Pre-surgical orthopedics and surgical follow-up of congenital cleft lip in pediatric patients

Abstract

Introduction: Cleft/cleft lip and palate is one of the most frequent malformations of the head and neck, it is associated with multiple genetic, local and environmental factors. The main objective of pre-surgical orthopedics is to achieve a normal anatomy early, thanks to the reduction in the size of the cleft and the reestablishment of a correct anatomical relationship between the cleft maxillary segments in order to lead the patient to prepare for surgical treatment. Objective: To present the case of a pediatric patient with congenital cleft lip and the orthopedic approach performed. Case Presentation: Male 2 years, 6 months old, admitted to the Pediatric Dentistry Specialty of the Autonomous University of Zacatecas, for review and assessment. Examination revealed a wide fissure of the left upper lip, rotation and protrusion of the premaxilla, absence of nasal floor, depressed and displaced left nasal wing, columella, and short and deviated nasal tip. Pre-surgical orthopedics is performed to prepare for cheiloplasty, using a cap with a nasal stent, to bring the segments of labial tissue closer together and raise the wing of the nose. Limited scope of orthopedic goals are predicted due to late surgical approach. Conclusions: Rehabilitation of affected patients is a complex process that provides better results when it starts early and includes a multidisciplinary approach with the aim of performing a comprehensive rehabilitation, improving the aesthetic appearance of the affected hard and soft tissues and adherence to treatment.