scholarly journals Surgical Techniques for Treatment of Unilateral Cleft Lip

10.5772/67124 ◽  
2017 ◽  
Author(s):  
Mustafa Chopan ◽  
Lohrasb Sayadi ◽  
Donald R. Laub
Keyword(s):  
Cleft Lip ◽  
Surgical Techniques

scholarly journals Revisional Techniques for Secondary Cleft Lip Deformities

2021 ◽  
Vol 35 (02) ◽  
pp. 065-071
Author(s):  
Shayan M. Sarrami ◽  
Anna J. Skochdopole ◽  
Andrew M. Ferry ◽  
Edward P. Buchanan ◽  
Larry H. Hollier ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Early Life ◽  
Cleft Lip ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Minimally Invasive Techniques ◽  
Adjacent Tissue ◽  
Tissue Transfer ◽  
Invasive Techniques

AbstractSecondary deformities of repaired cleft lips are an unfortunate complication despite the meticulous approach of modern primary procedures. Most of these surgeries take place in the patient's early life and must be strategically planned to provide optimal cosmesis with minimal interventions. Depending on the level of severity, treatment of the secondary deformities ranges from noninvasive or minimally invasive techniques to complete revision cheiloplasty. Many novel topical, injectable, and laser therapies have allotted physicians more technical flexibility in treating superficial distortions. Nonetheless, surgical techniques such as diamond excision and adjacent tissue transfer remain popular and useful reconstructive modalities. Deformities involving the orbicularis oris must be completely taken down to allow full access to the muscle. Complete revision cheiloplasty requires recreation of the cleft defect and reconstruction similar to the primary repair. Due to the myriad of presentations of these secondary deformities, familiarity with the various treatments available is imperative for any cleft surgeon.

scholarly journals Histologic Aspect of the Curved Vomerine Mucosa in Cleft Lip and Palate

2021 ◽  
pp. 105566562110314
Author(s):  
Benito K. Benitez ◽  
Andrzej Brudnicki ◽  
Prasad Nalabothu ◽  
Jeannette A. von Jackowski ◽  
Elisabeth Bruder ◽  
...  
Keyword(s):  
Nasal Mucosa ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Squamous Metaplasia ◽  
Periodic Acid ◽  
Surgical Techniques ◽  
Basal Cells ◽  
Periodic Acid Schiff ◽  
Tissue Samples ◽  
Nasal Floor

Background: Common surgical techniques aim to turn the entire vomerine mucosa with vomer flaps either to the oral side or to the nasal side. The latter approach is widely performed due to the similarity in color to the nasal mucosa. However, we lack a histologic description of the curved vomerine mucosa in cleft lip and palate malformations. Methods: We histologically examined an excess of curved vomerine mucosa in 8 patients using hematoxylin–eosin, periodic acid–Schiff, Elastin van Gieson, and Alcian blue stains. Tissue samples were obtained during surgery at 8 months of age. Results: Our histological analysis of the mucoperiosteum overlying the curved vomer revealed characteristics consistent with those of an oral mucosa or a squamous metaplasia of the nasal mucosa, as exhibited by a stratified squamous epithelium containing numerous seromucous glands. Some areas showed a palisaded arrangement of the basal cells compatible with metaplasia of respiratory epithelium, but no goblet cells or respiratory cilia were identified. Abundant fibrosis and rich vascularity were present. Conclusion: The vomer mucosa showed no specific signs of nasal mucosa. These findings should be considered in presurgical cleft orthopedics and palatal surgery for further refinement. Shifting the vomer mucosa according to a fixed physiologic belief should not overrule other important aspects of cleft repair such as primary healing and establishing optimal form and function of palatal roof and nasal floor.

Repair of Protruding Bilateral Cleft Lip and Palate With Staged Premaxilla Setback Osteotomy, Cheiloplasty, and Palatoplasty in Trisomy 17p Patient: A Review of Syndromic Clinical Characteristic

2021 ◽  
pp. 105566562110698
Author(s):  
Kristaninta Bangun ◽  
Jessica Halim ◽  
Vika Tania
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Chromosome 17 ◽  
Long Term Effects ◽  
Surgical Strategies ◽  
Increased Risk ◽  
The Cost

Chromosome 17 duplication is correlated with an increased risk of developmental delay, birth defects, and intellectual disability. Here, we reported a female patient with trisomy 17 on the whole short arm with bilateral complete cleft lip and palate (BCLP). This study will review the surgical strategies to reconstruct the protruding premaxillary segment, cleft lip, and palate in trisomy 17p patient. The patient had heterozygous pathogenic duplication of chromosomal region chr17:526-18777088 on almost the entire short arm of chromosome 17. Beside the commonly found features of trisomy 17p, the patient also presented with BCLP with a prominent premaxillary portion. Premaxillary setback surgery was first performed concomitantly with cheiloplasty. The ostectomy was performed posterior to the vomero-premaxillary suture (VPS). The premaxilla was firmly adhered to the lateral segment and the viability of philtral flap was not compromised. Two-flap palatoplasty with modified intravelar veloplasty (IVV) was performed 4 months after. Successful positioning of the premaxilla segment, satisfactory lip aesthetics, and vital palatal flap was obtained from premaxillary setback, primary cheiloplasty, and subsequent palatoplasty in our trisomy 17p patient presenting with BLCP. Postoperative premaxillary stability and patency of the philtral and palatal flap were achieved. Longer follow-up is needed to evaluate the long-term effects of our surgical techniques on inhibition of midfacial growth. However, the benefits that the patient received from the surgery in improving feeding capacity and facial appearance early in life outweigh the cost of possible maxillary retrusion.

Impact of cleft palate repair on speech and development of dentoalveolar deformities

2021 ◽  
Vol 16 (3) ◽  
pp. 47-53
Author(s):  
Yu.V. Stebeleva ◽  
◽  
Ad.A. Mamedov ◽  
Yu.O. Volkov ◽  
A.B. McLennan ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Normal Functioning ◽  
Primary Surgery ◽  
Cleft Palate Repair ◽  
Congenital Cleft ◽  
Palate Repair ◽  
Late Postoperative Period

Surgical repair of cleft palate is quite difficult because it aims not only to eliminate the anatomical defect of the palate, but also to ensure normal functioning, including speech. Moreover, successful surgery implies no or minimal deformation of the middle face that can be corrected in the late postoperative period. No doubt that primary surgery (both in terms of technique and time) is crucial for further growth and development of the maxilla. However, surgical techniques and the age of primary cleft palate repair vary between different clinics, which makes this literature review highly relevant. Key words: cleft palate repair, cleft palate, congenital cleft lip and palate

scholarly journals Other Scar Types: Optimal Functional and Aesthetic Outcome of Scarring in Cleft Patients

2020 ◽  
pp. 51-57
Author(s):  
Wouter B. van der Sluis ◽  
Nirvana S. S. Kornmann ◽  
Robin A. Tan ◽  
Johan P. W. Don Griot
Keyword(s):  
Surgical Technique ◽  
Psychosocial Functioning ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Surgical Techniques ◽  
Anatomical Structures ◽  
Patient Dissatisfaction ◽  
Optimal Function ◽  
Scar Management

AbstractCleft lip and palate are facial and oral malformation due to failures in the embryologic craniofacial development during early pregnancy. A unilateral cleft lip and palate is the most common type, whereby the upper lip, the orbicularis muscle, the alveolar bone, the floor of the nose, and the hard and soft palate are interrupted, creating an open communication between nasopharynx and oropharynx. Patients with a cleft lip and palate are treated in specialized cleft centers by a multidisciplinary team. Having cleft lip and/or palate has a noteworthy impact on quality of life and psychosocial functioning. Postoperative scarring is a common cause of patient dissatisfaction. The goal of cleft lip surgery is to close the lip, provide optimal function in terms of speech, mastication, dental protection, breathing and feeding, and provide an aesthetically pleasing facial scar. Precise surgical technique and adequate aligning of anatomical structures is important for the postoperative aesthetic result and scar formation. Different surgical techniques are available for this purpose. Optimal scar management can be divided in surgical (precise surgical technique, planning, and adequate aligning of anatomical structures) and nonsurgical methods (botulinum toxin, silicone application, carbon dioxide fractional laser).

Use of the Modified Unilateral Cleft Lip Repair Technique to Establish a Cupid’s Bow With a Natural Structure

2020 ◽  
pp. 105566562096236
Author(s):  
Tatsuya Ishigaki ◽  
Akikazu Udagawa
Keyword(s):  
Surgical Technique ◽  
Cleft Lip ◽  
Surgical Techniques ◽  
Lateral Side ◽  
Natural Structure ◽  
Repair Technique ◽  
Triangular Flap ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Projection Point

Introduction: There are several surgical techniques for unilateral cleft lip repair. In most of these techniques, the points where the postoperative scars cross the vermilion border are on the peak of the Cupid’s bow. These scars make the shape of Cupid’s bow indistinct. To maintain the natural shape of the Cupid’s bow, we modified the surgical technique. Methods: We modified the modified Millard’s surgical technique (Onizuka’s surgical technique). The main point of this modification was as follows: we combined a small triangular flap and a vermilion triangular flap (described by Noordhoff). We maintained the projection point on the lateral side of cleft lip which was coordinated to the peak of the Cupid’s bow. Results: We could preserve the shape and symmetry of the peak of the Cupid’s bow. Conclusion: To keep the projection point on the affected side of cleft lip and the surrounding vermilion border as one curve structure is important in maintaining the natural shape of the Cupid’s bow.

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