Single-Stage Posterior Vomerine Ostectomy, Premaxillary Setback, Bilateral Gingivoperiosteoplasties and Primary Bilateral Cheiloplasty in Patients with Protuberant Premaxilla

Various patients with complete bilateral cleft lip and palate present with a protruded premaxilla. Several techniques have been described for correctional repair of the projection with a plethora of unsatisfactory outcomes. This poses a challenge not only for the cleft team providing care but also f...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-05, Vol.13 (9), p.2609
Main Authors: Hamdan, Usama S, Garcia Garcia, Jose A, Haddad, Mario S, Younan, Robert A, Melhem, Antonio M, Kantar, Rami S, Najjar, Wassim W
Format: Article
Language:English
Subjects:
Birth defects
Bupivacaine
Care and treatment
Cleft lip
Cleft palate
Developing countries
Diagnosis
Evaluation
Interdisciplinary aspects
LDCs
Methods
Oral surgery
Orthodontics
Orthopedics
Patient outcomes
Patients
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Summary:Various patients with complete bilateral cleft lip and palate present with a protruded premaxilla. Several techniques have been described for correctional repair of the projection with a plethora of unsatisfactory outcomes. This poses a challenge not only for the cleft team providing care but also for the patients and their respective families. Multiple patients suffer from residual deformities after inadequate primary repair, which increase surgical, financial, and psychological burden. Premaxillary setback with posterior vomerine ostectomy and complete bilateral cleft lip repair can promote alignment of the premaxilla with the maxillary prominences. To effectively address this challenging deformity, we describe a single-stage surgical technique that includes vomerine ostectomy posterior to the vomero-premaxillary suture, bilateral gingivoperiosteoplasties with complete bilateral cleft lip repair, and primary cleft rhinoplasty. Careful surgical planning is essential for adequate matching between the length of the protruded premaxilla and the extent of ostectomy. The described technique offers several advantages for the management of complete bilateral cleft lip with a projected premaxilla. It can be applied anywhere around the world and is most beneficial in underprivileged areas where patients suffer from restricted access to healthcare, absence of presurgical orthodontics and lack of sufficient resources.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13092609