Introduction: Labial and nasal deformities have always been a fundamental problem in the treatment of cleft lip, alveolus and palate patients. The primary surgical treatment of nasolabial area is of paramount importance in order to obtain both an esthetical correction of the deformity and a progressive and a balanced development of mid-face. In this study the nasal deformities in patients with cleft lip, alveolus and palate (CLAP) were analyzed and the relevant role of the perinasal, perioral muscular balance and the inborn dislocation of the alar cartilages are presented.
Patients And Methods: 50 CLAP patients were analyzed, 40 UCLP and 10BCLP. The lip repair was done by modification of Millard's technique. The severity of the cleft appearance was evaluated pre and post operatively, according to a pre-agreed visual rating scale. There are 4° of severity of the deformity pre operatively (mild, moderate, severe and very severe) and post operatively 5 categories of outcome (excellent,very good, good, satisfactory and poor), depending on the scores obtained by summing up the points corresponding to different types of deformity. This scale is closely related to the American Cleft Palate classification of clefts.
Results: In the 40 UCLP patients, 8 excellent, 10 very good, 16 good and 6 satisfactory results were obtained following primary cheiloplasty. In 10 BCLP patients 1 very good, 7 good, 1 satisfactory and 1 poor result were obtained.
Conclusions: During the primary repair, it is important to correct the abnormal position of ala nasi, the nasal floor and the base of the columella. Abnormalities in the insertion of the nasolabial muscles with their abnormal function contribute to the cleft nose deformities. Therefore the reconstruction not only the orbicularis muscle but also of the paranasal muscles is therefore important for a symmetrical growth of the nose. Separate suture of intrinsic orbicularis oris provide a better shape to the vermillion. The position of the alar cartilage plays an important role for the symmetry of the nose. It is necessary to place the alar base symmetrically in three dimensions.
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http://dx.doi.org/10.1007/s12663-011-0298-6 | DOI Listing |
Chirurgie (Heidelb)
January 2025
Klinik für Mund‑, Kiefer- und Plastische Gesichtschirurgie, Zentrum für Zentrum für Lippen-Kiefer-Gaumenspalten und seltene oro-kranio-faziale Fehlbildungen, Universitätsmedizin Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
Background: Cleft lip and palate is the most frequent malformation in humans that requires surgical correction but is not primarily life-threatening. That is why in many economically not very well developed countries, special surgical care, such as for cleft lip and palate, is not guaranteed at all or is not sufficiently guaranteed, so that numerous aid organizations have been founded for over 50 years to provide help by organizing surgical aid missions. Even if this help seems primarily ethically harmless and very laudable, the lack of rules and instructions unfortunately regularly leads to the fact that legal, ethical and even medical treatment standards are often not observed to the detriment of the affected children.
View Article and Find Full Text PDFTurk J Pediatr
December 2024
Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
Background: Any impediment to the development of midline structures i.e. hypothalamus, pituitary and oral cavity may cause anatomical and functional issues.
View Article and Find Full Text PDFCleft Palate Craniofac J
January 2025
Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Objective: The purpose of this study was to quantify analgesic use following alveolar cleft bone grafting (ABG) utilizing a posterior iliac crest (PIC) donor site.
Design: This is a prospective cohort study of consecutive patients that underwent ABG with PIC in a 10 month period from November 2022 to September 2023.
Setting: Tertiary care free-standing pediatric hospital.
J Plast Reconstr Aesthet Surg
January 2025
Research & Evidence (RF&E), Vasant Kunj, New Delhi, India. Electronic address:
Am J Orthod Dentofacial Orthop
January 2025
Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey. Electronic address:
Introduction: The objective of this study was to evaluate the effects of the miniplate application sites in the maxilla and the applied force vector changes during skeletally supported facemask application in adolescent patients with unilateral cleft lip and palate (UCLP) using finite element model (FEM) analysis.
Methods: A FEM was obtained from a cone-beam computed tomography image of a 12-year-old female patient with UCLP. Miniplates were placed on 3 different sites of the maxilla; 500 g of advancement force was applied bilaterally, parallel (0°), and downward (-30°) to the occlusal plane.
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