2006, Number 4
Treatment for patients with bilateral cleft lip palate and prominent premaxila
Pérez GA, Ayuso AA, Alvarado LU, Alba PR
Full text
Language: Spanish
References: 16
Page: 174-180
PDF size: 63.21 Kb.
ABSTRACT
Introduction: Patients with complete cleft lip palate are a challenge for their correction. A multidisciplinary team is necessary for the establishment of priorities of attention according to the general condition of each patient, the severity of the defect and the patient’s age. The main objective of this study is to realize orthopedic surgery before the main repair with fast palate expansion, premaxilla retraction and posterior programmed surgery with anatomic closure of the nasal floor and cleft lip repair with the Mendoza technique.Objective: to shorten the time of the maxillar expansion and retroposition of the premaxilla in patients with bilateral cleft lip palate and prominent premaxilla, allowing better esthetical results.
Material And Methods: All patients admitted to the plastic surgery service with the diagnosis of bilateral clift palate and prominent premaxilla no longer than 3 years old, from January 2002 to December 2004. lateral cefalograms were realized , dentary models and clinical pictures before and after surgery. Under general anesthesia, the fast maxillar expansion procedure was realized by installing a Latham screw.
Secondarily a contention plaque with an expansion screw and two rings located anterior and medial to each palate segment of the plaque. Transversal to the premaxilla a nail was inserted for the support of its retraction, by fixing the nail to the palate plaque ring with an elastic chain. Finally bilateral cleft lip repair was made with the Mendoza technique.
Results: 16 patients were included, 13 male and 3 female ages from 9 months to 3 years, with an average of 5 months. It was observed during surgery that the maxillary process expanded and average of 11mm, allowing de correct orientation of the premaxilla at the post surgical time. The retro position of the premaxilla (18mm) was accomplished 21 days after surgery. The form of the arc was favorable for the surgical correction in a follow up of 30 months.
Conclussion: We found normal growth of the maxilla and an adequate relationship to the patients age. The post surgical expansion of the lateral segments allows in a brief time the adequate orientation of the premaxilla; this will give better esthetic results in bilateral cleft lip palate repair.
REFERENCES