Maxillofacial Plastic and Reconstructive Surgery

  • 제40권
  • /
  • Pages.43.1-43.5
  • /
  • 2018
  • /
  • 2288-8101(pISSN)
  • /
  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Bilateral cleft lip repair with simultaneous premaxillary setback and primary limited rhinoplasty

  • Park, Young-Wook (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Chan-Woo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University)
  • 투고 : 2018.08.20
  • 심사 : 2018.11.14
  • 발행 : 2018.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Functional closure of the orbicularis oris muscle and esthetic reconstruction of nasolabial components are impossible in patients with severely deformed premaxilla. Here, we review a surgical strategy for patients with unremedied premaxilla retrospectively. Results: Vomerine ostectomy and premaxillary setback with nasolabial repair were performed in 12 patients with bilateral cleft lip and palate. The mean age of patients was 21.7 months. The extent of ostectomy varied between 3 and 11 mm. There were no serious complications from defective perfusion to the premaxilla or the philtral flap. The follow-up period ranged from 2 to 25 months. Proper positioning of the premaxilla and satisfactory nasolabial esthetics were achieved in all patients. Conclusions: We performed nasolabial repair after premaxillary setback without jeopardizing the premaxillary segment or the philtral flap. Our surgical strategy could be recommended in poor socio-economic circumstances due to the cost effectiveness of limiting the number of surgeries.

키워드

참고문헌

  1. Latham RA (1973) Development and structure of the premaxillay deformity in bilateral cleft lip and palate. Br J Plast Surg 26:1-11 https://doi.org/10.1016/S0007-1226(73)80028-1
  2. Meazzini M, Lematti L, Mazzoleni F, Rabbiosi D, Bozzetti A, Brusati R (2010) Vertical excess of the premaxilla in bilateral cleft lip and palate patients. J Craniofac Surg 21:499-502 https://doi.org/10.1097/SCS.0b013e3181cffb4d
  3. Mahmood R, Flood T, Robinson S, Al-Gholmy M (2016) Early orthopedic retraction of the premaxilla in bilateral complete cleft lip and palate: an innovative approach to a difficult problem. Cleft Palate Craniofac J 53:363-367 https://doi.org/10.1597/14-045
  4. Vura N, Gaddipati R, Palla Y, Kumar P (2018) An intraoral appliance to retract the protrusive premaxilla in bilateral cleft lip patients presenting late for primary lip repair. Cleft Palate Craniofac J 55:622-625 https://doi.org/10.1177/1055665617732783
  5. Vyas RM, Kim DC, Padwa BL, Mullikan JB (2016) Primary premaxillary setback and repair of bilateral complete cleft lip: indications, technique, and outcomes. Cleft Palate-Craniofac J 53:302-308 https://doi.org/10.1597/14-099
  6. Mulliken JB (2000) Repair of bilateral complete cleft lip and nasal deformity-state of the art. Cleft Palate Craniofac J 37:342-347 https://doi.org/10.1597/1545-1569(2000)037<0342:ROBCCL>2.3.CO;2
  7. Narayanan RK, Hussain SR, Murukesan S, Murthy J (2006) Synchronous palatal closure and premaxillary setback in older children with bilateral complete cleft of lip and palate. Plast Reconstr Surg 117:527-531 https://doi.org/10.1097/01.prs.0000200768.32026.3f
  8. Murthy J (2009) Primary bilateral cleft lip repair with management of premaxilla without preoperative orthopedics. J Craniofac Surg 20:1719-1722 https://doi.org/10.1097/SCS.0b013e3181b3eec3
  9. Burezq H, Bang RL, George A, Mukhtar A (2007) Unusual clinical presentation of a severely protruding premaxilla in patients with bilateral clefts. J Craniofac Surg 18:971-974 https://doi.org/10.1097/scs.0b013e3180a77326
  10. Rahpeyma A, Khajehahmadi S, Ghaseme A (2016) Premaxillary osteotomy fixation in bilateral cleft lip/palate: introducing a new technique. Asian J Surg 39:90-95 https://doi.org/10.1016/j.asjsur.2015.03.016
  11. Cronin TD (1956) Management of bilateral cleft lip with protruding premaxilla. Am J Surg 92:810-806 https://doi.org/10.1016/S0002-9610(56)80185-2
  12. Trott JA, Mohan N (1993) A preliminary report on one stage open tip rhinoplasty at the time of lip repair in bilateral cleft lip and palate: the Alor Setar experience. Br J Plast Surg 46:215-222 https://doi.org/10.1016/0007-1226(93)90171-7
  13. Xu H, Salyer KE, Genecov ER (2009) Primary bilateral one-stage cleft lip/nose repair: 40-year Dallas experience: part I. J Craniofac Surg 20:1913-1926 https://doi.org/10.1097/SCS.0b013e3181b6c82d
  14. Fakih-Gomez N, Sanchez-Sanchez M, Iglesias-Martin F, Garcia-Perla-Garcia A, Belmonte-Caro R, Gonzalez-Perez LM (2015) Repair of complete bilateral cleft lip with severely protruding premaxilla performing a premaxillary setback and vemerian ostectomy in one stage surgery. Med Oral Patol Oral Cir Bucal 20:e500-e507
  15. Friede H, Morgan P (1976) Growth of the vomero-premaxillary suture in children with bilateral cleft lip and palate. A histological and roentgencephalometric study. Scand J Plast Reconstr Surg 10:45-55
  16. Friede H (1978) The vomero-premaxillary suture- a neglected growth site in mid-facial development of unilateral cleft lip and palate patients. Cleft Palate J 13:398-404
  17. Bittermann GKP, de Ruiter AP, Janssen NG, Bittermann AJN, van der Molen AM, van Es RJJ, Rosenberg AJWP, Koole R (2016) Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us. Clin Oral Invest 20:207-217 https://doi.org/10.1007/s00784-015-1589-y
  18. Padwa BL, Sonis A, Bagheri S, Mulliken JB (1999) Children with repaired bilateral cleft lip/palate: effect of age at premaxillary osteotomy on facial growth. Plast Reconstr Surg 104:1261-1269 https://doi.org/10.1097/00006534-199910000-00004
  19. Kobayashi S, Hirakawa T, Fukawa T, Satake T, Maegawa J (2017) Synchronous premaxillay osteotomy with primary cheiloplasty for BCLP patients with protrusion of premaxillae. PRS Global Open. https://doi.org/10.1097/GOX.0000000000001402