[Osteotomy of the median tubercule as a consequence of bilateral complete labio-maxillo-palatal cleft]

In the bilateral total labio-maxillary cleft the premaxilla is sometimes very protrusive at the completion of facial growth. This kind of malposition cannot be treated by orthodontics. Surgical repositioning of the premaxilla with simultaneous bilateral alveolar maxillary bone graft is done before the revision of lip and nose. Its goal is the reconstruction of a solid and harmonious dental and maxillary arch, closure of bucconasal fistulas, improvement of facial profile by closure of nasolabial angle. The authors describe the operation technique and illustrate it by two cases.