Surgical Strategy for the Treatment of Facial Clefts §
1. Introduction
- at the junction between the lateral nasal processes and the mid-nasal processes;
- between the maxillary processes where the palate is formed;
- between the maxillary and mandibular processes.
- formation of the body of the sphenoid;
- formation of the anterior and medial cranial fossae;
- reduction of the interorbital distance;
- union of the two nasal halves;
- development of the naso-maxillary complex;
- elongation of the mandibular branch.
- internasal;
- nasal;
- naso-maxillary;
- maxillary—the maxillary location can be subdivided into median and lateral clefts;
- malar dysplasia/or zygomatic (Treacher Collins Syndrome).
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- resection of abnormal or excessive tissues;
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- correction of hypertelorism by medial rotation of the orbits;
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- restoration of the nasal pyramid.
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- elongation and expansion of the orifices of the nasal cavities;
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- reconstructions of the nasal spine.
- nasal aplasia;
- nasal aplasia with the presence of a proboscis;
- nasal cleft;
- nasal duplication.
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- resection of abnormal or excessive tissues;
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- correction of hypertelorism by medial rotation of the orbits;
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- restoration of the nasal pyramid.
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- closure of the surrounding fragments of nasal mucosa by mobilizing and bringing the flaps closer;
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- reconstruction of the nasal integuments [17].
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- resection of abnormal or excessive tissues;
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- correction of hypertelorism by medial rotation of the orbits;
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- increase in maxillary volume.
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- dissection of the medial and lateral flaps of the cleft;
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- approach and fixation of the muscular and mucous structures to the periosteum;
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- elongation and interdigitation of the skin flaps of the cleft.
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- resection of abnormal or excessive tissues;
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- correction of hypertelorism, when present, by medial rotation of the orbits;
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- increase in maxillary volume if there is a deficit.
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- dissection of the medial and lateral flaps of the cleft; correction of the macrostomia with interdigitation of the orbicularis oris and its fixation;
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- fixation of the muscular and mucous structures and to the periosteum;
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- elongation and interdigitation of the skin flaps of the cleft.
2. Surgical Strategy
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- skeletal;
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- muscular;
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- cutaneous.
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- the determination of surgical times (timing) relating to corrections;
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- the programming of skin incisions.
2.1. Skeletal Level
2.2. Muscular Level
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- contraction of subcutaneous scar tissue in the first two post-operative months;
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- traction of the orbicular muscle through the canthal ligaments;
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- traction generated by inadequate dissection of the periosteal tissues of the orbital structures;
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- inadequate fixation of bone structures in the midline;
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- inadequate exemption of the tissues contained within the orbital cavity.
2.3. Skin Level
2.4. Programming of Skin Incisions
3. Discussion
4. Conclusions
Funding
Acknowledgments
Conflicts of Interest
References
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Roddi, R.; Oo, A.L.; Pepe, E.; Naing, E.E.; Sung, S.B.H. Surgical Strategy for the Treatment of Facial Clefts. Surg. Tech. Dev. 2023, 12, 34-42. https://doi.org/10.3390/std12010002
Roddi R, Oo AL, Pepe E, Naing EE, Sung SBH. Surgical Strategy for the Treatment of Facial Clefts. Surgical Techniques Development. 2023; 12(1):34-42. https://doi.org/10.3390/std12010002
Chicago/Turabian StyleRoddi, Roberto, Aung Lwin Oo, Ernesto Pepe, Ei Ei Naing, and Shalom Biak Hlei Sung. 2023. "Surgical Strategy for the Treatment of Facial Clefts" Surgical Techniques Development 12, no. 1: 34-42. https://doi.org/10.3390/std12010002