[Treatment of bilateral cleft lip]

Complexity of treatment of children for congenital bilateral clefts is caused by anatomical and functional impairments of the middle zone of the face present in it: splitting of the upper lip and alveolar process in 3 parts, protrusion of the intermaxillary bone, lack or hypoplasia of muscular fibers in the central portion of the lip, shortening of columella, flattering of the nose wings.

improvement of the methods of surgical treatment of patients for congenital bilateral clefts of the upper lip to obtain higher esthetic and functional results. 62 infants aged 3-9 months with congenital bilateral clefts of the upper lip and associated nose deformation were operated. 37 children were followed up from 2 to 10 years and their long-term results were obtained. Comparative analysis of the long- term results of the patient has shown that deformation of the spitted upper lip with significantly protruded permaxilla does not allow to completely eliminate the present anatomical and functional disorders of the upper lip and nose and thus significantly reduce the efficiently of surgical treatment. Presurgical orthodontic treatment directed to subsiding of intermaxillary bone and reduction of the width of the cleft is indicated to such patients. Surgical restoration of anatomical form of the upper lip and of the function of the circular muscle of the mouth, formation of vestibule of the mouth, correction of the nose deformation allow considerably improve appearance of the patients, contribute to more proper further development of the middle portion of the face and decrease probability for secondary deformation to arise.