“Comparative Evaluation of Aesthetic Outcomes in Unilateral Cleft Lip Repair Between Mohler’s And Fisher’s Repair Techniques – A Prospective, Randomised Observer Blind Study.”

Publication date: Available online 3 September 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mazin Deshmukh, Sushrut Vaidya, Gaurav Deshpande, Jyotsna Galinde, Srivalli Natarajan

Abstract

Purpose

Mohler's and Fisher's are two of the most widely used surgical techniques of cleft lip repair demonstrating satisfactory aesthetic results. Their random use and preference by some irrespective of the cleft severity has invited considerable doubt whether one performs better than the other. The aim of this study was to measure and compare the aesthetic outcomes between these two techniques of unilateral cleft lip repair.

Method

ology: This prospective randomised observer blind study included fifty patients with unilateral cleft lip with/without cleft palate. Pre-operative cleft severity was evaluated based on the Unilateral Cleft Lip Severity Index. All patients were then subjected to either of the 2 techniques of lip repair by randomisation which was performed by a single blinded surgeon. The post-surgical aesthetic outcome was evaluated by using the Surgical Outcomes Evaluation Scale by three laymen. A Pearson product-moment correlation was used to determine of any correlation between cleft severity and aesthetic outcome. A one-way ANCOVA was performed to determine the relation between the technique and the aesthetic outcome using technique as independent variable and aesthetic outcome as dependent variable with the means adjusted using cleft severity as the covariate. A simple main effect (post-hoc) test was performed to find out whether there was any difference in the mean aesthetic outcome for different cleft severity in both techniques.

Results

A total of 50 patients with unilateral cleft lip with/without cleft palate were included in the study among which left sided clefts predominated at 68%. The median age was 8.50 months. A significance was found when relating cleft severity with aesthetic outcomes with the latter worsening with an increasing severity. A significant difference was measured in the mean aesthetic outcome and technique of repair even when means were adjusted for initial cleft severity which showed that Fisher had a significantly better mean aesthetic outcome than Mohler.

Conclusion

Although both techniques showed clinical satisfactory post-operative aesthetics, it was Fisher's that fared better overall when compared to Mohler's.

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