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Simultaneous options for cleft secondary deformities.
Domenico Scopelliti1, Flavia Maria Graziana Fatone, Orlando Cipriani
1Department of Cranio-Maxillo-Facial Surgery, Santo Spirito Hospital, Rome, Italy.
Annals of Maxillofacial Surgery
|November 9, 2013
Summary
This study demonstrates that simultaneous corrective surgeries for cleft lip and palate significantly improve patient satisfaction with facial aesthetics and function. Combined surgical approaches offer a single-step solution, reducing patient distress and psychological impact.
Area of Science:
- Craniofacial Surgery
- Plastic Surgery
- Orthognathic Surgery
Background:
- Cleft lip and palate deformities present complex challenges requiring specialized surgical interventions.
- Secondary deformities arise from scar tissue, inhibited growth, and lip tension, necessitating advanced treatment strategies.
- Restoring regional anatomy to near-normal function and appearance is the primary goal in cleft surgery.
Purpose of the Study:
- To evaluate the efficacy of simultaneous corrective surgeries for cleft lip and palate deformities.
- To assess patient satisfaction with combined surgical procedures addressing both skeletal and soft tissue abnormalities.
- To determine the impact of single-stage surgical correction on patient well-being and functional outcomes.
Main Methods:
- A cohort of 25 patients with unilateral or bilateral cleft lip and palate underwent comprehensive diagnostic assessments including cephalometric, photographic, and radiological analyses.
- Advanced imaging techniques like temporomandibular joint (TMJ) tomography, MRI, and computerized gnatography were employed to evaluate TMJ function.
- Simultaneous surgical procedures included maxillomandibular osteotomies (Le Fort I and bilateral sagittal split osteotomy), genioplasty, rhinoplasty, and labioplasty, followed by patient questionnaires.
Main Results:
- Combined Le Fort I and bilateral sagittal split osteotomies were performed in 65% of patients; Le Fort I osteotomy alone in 35%.
- A low relapse rate of 4.5% was observed post-surgery.
- High patient satisfaction was reported: 96% for jaw surgery, 88% for lip-nose surgery, with 76% recommending the procedure.
Conclusions:
- Simultaneous correction of cleft lip and palate deformities offers a consolidated approach to improve facial aesthetics and function.
- Single-stage surgical intervention minimizes patient distress and reduces the risk of psychological consequences associated with multiple procedures.
- Combined orthognathic and reconstructive surgeries provide significant functional and aesthetic benefits, leading to high patient satisfaction.
