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Simultaneous Palatoplasty And Premaxillary Setback In Children With Bilateral Complete Cleft Lip And Palate With Protruding Premaxilla | 38732
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The bilateral cleft lip and nasal deformity has a wide degree of variability with regards to the severity of the cleft. Achieving
good results after primary repair in children with complete bilateral cleft lip and palate with protruding premaxilla is a
difficult task. Multiple surgeries can overcome these problems but due to financial constraints and the distance travel, these
patients prefer to come for fewer procedures with maximum benefits. Simultaneous palatal closure and premaxillary setback
in children with bilateral complete cleft of the lip and palate with severely protruding premaxilla can overcome the problem
with minimum surgeries. A prospective study was carried out in 20 patients. After osteotomy and resection of a segment of
vomer with nasal septal cartilage, the premaxilla was immobilized in all patients using the simple technique of Kirschner wire
fixation; an additional gingivoperioplasty was performed in a few patients. Good exposure of the vomer made premaxillary
setback easy without compromising the blood supply to it. Palatal closure was achieved with two flap techniques. Simultaneous
lip adhesions were also done. Proper positioning of the premaxilla was achieved in all patients. After 4-6 months of the primary
palate closure, lip repair was done. There were no complications like loss of the premaxilla or vascular compromise. One
patient had a postalveolar tiny fistula which healed spontaneously. Follow up period ranged from 6 months to 2 years. In
managing the children with bilateral cleft lip and palate and a protruding premaxilla, this technique is well indicated. It is
advantageous in achieving good results with fewer procedures and thus reduces the total expenditure and the length of the
patient��?s hospital stay.
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