PDF(Pubmed)
Abstract：
Various patients with complete bilateral cleft lip and palate present with a protruded premaxilla. Several techniques have been described for correctional repair of the projection with a plethora of unsatisfactory outcomes. This poses a challenge not only for the cleft team providing care but also for the patients and their respective families. Multiple patients suffer from residual deformities after inadequate primary repair, which increase surgical, financial, and psychological burden. Premaxillary setback with posterior vomerine ostectomy and complete bilateral cleft lip repair can promote alignment of the premaxilla with the maxillary prominences. To effectively address this challenging deformity, we describe a single-stage surgical technique that includes vomerine ostectomy posterior to the vomero-premaxillary suture, bilateral gingivoperiosteoplasties with complete bilateral cleft lip repair, and primary cleft rhinoplasty. Careful surgical planning is essential for adequate matching between the length of the protruded premaxilla and the extent of ostectomy. The described technique offers several advantages for the management of complete bilateral cleft lip with a projected premaxilla. It can be applied anywhere around the world and is most beneficial in underprivileged areas where patients suffer from restricted access to healthcare, absence of presurgical orthodontics and lack of sufficient resources.
摘要：
各种双侧唇裂和腭裂的患者均表现为前颌骨突出。已经描述了几种用于矫正投影的技术，结果很多不令人满意。这不仅对提供护理的left团队，而且对患者及其家人都构成了挑战。多名患者在初次修复不足后出现残余畸形，增加了手术，金融,心理负担。上颌前复位后vomerine骨切除术和完整的双侧唇裂修复可以促进前颌骨与上颌骨的对齐。为了有效解决这种具有挑战性的畸形，我们描述了一种单阶段的手术技术，包括vomerine骨切除术后的vomerine上颌前缝合，双侧牙龈骨膜成形术伴完全双侧唇裂修复，和原发性隆鼻术。仔细的手术计划对于在突出的前颌骨的长度和骨切除术的范围之间充分匹配至关重要。所描述的技术为处理带有前颌骨的完整双侧唇裂提供了一些优势。它可以在世界各地的任何地方应用，并且在患者无法获得医疗保健的贫困地区最有益。缺乏术前正畸治疗和缺乏足够的资源。
