Cleft lip and palate: current status from the literature and our experience

Many years after surgical correction, a complete unilateral or bilateral cleft is inclined to show an inaesthetism often associated with functional defects. This sequela disturbs the facial growth during childhood. Across the world, each surgical school uses its own protocol, but which is the best surgical protocol for patients with cleft? The aim of this study was to present a review of international literature concerning surgical techniques for the repair of cleft lip and palate (CLP) in children and to report our personal surgical techniques in this field. We focus on the main role of the primary surgery and propose a personalized protocol therapy, depending on the severity of the cleft. On 36 patients, most of them showed unilateral CLP at birth; only 4 showed bilateral cleft. In this study, we used 36 patients without cleft but with class I occlusion for comparison purposes. Analysis of the 2 groups regarding the development of the maxillary arch and the evaluation of palatal morphology was carried out using lateral cephalograms and dental casts. The main result showed 28 patients with acceptable teeth occlusion and speech quality, a valid nasal function, and a proper aesthetic aspect. Controversy still exists regarding the optimum timing and surgical technique for CLP repair. We propose the creation of a scientific database on internationally recognized protocol as a starting point depending on the severity of the cleft, thus avoiding controversies in CLP therapeutic treatment.