[Secondary treatment of cleft lip and palate].

For 18 years our protocol has corrected the cleft lip nose and achieved an intravelar veloplasty at the time of the first operation, leaving the least scaring as possible. No doubt that the best treatment of the sequellae is their prevention: - the oro-nasal fistulas have disappeared; the nostril is almost normal; the continuity of a wide maxillary arch is restored in primary dentition - all that favor a nasal ventilation. This context has changed the nature of the secondary treatment described here.

[Primary treatment of cleft lip and palate. Its fundamental principles].

If the multiplicity of functional protocols of cleft lip and palate treatment has been bewildering, it is now a source of learning. The lessons we can draw from them assist us to choose the best age for the primary surgery and a chronology that prevents the palate from the worst scaring. Eventually, with 18 years of follow-up, the best functional achievement comes unexpectedly from an ambitious primary rhinoplasty that had till now been condemned.

[Bifid mandibular condyle: position of the supernumerary condyle].

Introduction: Bifid condyles are uncommon and include post-traumatic aberrant reorganization of the temporomandibular joint (TMJ) and congenital forms.

Case Report: We report two cases of unilateral bifid condyles, responsible for functional dysfunction of the TMJ. The first case, probably of congenital origin, was oriented frontally.

[Nasal sequels of unilateral clefts: analysis and management].

Usually, the nasal sequels of unilateral cleft patient are just considered as an esthetic problem to be addressed after the growth spurt of adolescence. This very narrow vision has led the cleft lip and palate treatment to a deadend. Actually, nasal sequels are the worst in terms of consequence on facial growth.

[A functional approach in the primary treatment of labial-alveolar-velopalatine clefts for a minimum of sequels].

Is the poor potential of growth an ineluctable consequence of mesodermal deficiency? Should we agree with the idea that all protocols are equivalent? Actually, these opinions reflect the empiricism of previous generations. We must now become rational and develop a project without compromise to achieve good functions at primary surgery. 'The normal structures are present on either side of the cleft, only modified by the fact of the cleft.