• Yun Liang, Yusheng Yang, and Yilai Wu.
• Department of Oral and Craniomaxillofacial Surgery, The Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Institute of Stomatology, National Center for Clinical Research of Oral Diseases, Shanghai, China.
• Medicine (Baltimore). 2019 Jul 1; 98 (29): e16161e16161.

RationaleInsignifificant, asymmetrical or lack of labial tubercle often occurs after cleft lip surgery due to improper treatment of vermilion tissue. Especially in the cases of bilateral cleft lip, because of short front lip and insuffificient vermilion tissue, the median vermilion depression often occurs after surgery, forming a "whistling" deformity. The object of this study is to verify the outcomes of patients with median labial tubercle detects after treatment with bilateral vermilion musculomucosal sliding flflaps (VMSF).Patient ConcernsSix patients with median labial tubercle defect after bilateral cleft lip repair from March 2015 to May 2017 were enrolled in our department and subjected to bilateral lip deformity correction under general anesthesia.DiagnosesSecondary deformity of bilateral cleft lip forming a "whistling" deformity were diagnosed in all the patients.InterventionsBilateral VMSF were designed and used to reconstruct the median labial tubercles by sliding downward so as to eliminate the whistling deformity.OutcomesDuring the 10 to 37 months of follow-up, the reconstructed vermilion tubercles had stable morphology showing no whistling deformity and the overall lip shapes were satisfactory.LessonsReconstructing MVTD and eliminating whistling deformity using the scar tissues that need to be removed previously on the vermilion musculomucosa has achieved stable and satisfactory results and is worthy of clinical application.

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