Tennison randall triangular flap technique

Flap and tennisonrandall flap techniques for surgical. This triangular flap approach became known as the tennison randall repair. Triangular flap repair of the congenital earlobe cleft. Randalls modification randall 1959 modified by reducing the size of the inferior. Nov 22, 2017 basic steps of triangular flap technique sorry for the low light subscribers, please turn up brightness on your device. Once the basic principles of cleft lip repair are fully understood the operation is fairly. This triangular flap approach became known as the tennisonrandall repair. Basic steps of triangular flap technique sorry for the low light subscribers, please turn up brightness on your device. Though he called it a stencil method, it came to be known as the tennison triangular flap technique. A retrospective evaluation of the aesthetics of the. This technique is based on careful measurements of specific landmarks.

This repair technique is conceptually similar to the rotation advancement repair. We applied the tan technique to 32 consecutive 19 male and female patients with unilateral cleft. It gives less reason for mistakes according to the cut as you go techniques because of the basis of mathematical principles and measurements. Unilateral cheiloplasty iowa head and neck protocols. The method is a modification of that of millard and involves a small triangular flap on the end of the vermilion ridge. Quizlet flashcards, activities and games help you improve your grades. In 1966, thomas cronin from houston described elevation of the lateral triangular flap 1 mm above the mucocutaneous border to facilitate vermilion alignment. The inclusion criteria were a non syndromic patients. Tennison introduced the triangular flap technique of unilateral cleft liprepair, which preserved the cupids bow in 1952. A versatile technique to reconstruct the thumb mahesh prabhu1, rajesh powar 1 and sanjitsingh r sulhyan research paper background. The rotation advancement technique of millard has the greatest number of followers and is recognized as a simple method once experience is obtained however, a number of surgeons prefer a triangular technique, since it seems simpler to lay out and perform and is less of a cut as you go free hand performance. Tennisonrandall triangular flap repair it utilizes the interdigitation of triangular flaps geometric design. The tennisonrandall technique then creates a too long lip on the affected side, since you bring in a triangle of extra tissue. The rotation advancement technique of millard has the greatest number of followers and is recognized as a simple method once experience is obtained however, a number of surgeons prefer a triangular technique, since it seems simpler to lay out and perform and is.

Randall built on tennisons design by adding key anatomic landmarks and geometric techniques to seek mathematic symmetry at closure. Twentysix patients received the tennisonrandall technique and 74. The second most commonly used method of lip repair uses the interdigitation of triangular flaps tennison and randall. A comparative study of immediate wound healing complications. Some compromise among the criteria is required, especially for atypical cases, such as those with a long vertical height on the noncleft side and a short lateral lip element. Jun 22, 2008 the tennison randall procedure is known as a geometrical design requiring exact presurgical measurements. Others have, on the other hand, adopted tennisonrandall technique in their cleft lip repair because of its geometrical predictability and reliability, consistency in decreasing vertical lip. Surgical outcome and complications following cleft lip and.

Tennison was inspired by lemesurier, but moved the zplasty to the cleft side cupids bow peak. Nasolabial symmetry following tennisonrandall lip repair. These two points mark the base of the columella and the alar base. Triangular cleft repair vanderbilt university medical center. Repair of the unilateral cleft lip advanced considerably during the past century 7, 8, with two methods being popular among clinicians. Pdf comparison between millards rotational advancement flap. A number of surgical procedures for the repair of a unilateral cleft lip are well described, with a multitude of variations, including the lemesurier quadrilateral flap repair, randalltennison. The noordhoff technique utilizes a lateral lip triangular flap to reconstruct the dry. The length of the noncleft side of the lip is our goal. Tennisonrandall procedure and the millard procedure. Many papers have described surgery for congenital and acquired clefts.

Both techniques recognize the importance of repositioning the lip muscle orbicularis oris in a correct anatomic orientation that results in an aesthetic as well as a functional improvement. The first dorsal metacarpal artery fdma flap or kite flap or fouchers flap is an island pedicle flap proximally based on the first dorsal metacarpal artery and veins william c pederson, 2011. A distinct advantage of this technique is that the scar of the suture line recreates the natural philtral column. Karapandzic flap was used in one of the electrical burn patient due to the involvement of the oral commissure. The geometry of the triangular flap was described by. The marcks zplasty modification of the tennison triangular flap cleft lip repair results in excellent preservation of the cupids bow, but in more severe clefts this technique is stigmatized by a characteristic vshaped nasal rim deformity.

The triangular flap technique recognizes that cupids bow is high on the cleft side. The apically displaced flap technique is selected for cases that present a minimal amount of keratinized, attached gingiva. Tennison z plasty tennison 1952 frustrated by straightline scar contraction in blacks zplasty technique which preserves the cupids bow and places it in normal position he inserted a wedge from the lateral lip into the lower portion of the medial lip, and achieved good results and called it stencil method came to be known as the tennison triangular flap technique. A number of surgical procedures for the repair of a unilateral cleft lip are well described, with a multitude of variations, including the lemesurier quadrilateral flap repair, randalltennison triangular flap repair, millard rotationadvancement repair, 14, 15 and skoog and kernahanbauer upper and lower lip zplasty repairs. The tan repair lengthens the vertical lip using a triangular flap, resulting in a. This approach provides continuity of the vermilion ridge, and promotes a natural appearance of the upper part of the philtrum on the cleft side. Two points of closure along the nostril floor are designed so that. The geometry of thetriangular flap was described by randall, who popularized this method of liprepair. Subciliary transcutaneous lower eyelid blepharoplasty, skin technique. Dec 08, 2008 the tennison triangular flap technique described by randall demonstrates that the medial lip element contains the essential landmarks for cupids bow. A history of cleft lip and cleft palate surgery pocket. It involves the raising of a triangular flap at the cleft side lateral lip segment, which is moved into an artificial. On the other hand, our method also presents an excellent approximation of both the deep and.

This surgical technique is applicable for all complete or incomplete unilateral cleft lips. The gingivolabial sulcus incision was made and simonarts band transected with needle point cautery and the premaxillary flap was raised to release the tissue. Cleft lip and palate at university of british columbia. A triangular flap is made on the lateral side of the cleft, where the vermilion height is the greatest, just before the red line converges to meet the white roll at the cleft edge noordhoffs point. Child with an upper gi alteration 2 study guide by nd1993 includes 75 questions covering vocabulary, terms and more.

After suturing was complete, the skin wound was dressed with sofratulle gauze, over which dry gauze was placed, and plaster was applied over the dry gauze. The cleft lip appeared completely and incompletely in 11 and 21 patients, respectively. For example, the lemesurier 7 quadrangular flap, and the tennison 8randall 9 triangular flap. Rotation flap advancement flap lateral mobilization primary nasal correction primary alar cartilage dissection primary septal repositioning columella closure of the anterior hard palate at the time of cleft lip repair closure of lip postoperative care. Jun 04, 2019 tennison introduced the triangular flap technique of unilateral cleft lip repair, which preserved the cupids bow in 1952. The triangular flap operation sustained a long period of popularity with many variations. The most important side of being learn easily of tennison randall technique is because of being geometrical. The tennison triangular flap technique described by randall demonstrates that the medial lip element contains the essential landmarks for cupids bow.

Triangular with ala nasi tan repair of unilateral cleft. Millard rotationadvancement repair and tennisonrandall triangular flap technique. Millard ii skoogs technique mohlers technique tennisonrandall triangular flap delaires functional lip closure afroze technique bl cleft lip straight line closure columella lengthening. However the triangular flap again gained popularity with widespread practice in many highly regarded institutions. In 1959, randall modified the tennison method by reducing the size of the inferior. Techniques of repair ul cleft lip millards rotational advancement modifications of millards technique.

Study 14 cleft lip and palate flashcards from rob m. This point is chosen to create a symmetric cupids bow. Sep 28, 2016 techniques of repair ul cleft lip millards rotational advancement modifications of millards technique. Tennison randall procedure and the millard procedure. A schematic representation of the incisions for a tennison. In an effort to not only demonstrate that excellent results can be achieved when incisional patterns millard and tennison are used appropriately small versus large clefts, we compared the results of two types of repairs, performed by a single surgeon over a period of 30 years. Jun 15, 2018 a number of surgical procedures for the repair of a unilateral cleft lip are well described, with a multitude of variations, including the lemesurier quadrilateral flap repair, randall tennison triangular flap repair, millard rotationadvancement repair, 14, 15 and skoog and kernahanbauer upper and lower lip zplasty repairs. Child with an upper gi alteration 2 flashcards quizlet. The tan repair lengthens the vertical lip using a triangular flap, resulting in a nonlinear, zigzag scar on the philtral ridge and forming a symmetrical cupids bow, superiorities of the tennisonrandall repair.

Open rhinoplasty for correction of the secondary nasal. The geometry of the triangular flap was described by randall, who popularized this method of lip repair. The techniques described for the repair of acquired clefts are not always appropriate for congenital clefts. There is no agreement on the ideal timing and the technique of repair among established and experienced cleft surgeons. The technique plans for a diagonal incision directly above the raised lateral peak into the philtrum. Triangular flapthe triangular flap repair was initially described in 1952 by tennison, in 1959, randall described a mathematical approach to the triangular flap that was on the basis of precise measurements. The tennison randal triangular technique, a popular cleft lip repair technique, was favored on one occasion because the defect was located in the upper lip. Comparison between millards rotational advancement flap and. Both these techniques resulted in scars impinging on the lower. Elevation of the mucosasubmucosa from the orbicularis oris muscle was performed on the lateral cleft flap first using 3397 scissors.

Lemesurier 62 which of the following techniques is the ideal for the reconstruction of an upper or lower fullthickness eyelid defect of up to 50%. In addition, some operations specifically designed for congenital clefts require more complicated techniques. For example, the modified triangular flap, or tennisonrandall repair, can be of value when presented with the wider unilateral cleft lip. Pattern of presentation and management of lip injuries in a. The flap technique for pocket therapy pocket dentistry. Lemesurier 2 the pinch technique in blepharoplasty is most commonly used with which technique a. Patients treated using tennisonrandall flap triangular flap technique 30 patients. Unilateral cleft lip repair modified millards technique dr. Nov 20, 2017 this incision opens to achieve the desired height of the medial lip.

Triangular flap technique group t figure 1 millards rotational advancement flap technique group m figure 2 and was performed for 30 patients each. Tennisonrandalls triangular technique is the most widely used triangular technique due to its geometrical predictability and reliability and its consistency. This has proven extremely difficult to correct secondarily. The method of triangular repair most often described is p. Standardized steps or criteria for designing a triangular flap do not always fit for all types of cleft lip repair. Surgical techniques for treatment of unilateral cleft lip intechopen.

Oct 09, 2012 triangular flapthe triangular flap repair was initially described in 1952 by tennison, in 1959, randall described a mathematical approach to the triangular flap that was on the basis of precise measurements. Part 2 primary and secondary surgical surgical treatment. The popularity of the triangular flap technique tennison randall dimin. The popularity of the triangular flap technique tennisonrandall dimin ished in the 1970 to 1980s with the gaining popularity of the millard proce dure. This technique 5 matches a downward rotation flap on the medial lip with an advancement flap on the lateral lip.

Tennison introduced the triangular flap technique of unilateral cleft lip repair, which preserved the cupids bow in 1952. In twentytwo 10yearold uclap patients, who had the lip repaired using the tennisonrandall technique and did not undergo further revisional surgery, differences were determined between landmarks, surface areas of the upper lip vermilion and nostrils and virtual volumes of midface, nose and upper lip for cleft and noncleft sides, separately, after having established. Others have, on the other hand, adopted tennison randall technique in their cleft lip repair because of its geometrical predictability and reliability, consistency in decreasing vertical lip contraction, and its application in wide cleft. After suturing was complete, the skin wound was dressed with sofratulle gauze, over which dry gauze was placed, and plaster was ap. This incision opens to achieve the desired height of the medial lip. Cleft lip operation tennisonrandall vs millard lip surgery. Technical strategies triangular with ala nasi tan repair of. For example, the modified triangular flap, or tennisonrandall repair, can be of value. The triangular flap technique, originally presented in 1952 by tennison 1952 and modified in 1959 by randall 1959, is based on a geometric design and requires a high degree of precision in marking the incisions. The tennisonrandall procedure is known as a geometrical design requiring exact presurgical measurements. Most current techniques in north american focus on variations of the triangular flap technique of randalltennison,9, 10 or the rotation flap technique of millard11, 12. The tennisonrandall technique involves a backcut that extends from the cleft. Physical assessment of the infant with cleft lip andor palate. Cleft lip and palate surger dental implant courses.

Surgical techniques for treatment of unilateral cleft lip. The tennisonrandal triangular technique, a popular cleft lip repair technique, was favored on one occasion because the defect was located in the upper lip. The noordhoff technique utilizes a lateral lip triangular flap to reconstruct the dry vermilion. For this reason, the internal bevel incision should be made as close to the tooth as possible i. Triangular with ala nasi tan repair of unilateral cleft li. The concept underlying the technique can be similarly compared to a z plasty reconstruction of the lip. Millard rotationadvancement repair and tennison randall triangular flap technique. It involves the raising of a triangular flap at the cleft side lateral lip segment, which is moved into an artificial defect that is created in the medial lip segment after. Cleft lip surgery a practical guide the cleft surgery organisation. Tennison randall flap technique or triangular flap technique for.