A Custom Stabilizing Splint for the Management of BLCP with Protruding Premaxilla

Area of Science:

• Craniofacial Surgery
• Pediatric Plastic Surgery
• Cleft Lip and Palate Research

Background:

• A protruding premaxilla in bilateral cleft lip and palate (BCLP) hinders orbicularis oris muscle closure and nasolabial reconstruction.
• Surgical correction typically involves vomerine osteotomy and premaxillary setback, often staged due to vascular compromise risks.
• Existing stabilization methods for the premaxillary segment carry risks of compromising blood supply.

Purpose of the Study:

• To present a novel custom oral splint for stabilizing the premaxilla during BCLP repair.
• To evaluate the efficacy of a two-stage premaxillary setback using this splint.
• To assess the impact on vascular supply and subsequent cheiloplasty and rhinoplasty outcomes.

Main Methods:

• Development and application of a custom oral splint for premaxillary stabilization.
• Two-stage premaxillary setback procedure.
• Subsequent primary cheiloplasty and rhinoplasty after splint removal and healing.

Main Results:

• The custom oral splint effectively maintained premaxillary position.
• Minimal impingement on the blood supply to the premaxilla was observed.
• Successful primary cheiloplasty and rhinoplasty were achieved in both cases.

Conclusions:

• A custom-stabilizing oral splint is a viable method for managing premaxillary protrusion in BCLP.
• This technique offers improved stability with reduced risk of vascular compromise.
• It facilitates successful primary lip and nose repair in patients with BCLP and protruding premaxilla.