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Treatment Principles in Orofacial Clefts

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Fundamentals of Craniofacial Malformations

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Abstract

Orofacial clefts are among the most common malformations of all. The concepts for treatment are diverse and complex. The core goals of treatment are the functional and aesthetic rehabilitation of the patient. This chapter summarizes the basic principles of therapy and provides an overview of the most common basic techniques of surgical treatment.

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References

  1. Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg. 1976;4(2):69–92.

    Article  CAS  PubMed  Google Scholar 

  2. Mazzola RF, Mazzola IC. Facial clefts and facial dysplasia: revisiting the classification. J Craniofac Surg. 2014;25(1):26–34.

    Article  PubMed  Google Scholar 

  3. Binet A, de Buys Roessingh A, Hamedani M, El Ezzi O. Complete bilateral Tessier’s facial cleft number 5: surgical strategy for a rare case report. Surg Radiol Anat. 2019;41(5):569–74.

    Article  PubMed  Google Scholar 

  4. van der Meulen JC, Mazzola R, Vermey-Keers C, Stricker M, Raphael B. A morphogenetic classification of craniofacial malformations. Plast Reconstr Surg. 1983;71(4):560–72.

    Article  PubMed  Google Scholar 

  5. Portier-Marret N, Hohlfeld J, Hamedani M, de Buys Roessingh AS. Complete bilateral facial cleft (Tessier 4) with corneal staphyloma: a rare association. J Pediatr Surg. 2008;43(10):e15–8.

    Article  PubMed  Google Scholar 

  6. Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: synthesizing genetic and environmental influences. Nat Rev Genet. 2011;12(3):167–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Bell JC, Raynes-Greenow C, Bower C, Turner RM, Roberts CL, Nassar N. Descriptive epidemiology of cleft lip and cleft palate in Western Australia. Birth Defects Res A Clin Mol Teratol. 2013;97(2):101–8.

    Article  CAS  PubMed  Google Scholar 

  8. Hemprich A. Die operative Behandlung von Lippen-Kiefer-Gaumen-Spalten–Domaine des MKG-Chirurgen. MKG-Chirurg. 2018;11(4):221.

    Article  Google Scholar 

  9. Stanier P, Moore GE. Genetics of cleft lip and palate: syndromic genes contribute to the incidence of non-syndromic clefts. Hum Mol Genet. 2004;13:R73–81.

    Article  CAS  PubMed  Google Scholar 

  10. Reinert S, Krimmel M. Intravelare Veloplastik und plastischer Verschluss des harten Gaumens. MKG-Chirurg. 2019;12(1):2–10.

    Article  Google Scholar 

  11. Kauffmann P, Cordesmeyer R, Fouellefack GA, Schminke B, Wiese KG. Postoperative long-term results for the comparison of the symmetry of the upper lip during lip closure according to Millard and Pfeifer. Maxillofac Plast Reconstr Surg. 2018;40(1):18.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bernheim N, Georges M, Malevez C, De Mey A, Mansbach A. Embryology and epidemiology of cleft lip and palate. B ENT. 2006;2(Suppl 4):11–9.

    PubMed  Google Scholar 

  13. Smarius B, Loozen C, Manten W, Bekker M, Pistorius L, Breugem C. Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology. World J Methodol. 2017;7(3):93–100.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Johnston MC, Bronsky PT. Prenatal craniofacial development: new insights on normal and abnormal mechanisms. Crit Rev Oral Biol Med. 1995;6(4):368–422.

    Article  CAS  PubMed  Google Scholar 

  15. Kriens O. LAHSHAL-A concise documentation system for cleft lip, alveolus and palate diagnoses. In: Kriens O, editor. What is a cleft lip and palate? Proceedings of an advanced workshop. Stuttgart: Georg Thieme Verlag; 1989. p. 30–4.

    Google Scholar 

  16. Joos U, Schuon R. Defekt- oder Dislokationsfehlbildung? MKG-Chirurg. 2018;11(4):222–33.

    Article  Google Scholar 

  17. Shaw WC, Semb G, Nelson P, Brattström V, Mølsted K, Prahl-Andersen B, Gundlach KK. The Eurocleft project 1996–2000: overview. J Craniomaxillofac Surg. 2001;29(3):131–40.

    Article  CAS  PubMed  Google Scholar 

  18. Delaire J. La Cheilo—rhinoplastie primaire pour fente labio-maxillaire congenitale unilaterale. Rev Stomatol. 1975;76:193.

    CAS  Google Scholar 

  19. Delaire J. Theoretical principles and technique of functional closure of the lip and nasal aperture. J Maxillofac Surg. 1978;6(2):109–16.

    Article  CAS  PubMed  Google Scholar 

  20. Breitsprecher L, Fanghänel L, Noe A, Lockett E, Raab U. The functional anatomy of the muscles of facial expression in humans with and without cleft lip and palate. A contribution to refine muscle reconstruction in primary cheilo- and rhinoplasties in patients with uni- and bilateral complete CLP. Ann Anat. 2002;184(1):27–34.

    Article  CAS  PubMed  Google Scholar 

  21. Schliephake H, Hausamen J-E. Lippen-Kiefer-Gaumen-Spalten. In: Hausamen M, Reuther E, Kübler S, editors. Mund-, Kiefer- und Gesichtschirurgie. Heidelberg: Springer; 2012. p. 310–64.

    Google Scholar 

  22. Pausch NC, Halama D. Sekundäre Rhinoplastik bei Patienten mit Lippen-Kiefer-Gaumen-Spalte. MKG-Chirurg. 2018;11(4):250–8.

    Article  Google Scholar 

  23. Gröbe A, Gehrke G. Die primäre Kalottenosteoplastik bei Lippen-Kiefer-Gaumen-Spalten. MKG-Chirurg. 2018;11(4):234–42.

    Article  Google Scholar 

  24. Hotz MM, Gnoinski WM, Nussbaumer H, Kistler E. Early maxillary orthopedics in CLP cases: guidelines for surgery. Cleft Palate J. 1978;15(4):405–11.

    CAS  PubMed  Google Scholar 

  25. Kim SK, Lee JH, Lee KC, Park JM. Mulliken method of bilateral cleft lip repair: anthropometric evaluation. Plast Reconstr Surg. 2005;116(5):1243–51.

    Article  CAS  PubMed  Google Scholar 

  26. Latham RA. Orthopedic advancement of the cleft maxillary segment: a preliminary report. Cleft Palate J. 1980;17(3):227–33.

    CAS  PubMed  Google Scholar 

  27. Latham RA, Winslow RB, Bevin AG. Induction of new palatal growth as an aid to cleft closure in dogs: neopalate formation. Br J Plast Surg. 1974;27(3):264–73.

    Article  CAS  PubMed  Google Scholar 

  28. Rau A, Ritschl LM, Mücke T, Wolff KD, Loeffelbein DJ. Nasoalveolar molding in cleft care—experience in 40 patients from a single centre in Germany. PLoS One. 2015;10(3):e0118103.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Cutting C, Grayson B, Brecht L, Santiago P, Wood R, Kwon S. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg. 1998;101(3):630–9.

    Article  CAS  PubMed  Google Scholar 

  30. Grayson BH, Santiago PE, Brecht LE, Cutting CB. Presurgical nasoalveolar molding in infants with cleft lip and palate. Cleft Palate Craniofac J. 1999;36(6):486–98.

    Article  CAS  PubMed  Google Scholar 

  31. Gillies H, Kilner TP. Hare-lip: operations for the correction of secondary deformities. Lancet. 1932;220:1369–75.

    Article  Google Scholar 

  32. Le MA. A method of cutting and suturing the lip in the treatment of complete unilateral clefts. Plast Reconstr Surg. 1946;4(1):1–12.

    Google Scholar 

  33. Tennison CW. The repair of the unilateral cleft lip by the stencil method. Plast Reconstr Surg. 1946;9(2):115–20.

    Article  Google Scholar 

  34. Randall P. A triangular flap operation for the primary repair of unilateral clefts of the lip. Plast Reconstr Surg Transplant Bull. 1959;23(4):331–47.

    Article  CAS  PubMed  Google Scholar 

  35. Millard D. A primary camouflage of the unilateral harelip. In: Transactions of the International Society of Plastic Surgeons. Williams & Wilkinson: Baltimore; 1957. p. 160.

    Google Scholar 

  36. Pfeifer G. Lip corrections following earlier cleft surgery by way of wave-line incisions. Dtsch Zahnarztl Z. 1970;25:569–76.

    CAS  PubMed  Google Scholar 

  37. Veau V. Bec-de-lièvre: formes cliniques, chirurgie. Paris: Masson; 1938.

    Google Scholar 

  38. Cronin TD, Penoff JH. Bilateral clefts of the primary palate. Cleft Palate J. 1971;8:349–63.

    CAS  PubMed  Google Scholar 

  39. Cronin TD, Upton J. Lengthening of the short columella associated with bilateral cleft lip. Ann Plast Surg. 1978;1(1):75–95.

    Article  CAS  PubMed  Google Scholar 

  40. Mulliken JB. Repair of bilateral cleft lip and its variants. Indian J Plast Surg. 2009;42:S79–90.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Millard DR. Bilateral cleft lip and a primary forked flap: a preliminary report. Plast Reconstr Surg. 1967;39(1):59–65.

    Article  CAS  PubMed  Google Scholar 

  42. Pichler M, Trauner R. Mund-und Kieferchirurgie, Teil II. Wien: Urban&Fischer; 1948.

    Google Scholar 

  43. Leow AM, Lo LJ. Palatoplasty: evolution and controversies. Chang Gung Med J. 2008;31(4):335–45.

    PubMed  Google Scholar 

  44. Veau V, Borel S. Division palatine, anatomie, chirurgie, phonetique. Paris: Masson; 1931.

    Google Scholar 

  45. Veau V, Ruppie C. Anatomie chirurgicale de la division palatine. J Chir (Paris). 1992;1:20.

    Google Scholar 

  46. Axhausen G. Technik und Ergebnisse der Spaltplastiken. München: Hanser; 1952.

    Google Scholar 

  47. Kriens O. An anatomical approach to veloplasty. Plast Reconstr Surg. 1969;43:29–41.

    Article  CAS  PubMed  Google Scholar 

  48. Widmaier W. Ein neues Verfahren zum Verschluss von Gaumenspalten. Chirurg. 1959;30:274–8.

    CAS  PubMed  Google Scholar 

  49. Furlow LT Jr. Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg. 1986;78(6):724–38.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, University Medical Center Göttingen, Göttingen, Germany

    Philipp Kauffmann & Henning Schliephake

Authors
  1. Philipp Kauffmann
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  2. Henning Schliephake
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Correspondence to Philipp Kauffmann .

Editor information

Editors and Affiliations

  1. Center for Jaw-, Face- and Skull Surgery, Münster, Germany

    Ulrich Meyer

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Kauffmann, P., Schliephake, H. (2023). Treatment Principles in Orofacial Clefts. In: Meyer, U. (eds) Fundamentals of Craniofacial Malformations. Springer, Cham. https://doi.org/10.1007/978-3-031-28069-6_7

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  • DOI: https://doi.org/10.1007/978-3-031-28069-6_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28068-9

  • Online ISBN: 978-3-031-28069-6

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