Controversies and advances in unilateral cleft lip repair

The unilateral cleft lip and nasal deformity is a complex congenital malformation involving the bony skeleton and the soft tissues of the lip and nose. Correction of this deformity requires an understanding of the pathologic anatomy and of the effects on midfacial growth associated with surgical repair. This article discusses the timing and the common techniques used in surgical repair of unilateral clefts. Surgical treatment of the associated alveolar cleft, as well as the primary nasal deformity, is detailed. Recent experimental advances including in utero endoscopic repair of cleft deformities are discussed. The improved scar formation associated with fetal wound healing makes in utero cleft repair a promising technique for the future.