Preoperative nasal-lip-alveolar bone contouring treatment can be started about 2 weeks after birth for infants with cleft lip and palate. -Lip-nose surgery). This method is a practical, non-invasive, safe and economical way to treat cleft lip and palate sequentially.
It is well known that patients with cleft lip and palate need to undergo several surgical procedures during their growth in order to achieve aesthetic and functional requirements, such as cleft lip repair, cleft palate repair, alveolar cleft bone grafting, second-stage lip-nose deformity revision, and even orthognathic surgery. Although surgical methods are emerging and becoming increasingly sophisticated, the results of pure surgical revision surgery to solve the many problems of cleft lip and palate patients are often unsatisfactory. The reasons for this are, firstly, the congenital deformity of the tissue architecture of the cleft lip and palate patient; and secondly, the traumatic interventions of multiple surgeries and their scar tissue production resulting in the suppression of facial development. In view of this, multidisciplinary and collaborative sequential treatment of cleft lip and palate is of increasing interest to cleft lip and palate surgeons.
The innovation of preoperative nasal-labial-alveolar bone contouring in infants with cleft lip and palate lies in the non-surgical contouring and repositioning of the deformed nasal cartilage, lengthening of the short nasal column, narrowing of the labial fissure to restore the normal labial-nasal structure, narrowing of the wider alveolar fissure, recession of the anterior jaw to form a normal maxillary arch, improvement of the surgical conditions, and early revision surgery with the aim of achieving good postoperative facial morphology and maximum restoration of oral-nasal function. The aim is to achieve good postoperative facial morphology and maximum restoration of oral-nasal function. After more than two years of clinical practice, it has been shown that the preoperative orthodontic non-surgical methods have significantly improved the facial morphology of the patient, narrowed the lip and alveolar fissures, lengthened the short nasal column, raised the height of the nasal tip, promoted the symmetry of the nasal structure, repositioned the anterior jaws, and formed the ideal arch morphology. The improvement of these defects and displacements reduces the difficulty of the surgery; it also significantly improves the feeding status of the child, allowing the patient to receive adequate nutrition and facilitating the early implementation of the revision surgery; reduces the number of surgeries; reduces the cost; reduces the postoperative scarring; and increases the aesthetic appearance of the face.
The nasal-alveolar contouring with early surgical contemporaneous alveolar-labial-nasal revision has the following features: (1) The preoperative contouring treatment reduces the width of the alveolar bone fissure for the implementation of gingival osteoplasty, and we found that the alveolar bone at the alveolar bone fissure has been We found that the alveolar bone was connected and the continuity and stability of the alveolar bone were enhanced after 15-36 months of regular follow-up. (2) Preoperative rhinoplasty minimizes the scope and difficulty of surgery, resulting in less scar tissue and more consistent postoperative results. (3) Non-surgical lengthening of the nasal minors avoids second-stage surgical lengthening of the minors and surgical scarring at the labial-nasal minors union; postoperative nasal symmetry is significantly improved. This reduces the number of surgical procedures necessary in the sequential treatment of cleft lip and palate patients (three-stage surgery, i.e., cleft lip repair, second-stage lip-nose deformity revision, and alveolar cleft bone grafting) and the degree of cost savings. (5) The nasal-alveolar shaping, at the same time, can promote the narrowing of the palatal cleft, facilitate the early surgical treatment of children with cleft lip and palate, prevent the formation and development of pathological speech, guide the precise synchronization and harmonious movement of the brain, palate, pharynx, tongue and lip muscles during the correct pronunciation of the child, and also help reduce the infection of the nasopharynx, respiratory tract and middle ear, thus promoting the voice rehabilitation of the child. (6) Early repair of cleft lip and palate can prevent the child from developing an inferiority complex and ensure the physical and psychological health and development of the child.