Cleft Lip, Cleft Palate, and Velopharyngeal Insufficiency

Abstract

This article provides an introduction to the anatomical and clinical features of the primary deformities associated with unilateral cleft lip-cleft palate, bilateral cleft lip-cleft palate, and cleft palate. The diagnosis and management of secondary velopharyngeal insufficiency are discussed. The accompanying videos demonstrate the features of the cleft lip nasal deformities and reliable surgical techniques for unilateral cleft lip repair, bilateral cleft lip repair, and radical intravelar veloplasty.

Cleft Rhinoplasty: A Surgical Technique

“…The aberrant attachment creates an unopposed force that pulls the columella and caudal nasal septum to the noncleft side. 6 On the cleft side, the orbicularis oris muscle inserts into the nasal base, retracting it laterally and inferiorly. In addition to it, due to poor maxillary skeletal support at the alar base, the ala is further displaced posteriorly.…”

Does division of pharyngeal flap operated for correction of velopharyngeal insufficiency affects speech results?

“…Dudak onarımı ile ön planda estetik görünüm açısın-dan kabul edilebilir sonuçlar elde edilmesi amaçlanır-ken, damak yarığı nedeniyle gerçekleştirilen damak onarımı cerrahisinin temel amacı maksiller büyüme potansiyelini kısıtlanmaksızın, başarılı konuşma sonuçları elde edilmesidir (4,5) . Bu noktada başarı, seslerin doğru ve anlaşılır çıkarılması, bu sırada nazal boşluk ile ağız boşluğu arasında anatomik ilişkinin kesilmesi ve sonuç olarak hastanın iletişim açısından sağlıklı bir birey olarak sosyal çevre ile adaptasyonun sağlanmasıdır (6,7) .…”

Modification of classic reconstructive techniques and evaluation of new esthetic methods in terms of the expectations of modern oto-rhino-laryngology and head-neck surgery

“…Cleft lip and palate (CLP) deformities are among the most common congenital malformations (24). In Hungary the incidence of combined oro-facial clefts is 2 in 1000 live births (25).…”

“…In Hungary the incidence of combined oro-facial clefts is 2 in 1000 live births (25). Although CLP together occur more commonly in males, isolated cleft palate is more common in females (24,25). Surgical correction of CLP should be performed before the first year of age, usually between 3-6 months-of-age, prior to speech development (24,25).…”

“…This functional repair helps also with the preservation of facial growth and the development of proper dentition (24,25). If this adequate primary surgical correction of CLP fails, the consequentially developing nasal deformity associated with CLP is one of the most challenging reconstructive problems in rhinoplasty.…”