[Surgical protocol of velo-palatal and labio-nasal clefts]

Based on a series of 52 cases of velopalatine and labionarinal clefts treated according to the same principle of therapeutic chronology, the authors define their recent surgical protocol for the primary repair of these clefts. Satisfactory functional repair of the tongue and platysma muscles of the face determine the good anatomical results and, in particular, the development of the maxilla together with the results on speech and middle ear pathology. Pathophysiological elements argue in favour of staphylorrhaphy as the first operative stage in unilateral labiovelopalatine clefts associated, at the same time, with cheilorhinoplasty; passive orthodontia is generally performed until the secondary palatoplasty. The surgical repair technique is closely related to this therapeutic timing in terms of the muscular and periosteal detachments.