Unilateral complete cleft lip and palate repair using lip adhesion and passive alveolar molding appliance

To manage a unilateral complete cleft lip and palate, lip adhesion along with the positioning of a passive alveolar molding appliance was performed in infants at 3 to 6 weeks of age. The lip adhesion creates a force acting on the cleft alveolus. There-after, the greater segment of the alveolus is guided by the appliance, while the lesser segment of the alveolus is prevented from collapsing. Definite cheiloplasty was then performed at 5 to 6 months of age and palatoplasty at 12 to 14 months of age. Fifteen patients with a unilateral complete cleft lip and palate were treated using this protocol from April 1995 to October 1998. Nine were female and six were male. The mean follow-up period was 13 months. The lip adhesion failed in one patient and was performed again 1 month later. Thirteen patients developed good or fair symmetrically aligned alveolar segments plus a symmetric platform for the nose. However, two patients developed poor maxillary orthopedics because of the displacement of the appliance by the patient. The resulting lip scar was aesthetically acceptable in most patients.