Cleft - Ultimate Treatment
Median clefts with premaxillaprolabium-columella agenesis - The ULTIMATE Clinical pearls To achieve the best clinical outcome various aspects have to be followed. Ignoring one or more of these aspects may lead to suboptimal aesthetic and functional results. 1. Median facial clefts are rare with a prevalence of 2.3% among all clefts. In 65.3% they are associated with a holoprosencephaly and in 9.5% with another syndrome. 2. Patients born with a holoprosencephaly, with median cleft and premaxilla-prolabium-columella agenesis, are operated under the following criteria: (i) being in good health for more than one year and if suffering from epileptic seizures, being well-controlled; (ii) if parents are well-informed informed about the long-term prognosis, but still desire surgery, and (iii) if the baby is to be baptized in public or needs to have a normal facial appearance for similar occasions. 3. One anaesthetic procedure only is of major benefit to patients with a holoprosencephaly as they are prone to develop complications during and/or after the anaesthesia. 4. A modified Cronin columella repair is suitable for patients who previously had cleft lip surgery only. 5. To reconstruct the columella, an intra-nasal skin flap, without strut, is used, and is rotated and connected during the simultaneous median lip closure.
Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...