Bilateral Cleft Lip and Cleft Palate

Abstract

Background : Infant born with cleft lip and cleft palate problem requires treatment to restore the integrity of facial soft tissue

Objective : The objective of this article is to present a treatment procedure for the bilateral compleate cleft lip and cleft palate infant.

Setting : Orthodontic Department, Faculty of Dentistry, Khon-Kaen University and Srinagarind Hospital, Faculty of Medicine, Khon-Kaen University

Intervention : The initial treatment used a presurgical orthopedic appliance. The surgical treatment comprised gingivoperiosteoplasty, primary lip and nasal reconstruction, all done in one-stage.

Result : A better early facial soft tissue esthetics was achieved.

Conclusion : A Thai male infant, aged 15 days, born in Khon-Kaen Province, came to Sringarind Hospital with the problem of complete bilateral cleft lip and cleft palate. An obturator with lip strapping was delivered in order to help with the feeding problem. At the same time, time, this appliance was used to mold the primary palate and lateral palatal segments into a better relationship, and to lessen the gap width of the cleft. The reduced distance between the prolabium and lateral lip segments helped decrease soft tissue tension during and after lip repair. Besides, a special appliance, the Naso-Alveolar Molding appliance (NAM) was used for this baby in order to help molding the alar cartilages and extending the columella length before the surgery. A one-stage surgery combining the gingivoperiosteoplasty, lip and nasal reconstruction was performed. The result of this coordinated treatment brought about better early esthetics of the soft tissue lip and nose.

Key words : Nasoalveolar Molding Appliances. Bilateral Cleft Lip and Cleft Palate. Presurgical Orthopedics. Primary lip and nose reconstruction. Gingivoperios teoplasty