# Surgical Treatment of Lip Pits in Van der Woude Syndrome: A Preliminary Retrospective Study of 24 Patients

## TL;DR

This study examines the surgical treatment of lip pits in 24 patients with Van der Woude syndrome, highlighting the challenges in achieving good aesthetic outcomes.

## Contribution

The paper provides a retrospective analysis of surgical outcomes for lip pits in a single-center cohort of Van der Woude syndrome patients.

## Key findings

- Lip pits were often bilateral in patients with Van der Woude syndrome.
- Many patients required secondary corrections due to unsatisfactory aesthetic results.
- The average number of primary surgical interventions per patient was relatively low.

## Abstract

Van der Woude syndrome (VWS) is a rare congenital malformation characterized by lower lip pits among patients with a lip and/or palate cleft. It is transmitted by an autosomal dominant inheritance with variable expressivity.

The study group consisted of 24 consecutive patients (13 males and 11 females) with VWS operated on at a single center between 2009 and 2022. They suffered from: bilateral cleft lip and palate – 6 patients; unilateral cleft lip and palate – 9 patients; cleft lip – 1 patient; and isolated cleft palate – 8 patients.

In 16 (66%) cases pits of lower lip occurred on both side of midline, while in 8 (34%) the pits were detected unilaterally. The primary cleft repairs were performed according to one-stage principle at the mean age of 8.6 months (SD 1.4, range 6–12). In all patients lower lip pits repairs were performed after the primary cleft repairs as a separate procedure at the mean age of 37 months (SD 11.3 range 14–85). The mean number of all primary repairs of the syndrome—both cleft defect and lower lip pits repairs—was 2.46. Nine patients (37.5%) required additional secondary corrections of the lower lip due to the poor aesthetic post-operative outcome.

The frequent need for secondary corrections of residual lower lip deformities indicates the considerable difficulties in obtaining a satisfactory outcome of the repairs to lip pits caused by VWS. The average number of the primary surgical interventions in evaluated material remained low.