Optimizing Aesthetic Outcomes in Unilateral Cleft Lip Repair: Three-Dimensional Anthropometric Analysis of the Modified Onizuka Technique
Issued Date
2026-04-27
Resource Type
ISSN
10492275
eISSN
15363732
Scopus ID
2-s2.0-105044898083
Journal Title
Journal of Craniofacial Surgery
Volume
Publish Ahead of Print
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Craniofacial Surgery Vol.Publish Ahead of Print (2026)
Suggested Citation
Chaisrisawadisuk S., Jaruniphakul K., Seesun P., Nakkon M., Apichonbancha S., Sinmaroeng C., Chaisrisawadisuk S. Optimizing Aesthetic Outcomes in Unilateral Cleft Lip Repair: Three-Dimensional Anthropometric Analysis of the Modified Onizuka Technique. Journal of Craniofacial Surgery Vol.Publish Ahead of Print (2026). doi:10.1097/SCS.0000000000012803 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/118173
Title
Optimizing Aesthetic Outcomes in Unilateral Cleft Lip Repair: Three-Dimensional Anthropometric Analysis of the Modified Onizuka Technique
Author's Affiliation
Corresponding Author(s)
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Abstract
This study evaluates anthropometric outcomes of a modified Onizuka technique for unilateral cleft lip (CL) repair using 3-dimensional (3D) photogrammetry, with emphasis on anatomic subunit reconstruction without preoperative numerical measurements. A prospective cohort study was conducted at a tertiary craniofacial center. Sixty-one patients with unilateral CL and/or palate who underwent CL repair using the modified Onizuka technique were enrolled. The technique relocates key landmarks to the footplate of the medial crus, preserves an 80° angular design at the peak of Cupid’s bow, and uses a V-Y advancement flap for frenulum reconstruction. Concurrent primary rhinoplasty and gingivoplasty were performed. Anthropometric symmetry was assessed via 3D imaging at ≥1-year follow-up, including nostril width, columellar height, central and medial lip height, lateral lip height and length, and hemi-Cupid’s bow width. The cohort comprised 60.7% males, with 70.5% having left-sided clefts and 67.2% having complete clefts. Median age at surgery was 5.0 months. All intraclass correlation coefficient values exceeded 0.75, indicating good to excellent reliability. No statistically significant differences were observed between cleft and noncleft sides (all P>0.05). Mean differences were <0.2 mm, below the threshold of human visual perception. The modified Onizuka technique achieves symmetric outcomes in unilateral CL repair, validated by objective 3D metrics. Its emphasis on anatomic subunit reconstruction without preoperative numerical marking offers a versatile, reproducible approach for diverse cleft phenotypes.