ABSTRACT
The earliest documented history of cleft lip is based on a combination of religion,
superstition, invention and charlatanism. While Greeks ignored their existence, Spartans
and Romans would kill these children as they were considered to harbour evil spirits.
When saner senses prevailed Fabricius ab Aquapendente (1537–1619) was the first to
suggest the embryological basis of these clefts. The knowledge of cleft lip and the
surgical correction received a big boost during the period between the Renaissance
and the 19th century with the publication of Pierre Franco's Petit Traité and Traité
des Hernies in which he described the condition as “lièvre fendu de nativitè” (cleft
lip present from birth). The first documented Cleft lip surgery is from China in 390
BC in an 18 year old would be soldier, Wey Young-Chi. Albucasis of Arabia and his
fellow surgeons used the cautery instead of the scalpel and Yperman in 1854 recommended
scarifying the margins with a scalpel before suturing them with a triangular needle
dipped in wax. The repair was reinforced by passing a long needle through the two
sides of the lip and fixing the shaft of the needle with a figure-of-eight thread
over the lip. Germanicus Mirault can be credited to be the originator of the triangular
flap which was later modified by C.W. Tennison in 1952 and Peter Randall in 1959.
In the late 50s, Ralph Millard gave us his legendary ‘cut as you go’ technique. The
protruding premaxilla of a bilateral cleft lip too has seen many changes throughout
the ages OE from being discarded totally to being pushed back by wedge resection of
vomer to finally being left to the orthodontists.
KEY WORDS
Cleft lip surgery - History of cleft lip - History of premaxilla management
