Repair of unilateral cleft lip deformity: maxilla, nose and lip

The congenital cleft lip deformity is defined as a tripartite reconstructive problem: restoration of the cleft maxilla, correction of the nasal deformity, and repair of the lip. Procedures extensively based on new principles for the surgical management of these malformations are described and shown in detail. They allow consideration of the entire reconstructive task in the primary operation.For maxillary reconstruction the osteogenic capacity of tissues bordering the cleft is utilized. The operation involves subperiosteal exposure of the bone and the establishment of periosteal continuity between the maxillary segments, using local flaps of the periosteal membranes. Surgicel® is used as a scaffolding between the periosteal surfaces to bring about deposition of a mass of bone. In complete clefts a two-stage procedure is recommended for periosteal repair and for the implantation of Surgicel. Observations on the effect of periosteo-plasty confirmed previous reports: the procedure will lead to the formation ...