Fetal anomalies are now routinely detected by ultrasound allowing for intervention in utero, as a result of this fetal deformities have been treated successfully. The purpose of this study was to examine the long-term (6 months) facial growth after in utero repair of a cleft lip model in the fetal lamb. At 100 days gestation, the uterus was exposed through laparotomy, surgiports were placed in the uterus and a 3–4 mm wedge of upper lip extending into the base of the nose was excised under endoscopic visualization. Repair of the defect was performed endoscopically with staples or in an open fashion with sutures. The treatment groups were: 1) control: fetus observed with endoscope; 2) lip defect created; 3) neonatal repair: lip defect created, lip repair at 5 days old; 4) fetal staple repair: lip defect created and repaired, and; 5) fetal suture repair: lip defect created and repaired. Three-dimensional CT scans of the skulls were obtained at one week and six months of age. Direct measurements of the dry skulls were obtained at six months along with lip histology. The fetal “cleft” model in the lamb demonstrated long-term mid-facial growth inhibition. There was no difference in facial growth between endoscopic staples versus open hysterotomy suture repair. The fetal lamb model does not afford reliable neonatal repair after creation of a cleft defect endoscopically. Intrauterine repair of a cleft lip model appears to improve facial growth as measured at six months of age, both by 3-D CT scan and dry skull measurements.
European Journal of Plastic Surgery – Springer Journals
Published: Jan 1, 1997
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