[Long-term morphologic results of a 32 successive patients series presenting unilateral complete cleft lip and palate with surgery at early age]

R Le Pendeven, V Martinot-Duquennoy, P Pellerin
Annales de Chirurgie Plastique et Esthétique 2009, 54 (1): 7-15

STUDY OBJECTIVE: The aim of this retrospective study is to describe and evaluate the long term morphologic results of patients who present unilateral complete cleft lip and palate.

PATIENTS AND METHODS: Thirty-two patients with non syndromic unilateral complete cleft lip and palate were operated early by the same surgeon, at the mean age of 70,4 days old, with two operating procedures. The first group was operated of cheiloplasty with the Millard method during the neonatal period, associated to the closure of the palate in the same time. The second group was operated with a modified Millard method during the neonatal period associated to a closing of the palate by the Wardill method at the age of ten months old. The criteria of evaluation were the anatomic remaining abnormalities after surgery of nose, lips, primary and secondary palate (back of 17 years).

RESULTS: Our results show that Millard method and derived are taken as a whole effective, even if the number of secondary surgery and supplementary adjustments was sizeable (87%). The postoperative abnormalities concerning red lip (discontinuity, mucous excess) were frequent (53%), but easily correctable. The secondary surgeries were mainly for minor touch up of lip (46%), second time palate surgeries (53%), and rhinoplasties (40%).

CONCLUSION: Progress in anesthesia and reanimation allowed us to assure an early management of clefts. The absence of incorrigible after-effects by a secondary surgery of the first-operated patients encouraged the team to continue in this way.

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