Single-Stage Repair of Asymmetrical Bilateral Cleft Lip with Contralateral Lesser Form Defects
Bibliographic record
Abstract
BACKGROUND: Complete or incomplete cleft lip may include a contralateral lesser form of incomplete cleft lip to give rise to an asymmetrical bilateral cleft lip deformity. The principle of simultaneous bilateral cleft repair remains an area of contention with regard to asymmetrical cases, including a lesser form deformity. METHODS: The cleft lip database of the senior author (D.M.F.) was searched for patients with complete or incomplete bilateral cleft lip with a contralateral lesser form defect. Results were assessed by reviewing photographs and recording revisions. RESULTS: Of 111 patients with bilateral cleft lip, 35 (32 percent) had asymmetrical cleft lip, with 13 patients having contralateral lesser form defects. All infants with complete cleft lip-cleft palate underwent presurgical orthodontics. All patients subsequently went on to single-stage bilateral cleft lip repair. Seven revisions were performed in the symmetrical complete bilateral cleft lip group; no revisions were performed in the asymmetrical bilateral cleft lip group. CONCLUSIONS: The authors recommend a single-stage operation for repair of the bilateral cleft lip irrespective of the extent: complete, incomplete, lesser form, symmetrical, or asymmetrical. This approach provides the best opportunity to achieve symmetry of the Cupid's bow and of the resultant scar, and provides the ideal opportunity for reconstruction of the prolabial deficiencies of the cutaneous roll, vermilion, and median tubercle. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".