Objective To attempt to achieve a more satisfactory results in correcting the unilateral cleft lip nasal deformities caused by deficiency of the maxilla and collapse of the alar cartilage, using onlay implantation and stable fixation for implants. Methods Since 1996, the authors had implanted rib cartilage (12 cases), rib bone and cartilage (4 cases), silicon rubber (8 cases), skull bone and ePTFE (one case each) in total 26 patients with moderate to severe nasal deformities of unilateral cleft lip to elevate the retro-position alar base in hypoplastic maxillar area and to augment the buckled lateral alar cartilage in effected side. All implants were fixed by absorbable sutures on alar cartilage, and titanic screw and/or plate on maxilla under alar base. Results All wounds recovered without any complication. During 3 to 18 months follow-up postoperatively in 19 cases, the nasal appearences were significantly improved. The implants still provided support for the depressed alar base and the collapsed alar cartilage without obvious displacement, absorption and rejection. Conclusion The onlay implantation and stable fixation using suture and rigid fixation of titanic screw and/or plate for implants is reasonably good in nasal deformity correction of unilateral cleft lip advocated. The definitive effects and well-maintenance of the implant dimension and position have been documented.

Objective To verify the clinical reliability of a simple abrasive method for reduction mandibular osteoplasty.Methods A total of 598 cases of reduction mandibular osteoplasty were performed by using the abrasive method since 2002.Through intraoral incisions,the low part of mandibular ramus,angle region,buucal cortice and inferior border of mandible were exposed and abrasive osteoplasty was taken with special designed retractors,rasp and grinding burs with protecting sheath.The inferior alveolar nerve could be preserved.Results There was no nerve injury and only one hemorrhage case during operation without unfavorable result.In 6 to 1～2 months follow-up for 168 cases,the satisfactory rate for contour results was 95.24%.Conclusion Through the intraoral approach,the abrasive mandibular reduction osteoplasty is a simple,safe and effective method for mandibular osteoplasty.It is not to correct the prominent mandibular angle but to reduce the thickness of the mandibular ramus and body.This method could contribute the same results of angle ostectomy and split cortical bone ostectomy and result a good contour of the jaw region.

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.

Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Infant ; Male ; Treatment Outcome