the same group, the two groups as well as the changes by time in each single group. The significance level was set at P ≤ 0.05.
Results: No significant differences were found in philtrum length, nostril width or scar width between the two groups at 6 months follow up postoperatively.
Conclusion: Both modified Millard’s technique and orbicularis oris muscle z-plasty modified Millard’s technique are successful interventions in transforming nose and lip aesthetics and function. After surgical lip repair, both groups had matching aesthetics.

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