الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
UCL repair surgical techniques developed dramatically in the last few decades. The scope nowadays is not focused on surgical modifications only; however, it is more targeting the underlying concepts and foundation. The concept of hiding the scar lines in the least detectable anatomical fusion areas was the basic idea behind the WRV flap developed by Mishra et al. WR continuity preservation and gaining symmetrical CBs was one of the WRV flap motivators. Giving attention to OOM’s role in the aesthetic and symmetrical outcomes in UCL repair structured our basic study design idea. We conducted our clinical study aiming to investigate the role of MOOM repair modifications in either dissection or suturing in conjunction with WRV flap on the aesthetic results after PCLR. Thus, we enrolled 40 infants with an age range of 2.5 – 5 months born with non-syndromic UCL. We divided them into two equal groups. The basic group was the WRV group with simple OOM repair via judicious dissection and simple interrupted suturing. The 2nd study group was the MOOM group with meticulous, anatomical dissection and orientation in addition to horizontal mattress suturing to gain and elevated PR support for the cutaneous scar and to aid in anatomically regaining the muscle orientation. The assessment was divided into two main categories: aesthetic evaluation and symmetrical measurements.
The aesthetic evaluation was in the form of professional evaluation such as the Asher McDade index for four parameters (nasal form, deviation, vermillion border, and nasal profile) which showed a general clinically significant improvement at 3 months in each group in comparison with the 1 month within each group with an insignificant difference between the two groups at 1 and 3 months.
Another professional evaluation was a VAS score of 100 mm for WR continuity and philtrum similarity which resulted in a significant improvement at 3 months in comparison with the 1 month within each group with better results in the MOOM group compared with the WRV group. The guardian’s perception of the general overall appearance and the surgical scar was evaluated via an interview questionnaire. which showed there was a significant increase in the level of satisfaction in the MOOM group compared with the WRV group at 6 months.
The final assessment tool was the objective calibration and measurement of PR length to compare the operated side with the normal non-cleft side. and this showed a clear PR length improvement at 6 months compared with immediate postoperative in each group and on each side. In the scope of those results, we concluded that OOM anatomical repair is a good solution for scar contraction prevention or limitation, which augments the PR support, and that repair modification allowed more aesthetic stability. Finally, we recommend applying the WRV flap with MOOM protocol for further clinical studies such as bilateral CL repair, to evaluate our results via digital 3D soft tissue scanners, and to participate in community service educational programs.