Document Detail

Repair of bilateral cleft lip: review, revisions, and reflections.
MedLine Citation:
PMID:  14501318     Owner:  NLM     Status:  MEDLINE    
Rarely does the appearance of a child with a repaired bilateral cleft lip compare favorably with that of a child with a repaired unilateral cleft lip. However, there has been a major change in operative strategy during the past decade, and as a result, the typical bilateral cleft nasolabial stigmata are no longer so obvious. The senior author restates the principles for correction of bilateral cleft lip and nasal deformity, and underscores the essential role of preoperative premaxillary positioning. He reviews his method of single-stage closure of the cleft primary palate, including three-dimensional adjustments based on predicted four-dimensional changes. Operative modifications are described for variations of bilateral cleft lip. The authors emphasize the surgeon's obligation for periodic assessment. In a consecutive series of 50 patients with repaired bilateral complete cleft lip/palate, the revision-rate was 33% as compared with 12.5% if the secondary palate is intact. No revisions were necessary for philtral size or columellar length. The authors propose that nasolabial appearance and speech are the priorities in habilitation of the child with bilateral cleft lip/palate rather than the traditional emphasis on maxillary growth.
John B Mulliken; June K Wu; Bonnie L Padwa
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  14     ISSN:  1049-2275     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-22     Completed Date:  2003-11-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-20     Citation Subset:  D    
Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Child, Preschool
Cleft Lip / pathology,  surgery*
Cleft Palate / surgery
Maxilla / surgery
Maxillofacial Development
Oral Surgical Procedures / methods*
Orthodontics, Interceptive
Reconstructive Surgical Procedures / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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