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    • Does the Botulinum Toxin Affect the Philtral Length in Primary Repair of Unilateral Cleft Lip?

    1Dawlat Emara, Mamdouh Aboulhassan, 1Waleed El-Moez Reda, 2Malek Tawfiq
    Department of 1Plastic and Reconstructive Surgery, Faculty of Medicine, Cairo University; 2Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University

    Background: Repair of cleft lip deformities requires careful planning to create functional and aesthetically pleasing upper lip contour. Cleft lip scar has a serious impact on appearance. Many factors affect the formation of a scar, as continuous muscle contraction. The botulinum toxin has been used recently to minimize facial scarring by decreasing wound tension as it produce a localized muscle weakness. The injection of botulinum toxin into lip muscles reduces the continuous muscle contraction and skin tension and creates a good condition for wound healing and reduction of the formation of hypertrophic lip scar after lip repair. We suggest that preoperative botulinum toxin injection into the orbicularis oris muscle of wide cleft lip patients improves the outcome of cleft lip repair. Methods: In this study, 20 patients with complete unilateral cleft lip were divided into two groups, the first group was injected with botulinum toxin (10 patients) and the other group control (10 patients) was injected with saline. Injection was done with insulin syringe 7 days before primary lip repair using modified Millard cheiloplasty. The patient’s scars were assessed using photography and scar length and width measurements after 3 and 6 months. Results: The difference between the two groups was statistically significant after 3 and 6 months. These results show that botulinum toxin had a better effect in decreasing the scar width and increasing the philtral length. Conclusions: Botulinum toxin injection into the orbicularis oris muscle in unilateral complete cleft lip preoperatively shows significant improvement in the cheiloplasty scar. Key words: Botulinum toxin, Cleft lip repair, Philtral length. 

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