Achieving Complete Nasal Lining Closure at Primary Cleft Palate Repair When the Lesser Segments Have Collapsed

FACE ◽  
2021 ◽  
pp. 273250162110489
Author(s):  
Mert Calis ◽  
Raymond W. Tse
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Palatal Shelf ◽  
Alveolar Bone Grafting ◽  
Medial Pterygoid ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Inside Out ◽  
Anatomic Relationship

Obtaining a tension-free 2-layer anatomic closure at cleft palate repair reduces risks of fistula and facilitates later alveolar bone grafting. Anterior nasal lining closure can be one of the most challenging aspects of repair but is rarely discussed. We present our approach to palatoplasty for BCLP and additional technical maneuvers for closure in the unfavorable configuration when the lesser segments are collapsed against the vomer: “inside-out” approach along the cleft margin provides access for accurate incision; elevation of medial pterygoid mucoperiosteum provides access further anteriorly to separate nasal lining from palatal shelf; mobilization of lining off of bone when 2 structures are in apposition opens a space for access; nasal lining can be drawn into view with a hook; and the nasal lining closure can be passed back through the space to heal in an anatomic relationship, cephalic to the bony shelves.

scholarly journals BILATERAL CLEFT PALATE REPAIR BY USING TONGUE FLAP FOLLOWED BY ALVEOLAR BONE GRAFTING - A CASE REPORT

2021 ◽  
Vol 71 (1) ◽  
pp. 370-72
Author(s):  
Memuna Kausar Satti ◽  
Zainab Qasim ◽  
Farwa Rais ◽  
Ayousha Iqbal ◽  
Maahin Shoaib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Alveolar Bone ◽  
Postoperative Results ◽  
Tongue Flap ◽  
Alveolar Bone Grafting ◽  
Cleft Palate Repair ◽  
Palate Repair

A clinical case of bilateral cleft palate repair using previous tongue flap followed by Alveolar Bone Grafting(ABG). After pre-surgical orthodontics a surgical procedure whereby previous tongue Flaps were reflected, nasalbeds were prepared on both sides. A cortico-cancellous bone of 2 cm was harvested from iliac crest and grafted inclefts. Patient is kept on follow up to monitor healing, postoperative results and any post- operative complication.

Wharton's Jelly for Augmented Cleft Palate Repair in a Rat Critical-Size Alveolar Bone Defect Model

2020 ◽  
Vol 26 (11-12) ◽  
pp. 591-601 ◽  
Author(s):  
Suchit Sahai ◽  
Marysuna Wilkerson ◽  
Hasen Xue ◽  
Nicolas Moreno ◽  
Louis Carrillo ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Bone Defect ◽  
Alveolar Bone ◽  
Critical Size ◽  
Wharton’S Jelly ◽  
Defect Model ◽  
Wharton's Jelly ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Alveolar Bone Defect

Alveolar Bone Grafting

2019 ◽  
pp. 95-98
Author(s):  
Raj M. Vyas ◽  
Gennaya L. Mattison
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Crucial Role ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting ◽  
Cleft Lip Repair

Alveolar bone grafting plays a crucial role in cleft reconstruction. When neonatal presurgical orthodontia is successful in aligning the cleft segments, alveolar reconstruction can be initiated as a gingivoperiosteoplasty during primary cleft lip repair. In children with cleft palate, alveolar bone grafting is usually done after transverse maxillary expansion with a palatal expander. Exact timing of bone grafting is controversial; most centers initiate orthodontic evaluation/expansion between ages 7 and 8 years (beginning of mixed dentition) with an aim to bone graft before age 10 in order to allow osteogenic incorporation prior to eruption of the permanent canine teeth.

Evaluation of Alveolar Bone Grafting: A Survey of ACPA Teams

2005 ◽  
Vol 42 (1) ◽  
pp. 99-101 ◽  
Author(s):  
Ananth S. Murthy ◽  
James A. Lehman
Keyword(s):  
North America ◽  
Cleft Palate ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Alveolar Bone ◽  
Donor Site ◽  
X Rays ◽  
Alveolar Bone Grafting ◽  
Missing Tooth

Objective To evaluate the management of alveolar clefts by cleft palate and craniofacial teams in North America. Design An anonymous survey was mailed to 240 American Cleft Palate– Craniofacial Association teams across North America regarding alveolar bone grafting. The questionnaire included multiple questions about each team's approach to alveolar bone grafting and options for the missing tooth. Results Consensus was achieved in three areas: 90% of centers performed secondary alveolar bone grafting, 78% performed grafting between ages 6 and 9 years, and iliac crest donor site was the most popular site (83%). There was no consensus with respect to dental criteria for the timing of grafting, follow-up x-rays, or the use of a grading system for evaluating results. In addition, there was no consensus on the management of the missing tooth. Conclusion There is wide acceptance of secondary bone grafting and there is a consensus for the age of grafting (6 to 9 years) and donor site (iliac crest). The disturbing finding was the lack of postoperative x-ray evaluation of the results. With so much variability in management, the use of a routine, standardized scale to measure postoperative results would allow for better outcome studies in alveolar bone grafting.

Cleft Palate Repair

2019 ◽  
pp. 519-530
Author(s):  
Catharine B. Garland ◽  
Joseph E. Losee
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Postoperative Care ◽  
Cleft Palate Repair ◽  
History Of ◽  
Palate Repair ◽  
Alternative Techniques ◽  
Relationship Of ◽  
Normal Speech ◽  
Anatomic Relationship

Cleft palate repair is performed to allow for normal speech production, development, and social interactions. The goal of surgery is to restore the normal anatomic relationship of the tissues and muscles. The history of cleft palate repair has evolved from techniques that simply closed the mucosal layers to those that return the musculature of the palate to its normal anatomic position. A variety of techniques remain in common use today. This chapter reviews the relevant anatomy, preoperative and postoperative care, and the operative technique. The authors emphasize their preferred method of repair, the Furlow palatoplasty, and discuss in detail the steps for reconstruction of the hard and soft palate, with modifications as necessary to suit different cleft anatomy. Alternative techniques for cleft palate repair are reviewed in brief.

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