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. 2009 Oct;42 Suppl(Suppl):S116-22.
doi: 10.4103/0970-0358.57202.

Management of cleft lip and palate in adults

Jyotsna Murthy  1
Affiliations

Management of cleft lip and palate in adults

Jyotsna Murthy. Indian J Plast Surg. 2009 Oct.

Abstract

Introduction: With advancement of medical services in developed countries and awareness among the patients, it is rare to find an adult with an unoperated cleft lip and palate. However, the scenario is totally different in developing countries. Working as a part of a team in developing country, where co-coordinated team work is primitive, resources to provide treatment are very thin, public awareness of availability of treatment for this anomaly is minimal, the age of patients reaching for primary treatment varies from few days to late forties. Though the aim and aspiration is to provide holistic multidisciplinary care, the priority is getting treatment for all cleft patients. In such situation, the management of cleft lip and palate demands changes of approach, techniques and philosophy.

Aims and objectives: The deformed anatomy especially the facial bones and dentition is described. Due to well established deformities, the approach for management is individualized. The procedures and modification of procedures has been described. Results and Outcome: The outcome of the primary repair is adults certainly have less than satisfactory outcome for obvious reasons. The expected outcome and expectation of patients and families following primary surgeries in cleft lip and palate has been discussed. Though all adult patients got some improvement in speech after palate repair, achieving normal speech was difficult. The naso-labial appearance was not perfect, but well accepted by the patients and families. There are many psychosocial problems in these patients, the objective evaluation could not be done due to too many variables. However, primary repair of cleft lip and palate is justified and beneficial for the patients.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Cephalogram and dental deformities in unoperated cleft patient
Figure 2
Figure 2
Unilateral cleft lip and palate repair
Chart 1
Chart 1
Our plan of managing protruding premaxilla in unoperated adults
Figure 3A
Figure 3A
Diagram for pre-maxillary setback with palate repair
Figure 3B
Figure 3B
Pre-maxillary setback followed by palate repair
Figure 4
Figure 4
Bilateral cleft lip and palate repair
Figure 5
Figure 5
Primary Abbe flap in bilateral cleft lip repair
See this image and copyright information in PMC

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