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Treatment Protocols From Neonate To Adult

Reasons for a surgical protocol 1. To achieve optimal closure and to avoid oro-nasal fistulae (principle → closure from inside to outside, the mirror-image protocol) 2. To utilise the best predictable surgical techniques for a complete closure:

sP:

an intravelar veloplasty with

a tensor stitch to activate the Eustachian tube

a Sommerlad’s levator and palato-glosso-pharyngeal muscle repositioning and reconstruction, and an Ivanov’s uvula reconstruction

an inferior or caudally-based vomer flap or

hP:

a superior or cranially-based vomer flap with a PdLAlLA* resorbable sheet

CA:

an anterior nasal floor flap in the cranial part of the cleft

CL:

an anatomical lip-plasty [unilateral type] and

a Broadbent’s modification or Noordhoff-Trott [bilateral] type technique

3. To achieve optimal speech development and occlusal function 4. To avoid midfacial growth disturbances (= dysgnathia) by choosing adequate primary surgical techniques 5. To avoid revision surgeries and excessive orthodontic treatment * Poly-lactic acid sheet (a sheet to cover the vertical triangular defect for maintaining the blood clot; as such to achieve an ideal flat palatal healing)

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Cleft Ultimate Treatment  

Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...

Cleft Ultimate Treatment  

Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...

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