Chapter 1:
Surgery of Cleft Palate 


Clefts of the Lip and Palate

Feeding an Infant

Surgery

Unilateral Cleft Lip Repair

Bilateral Cleft Lip 

Cleft Palate Repair

Pharyngeal Flap

Late Cleft Treatment

Pierre Robin Syndrome

 

CHAPTERS 

Introduction

Clefts of the Lip and Palate

Ear Reconstruction

Craniosynostosis

Orbital Reconstruction

Treacher Collins Syndrome

Nasal Reconstruction

Orthognathic Surgery

Trauma Reconstruction

Hemifacial Microsomia

Summary

Cleft Lip Repair - The objective in repairing the lip is to close the cleft to create a pleasing face that will develop normally with minimal scarring. Closure of the lip is performed by the plastic surgeon when the baby is approximately 3 months of age and weighs at least 10 pounds. When there is involvement of the alveolus and palate, an orthodontic appliance may be placed in the maxillary segments as the first procedure. This is performed by the team dentist as an outpatient surgical procedure. The appliance is used to align the alveolus so that it can be repaired (gingivoperiosteoplasty) at the time of the lip repair or lip adhesion. This improves nasal support on the cleft side and creates a tunnel that should develop bone, closing the cleft. If the alveolus is not closed in infancy, then the alveolar ridges will be orthodontically aligned and a bone graft performed to stabilize the maxilla (5-10 years of age). Correction of the nasal deformity is usually performed at the time of lip repair. Additional procedures may be necessary to enhance the appearance of either the lip or nose.

       Surgery of Clefts of the Lip and Palate

A unilateral cleft lip is shown. 

A custom fitted Latham appliance has been fabricated and placed to rotate alveolar segments together.

Postoperative result is shown after repair of alveolar 
cleft and lip. 

 
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The Tennessee Craniofacial Center, part of the Erlanger Health System, is located in Chattanooga, Tennessee. The Center, led Larry A. Sargent, M.D., specializes in the evaluation and treatment of patients of all ages with craniofacial deformities. Location: 975 East Third Street. Chattanooga, Tennessee 37403
Phone: 423-778-9192 or 800-418-3223 Fax: 423-778-8172
Internet: www.craniofacialcenter.com Copyright ©1997, 2000, Erlanger Health Systems