INCIDENCE OF SECONDARY LIP SURGERIES AS A FUNCTION OF CLEFT TYPE AND SEVERITY - ONE CENTERS EXPERIENCE

Objective: This study was conducted to ascertain the frequency of surg eries typically required to adequately repair a cleft lip. Material: A ll operations performed on patients with clefts of the lip (alveolus a nd palate) from 1968 to 1990 in the Restock Cleft Center were evaluate d. Methods: Procedures were classified as primary labioplasties versus secondary revisions. Patients were also classified according to cleft type, the anatomical segment revised, and the reason for lip revision . Two indices were calculated. The revision index related the number o f revisions to the number of primary labioplasties. The index of indic ation related the number of patients with revisions to the number of p rimary labioplasties. Results: During the period of study, 712 primary labioplasties and 771 secondary revisions were performed. The overall revision index was 1.10. The index of indication varied from 0.28 for unilateral complete clefts of the lip to 0.67 for bilateral complete clefts of the lip. Revision of the lip was the most common secondary p rocedure, followed by nostril and columella revision, and revision of the oral vestibule. Conclusions: The incidence of secondary surgery of the repaired cleft lip (index of indication) of about 35% is similar to previously reported data. However, the incidence varies with cleft type and is required more often with bilateral complete clefts of the lip.