Cleft - Ultimate Treatment
Orthognathic repair for cleft deformities - The ULTIMATE Clinical pearls To achieve the ultimate result various aspects have to be considered. Ignoring one or more of these aspects will lead to suboptimal aesthetic and functional results. 1. About 20% to 30% of facial cleft deformity patients need orthognathic surgical intervention. 2. Accurate planning of orthognathic deformity in cleft lip and palate cases is essential. Besides the occlusal and skeletal aspects, soft tissue planning for the facial appearance is very important. 3. Sometimes optimal aesthetics as well as optimal functions in patients with facial cleft deformity cannot be achieved equally, even with perfect orthognathic surgery. Optimal aesthetics might sometimes lead to compromised function. 4. Conventional surgical approaches for osteotomies may be used in CL and CLA cases. In CLAP, hPsP and sP cases, velopharyngeal competence always needs to be assessed. In these cases with full velopharyngeal competence, but NOT for cases with a borderline competence, conventional orthognathic surgery is feasible. Maxillary anterior positioning in CLAP, hPsP and sP of more than 5 to 6 mm should be done by distraction osteogenesis.
Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...