Correction of labial tubercle defect in repaired bilateral cleft lips using bilateral vermilion musculomucosal sliding flaps Case series

Rationale: Insignifificant, asymmetrical or lack of labial tubercle often occurs after cleft lip surgery due to improper treatment of vermilion tissue. Especially in the cases of bilateral cleft lip, because of short front lip and insuffificient vermilion tissue, the median vermilion depression often occurs after surgery, forming a "whistling" deformity. The object of this study is to verify the outcomes of patients with median labial tubercle detects after treatment with bilateral vermilion musculomucosal sliding flflaps (VMSF). Patient concerns: Six patients with median labial tubercle defect after bilateral cleft lip repair from March 2015 to May 2017 were enrolled in our department and subjected to bilateral lip deformity correction under general anesthesia. Diagnoses: Secondary deformity of bilateral cleft lip forming a "whistling" deformity were diagnosed in all the patients. Interventions: Bilateral VMSF were designed and used to reconstruct the median labial tubercles by sliding downward so as to eliminate the whistling deformity. Outcomes: During the 10 to 37 months of follow-up, the reconstructed vermilion tubercles had stable morphology showing no whistling deformity and the overall lip shapes were satisfactory. Lessons: Reconstructing MVTD and eliminating whistling deformity using the scar tissues that need to be removed previously on the vermilion musculomucosa has achieved stable and satisfactory results and is worthy of clinical application.