Primary Repair of Bilateral Cleft Lip and Nasal Deformity
- 1 July 2001
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 108 (1), 181-194
- https://doi.org/10.1097/00006534-200107000-00028
Abstract
After studying this article, the participant should be able to: 1. List five principles that guide synchronous repair of bilateral complete cleft lip and nasal deformity. 2. Explain how different growth rates for the principal nasolabial features are applied during primary repair. 3. Describe two approaches for positioning the alar cartilages to form the columella. 4. Discuss the influences on referral patterns for a newborn with bilateral cleft lip. --Traditional repair of bilateral cleft lip focused on labial closure but accentuated the nasal deformities, which were addressed later. By the end of the past century, single-staged labial closure had replaced the old multistaged procedures and the technical emphasis had begun to shift from secondary to primary nasal correction. Now, presurgical maxillary orthopedics sets the bony foundation for synchronous nasolabial repair and for closure of the alveolar clefts. The study of normal nasolabial growth and the typical stigmata of the conventional methods provides the necessary foreknowledge to guide surgical sculpture in three dimensions and to anticipate the fourth dimension. The convergence of several forces are changing referral lines for children born with bilateral cleft lip. These include affirmation of centers of excellence, surgeons' self-regulation, prenatal diagnosis, economics of health-care delivery, and increasing parental sophistication. These pressures are not necessarily in conflict. Care by a subspecialized plastic surgeon and experienced team is in the best interests of the child and the third-party payer.Keywords
This publication has 48 references indexed in Scilit:
- Cleft Palate and Craniofacial Teams in the United States and Canada: A National Survey of Team Organization and Standards of CareThe Cleft Palate Craniofacial Journal, 1998
- Tulip Flap for Reconstruction of the Central Tubercle in Cleft Lip PatientsPlastic & Reconstructive Surgery, 1998
- Three-Dimensional Facial Anthropometry Using a Laser Surface Scanner: Validation of the TechniquePlastic and Reconstructive Surgery, 1996
- Bilateral Complete Cleft Lip and Nasal DeformityPlastic and Reconstructive Surgery, 1995
- Facial Impairment Scales for CleftsPlastic and Reconstructive Surgery, 1994
- Augmentation of the Nostril Splint for Retaining the Corrected Contour of the Cleft Lip NosePlastic and Reconstructive Surgery, 1990
- Principles and Techniques of Bilateral Complete Cleft Lip RepairPlastic and Reconstructive Surgery, 1985
- Cleft Lip Nasal DeformityAnnals of Plastic Surgery, 1984
- CLOSURE OF BILATERAL CLEFT LIP AND ELONGATION OF COLUMELLA BY TWO OPERATIONS IN INFANCYPlastic and Reconstructive Surgery, 1971
- BILATERAL CLEFT LIP REPAIR AND THE FLOATING PREMAXILLAPlastic and Reconstructive Surgery, 1961