Abstract
Post-surgical scars of cleft lip patients can lead to abnormal lip activity, which causes deficient maxillary growth. The aim of the present study was to assess the effect of laser therapy on the appearance and electrical activity of the upper lip in cleft lip and palate patients. Twelve patients with cleft lip and palate participated in this study. All patients had surgically repaired the cleft lip at the age of about 3–6 months. The lip scars underwent five fractional CO2 laser treatment sessions with a 4-week interval. Improvement of the quality of the skin texture was recorded according to quartile grading scale based on photographs taken before and 1 month after treatment. Patients’ satisfaction survey was also recorded using Patient Scar Assessment Questionnaire (PSAQ) before and after laser therapy. Moreover, the EMG activity of the upper lip muscle was measured before and after treatment. According to dermatologists, the improvement of scar appearance ranged from 0.5 to 3, with a mean of 1.29 ± 0.86. Mean scores of the scar appearance (p < 0.001), symptoms (p = 0.003), and scar consciousness (p < 0.001) subscales of the PSAQ questionnaire had significantly increased after treatment. The EMG recording of the upper lip had decreased significantly after laser treatment at rest (p = 0.009) and maximum lip compression (p = 0.007). The fractional CO2 laser is an effective method for treating old scars of the cleft lip with a significant change in the opinion of patients about their scar appearance. Also, the therapy can help to reduce the EMG activity of the upper lip at rest.
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References
Eslami N, Majidi MR, Aliakbarian M, Hasanzadeh N (2013) Oral health-related quality of life in children with cleft lip and palate. J Craniofac Surg 24:e340–e343
Li W, Lin J, Fu M (1998) Electromyographic investigation of masticatory muscles in unilateral cleft lip and palate patients with anterior crossbite. Cleft Palate Craniofac 35:415–418
Konan P, Manosudprasit M, Pisek P, Pisek A, Wangsrimongkol T (2015) Oral health-related quality of life in children and young adolescent orthodontic cleft patients. J Med Assoc Thail 98(Suppl 7):S84–S91
Antoun JS, Fowler PV, Jack HC, Farella M (2015) Oral health-related quality of life changes in standard, cleft, and surgery patients after orthodontic treatment. Am J Orthod Dentofac Orthop 148:568–575
Hasegawa T, Matsukura T, Mizuno Y, Suga Y, Ogawa H, Ikeda S (2006) Clinical trial of a laser device called fractional photothermolysis system for acne scars. J Dermatol 33:623–627
Behroozan DS, Goldberg LH, Dai T, Geronemus RG, Friedman PM (2006) Fractional photothermolysis for the treatment of surgical scars: a case report. J Cosmetic Laser Ther 8:35–38
Waibel J, Beer K (2009) Ablative fractional laser resurfacing for the treatment of a third-degree burn. J Drug Dermatol 8:294–297
Cervelli V, Gentile P, Spallone D, Nicoli F, Verardi S, Petrocelli M et al (2010) Ultrapulsed fractional CO2 laser for the treatment of post-traumatic and pathological scars. J drug Dermatol 9:1328–1331
Liao Y-F, Mars M (2005) Long-term effects of palate repair on craniofacial morphology in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J 42:594–600
Doğan S, Önçağ G, Akın Y (2006) Craniofacial development in children with unilateral cleft lip and palate. Br J Oral Maxillofac Surg 44:28–33
Szyszka-Sommerfeld L, Woźniak K, Matthews-Brzozowska T, Kawala B, Mikulewicz M (2017) Electromyographic analysis of superior orbicularis oris muscle function in children surgically treated for unilateral complete cleft lip and palate. Craniomaxillofac Surg 45:1547–1551
Asilian A, Salimi E, Faghihi G, Dehghani F, Tajmirriahi N, Hosseini SM (2011) Comparison of Q-Switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar. J Res Med Sci 16:1189
Alster TS, Tanzi EL, Lazarus M (2007) The use of fractional laser photothermolysis for the treatment of atrophic scars. Dermatol Surg 33:295–299
Lee SH, Zheng Z, Roh MR (2013) Early postoperative treatment of surgical scars using a fractional carbon dioxide laser: a split-scar, evaluator-blinded study. Dermatol Surg 39:1190–1196
Tanzi EL, Alster TS (2004) Comparison of a 1450-nm diode laser and a 1320-nm Nd: YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatol Surg 30:152–157
Tierney E, Mahmoud BH, Srivastava D, Ozog D, Kouba DJ (2009) Treatment of surgical scars with nonablative fractional laser versus pulsed dye laser: a randomized controlled trial. Dermatol Surg 35:1172–1180
Mundy LR, Miller HC, Klassen AF, Cano SJ, Pusic AL (2016) Patient-reported outcome instruments for surgical and traumatic scars: a systematic review of their development, content, and psychometric validation. Aesthet Plast Surg 40:792–800
Ryu HJ, Choi JE, Ahn HH, Kye YC, Seo SH (2014) A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars. Dermatol Surg 40:973–978
Ha JM, Kim HS, Cho EB, Park GH, Park EJ, Kim KH et al (2014) Comparison of the effectiveness of nonablative fractional laser versus pulsed-dye laser in thyroidectomy scar prevention. Ann Dermatol 26:615–620
Karmisholt KE, Taudorf EH, Wulff CB, Wenande E, Philipsen PA, Haedersdal M (2017) Fractional CO2 laser treatment of caesarean section scars—a randomized controlled split-scar trial with long term follow-up assessment. Lasers Surg Med 49:189–197
Acknowledgments
The authors like to thank vice-chancellor of research of Mashhad University of Medical Sciences (Iran). The results of this study are drawn from a post-graduate thesis.
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This study was financially supported by the Mashhad University of Medical Sciences (Grant No.= 941141).
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Author A has received a research grant from the University of Medical Sciences. There are not any other conflicts of interests.
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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee of the University of Medical Sciences and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Jahanbin, A., Eslami, N., Layegh, P. et al. Fractional CO2 laser treatment for post-surgical lip scars in cleft lip and palate patients. Lasers Med Sci 34, 1699–1703 (2019). https://doi.org/10.1007/s10103-019-02819-z
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DOI: https://doi.org/10.1007/s10103-019-02819-z