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Bilateral Cleft Lip: Primary Repair.

Joseph Firriolo1, Ingrid M Ganske2

  • 1Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.

Oral and Maxillofacial Surgery Clinics of North America
|March 18, 2026
PubMed
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Presurgical infant orthopedics improve outcomes for primary bilateral cleft lip repair by managing the prominent premaxilla and aligning alveolar segments. Key principles focus on symmetry and detailed anatomical reconstruction for better results.

Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Pediatric Surgery

Background:

  • Primary bilateral cleft lip repair is a complex surgical procedure.
  • A prominent premaxilla and misaligned alveolar segments pose challenges in achieving optimal outcomes.
  • Presurgical infant orthopedics (PSIO) aims to address these challenges prior to surgical intervention.

Purpose of the Study:

  • To review and emphasize the principles of PSIO for optimizing primary bilateral cleft lip repair.
  • To highlight the impact of established surgical principles on improving repair quality.

Main Methods:

  • Review of established surgical principles for bilateral cleft lip repair.
  • Discussion of PSIO techniques for premaxillary and alveolar management.
  • Emphasis on anatomical considerations for reconstruction.
Keywords:
Bilateral cleft lipCleft lipOrofacial cleft

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Main Results:

  • PSIO effectively addresses the prominent premaxilla and aids in alveolar segment alignment.
  • Adherence to principles like symmetry, synchronous repair, and anatomical reconstruction enhances repair quality.
  • Specific techniques include proper philtral flap design and median tubercle construction.

Conclusions:

  • PSIO is crucial for preparing the cleft site for optimal primary bilateral cleft lip repair.
  • Enduring surgical principles, focusing on anatomical detail and symmetry, are vital for superior outcomes in cleft lip reconstruction.