tailieunhanh - Cleft Lip and Palate - part 7

Columellar kéo dài được thực hiện bằng cách bóc tách rộng của da mũi từ sụn thuộc về cánh, loại bỏ chất béo intercrural, và chỉ khâu McComb song phương. Nhiều khâu lu mờ tiền đình được thông qua, và một ống đỡ động mạch mũi được duy trì trong tuần sau phẫu thuật đầu tiên | 468 Fig. a-f. Case 5. A complete bilateral cleft and protruding premaxilla is shown preoperatively Fig. . Treatment consisted of presurgical maxillary orthopedics Latham followed by bilateral GPPs and lip and nose correction at 6 months of age. The columellar lengthening was accomplished by wide dissection of nasal skin from the alar cartilages removal of intercrural fat and bilateral McComb sutures. Multiple vestibular effacement sutures were passed and a nasal stent was maintained for the first postoperative week. The patient is shown at 18 months of age before closure of the palatal cleft. Case 6. A very wide complete bilateral cleft of the lip and palate with a projecting premaxilla and very wide alveolar clefts. Initially treated with presurgical maxillary orthopedics Fig. in preparation for the first surgery where the patient underwent a GPP closure of the alveolar clefts and closure of the anterior palate. One year later the patient underwent closure of bilateral cleft palate and revision of the lip and nose using the McComb technique which is shown. The patient is shown postoperatively 2 months after the final procedure. Chapter 22 Surgical Treatment of Clefts of the Lip 469 Fig. a-k. 470 Fig. a-k. continued Case 7. This patient had primary closure from another surgeon of her incomplete bilateral cleft of the lip using a standard bilateral technique. As the photographs show Fig. she did not have a Cupid s bow with a fairly tight upper lip and lacking nasal projection. The patient underwent an iliac bone graft to the right alveolar cleft an Abbe flap and a cleft lip rhinoplasty which redefined her Cupid s bow gave her more nasal tip projection and a fuller upper lip. Case 8. A bilateral cleft lip was corrected in another country. The preoperative pictures show the patient following a radial forearm flap performed for a very large palatal defect following orthodontic .