The Double Unilimb Z-Plasty Technique for Whistler Deformity Repair in Unilateral Cleft Lip Patients An Anthropometric Study

Objective: The purpose of this study was to evaluate the symmetry in lip and vermillion height after using the double unilimb Z-plasty method for whistler deformity repair. Design: This is a retrospective audit of 1 surgeon's outcome of 52 consecutive performed whistler deformity repairs. Setting: Data from the Outreach Surgical Center Program, Lima, Peru, were used. Patients: Since 2009, 52 adult patients with lip deformity related to unsatisfactory unilateral cleft lip repair were operated on using the double unilimb Z-plasty. All these patients met the study criterion of having anthropometric measurements performed at least 1 year postoperatively. Main Outcome Measures: Data collection of lip and vermilion height was performed at the right and left side of the lip, immediately before the surgery (preoperatory) and at least 1 year postoperatively. The lip measurements were obtained using calipers. Analysis: The matched pair t test analyses were performed when the assumptions required were met. When the normality assumption was not met, the Wilcoxon signed rank test, a nonparametric test, was used to assess the statistical significance of differences between the cleft side and the noncleft side. Results: The study found no statistically significant differences between the right and left side in lip height (P = 0.51) and vermilion height (P = 0.57) after lip repair using the double unilimb Z-plasty technique measured at least 1 year postoperatively. Conclusions: The findings suggest that the double unilimb Z-plasty technique is a good alternative to address the whistler deformity related to the unilateral cleft lip primary repair. This is a simple method, easy to perform by surgeons, for whistler deformity management in unilateral cleft lip patients.