Quantifying Sagittal Lip Changes in Patients with Bilateral Cleft Lip Post Abbe Flap Reconstruction

Abstract

Objectives To objectively quantify results of sagittal lip changes following Abbe flap reconstruction in patients with bilateral cleft lip. Design Retrospective, observational study. Setting Single institution, 8-year retrospective review. Patients/Participants In total, 17 patients with bilateral cleft lip that underwent Abbe flap reconstruction were included in this study. Intervention Patients had lateral photographs taken prior to Abbe flap reconstruction and at least 8 months post-Abbe flap. Main Outcome Measurements Vegter's index, Sushner's S2 line and Burstone's B line reference lines were used for evaluation of sagittal lip changes. Wilcoxon signed rank tests were used in analysis. Results The mean pre-Abbe flap upper to lower lip ratio, defined as Vegter's Lip Index, was 0.906 compared to a mean of 0.946 following Abbe flap reconstruction. The mean upper to lower lip ratio for Sushner's S2 and Burstone's B line exhibited an increase in upper lip sagittal projection from −0.164 to 1.459 and 0.259 to 0.957, respectively (P < 0.001). Conclusions This study quantifies sagittal changes to upper and lower lip position after Abbe flap reconstruction. These findings may aid in operative planning and patient/caregiver expectations during counseling.