Surgical Tactics for Eliminating Complex Variants of Congenital Cleft Palate

Abstract

Subject. Surgical methods for eliminating congenital clefts of the upper lip and palate are widely presented in the specialized literature and correspond to the variety of types of lesions of the maxillofacial region. At the same time, international and domestic experience, research results on these issues emphasize the need for continuous improvement of surgical and rehabilitation techniques to eliminate them. In most cases, the use of these developments follows the path of detailing and updating existing classical technologies.
 Purpose ― to present a surgical method for removal of a congenital asymmetric cleft of the palate with a deficit of its own tissues.
 Methodology. There was carried out a retrospective analysis of the results of surgical correction of congenital cleft palate in 497 patients (2015―2019). Was selected a group of 53 people having complex variants of the cleft of the sky. 
 Results. Was presented a method for surgical removal of an asymmetric cleft of the palate according to the severity of the defect and the age of the child. Was proposed the technique of using "titanium silk" with asymmetric clefts of the sky with a deficit of their own tissues.
 Conclusions: The choice of optimal methods for surgical elimination of complex options for cleft palate should be patient-oriented and can form a new tactic of surgical aid, taking into account preliminary interdisciplinary counseling. The use of "titanium silk" as an additional material for uranoplasty in cases of wide splitting of the hard and soft palate (more than 1.5-2 cm) ensures reliable elimination of the defect at any age of the patient and creates a favorable condition for the completion of the systemic rehabilitation complex. A multifactorial mechanism for choosing the method of surgical elimination of complex variants of palatal clefts should be implemented in a specialized clinic, taking into account many years of experience.