Presurgical Orthopedic Treatment in a Case of Unilateral Cleft Lip and Palate

Abstract

Introduction Cleft lip and palate is a congenital malformation resulting from the failure of fusion of the maxillary processes during the 4th to 9th weeks of intrauterine life, affecting orofacial functions. Case Report A 7-week-old female patient presented for treatment. She was diagnosed with an incomplete cleft lip, a complete unilateral right cleft alveolus, and a complete cleft palate. Clinical examination revealed a depressed right alar cartilage, deviated columella, and a rotated larger maxillary segment. Treatment stages began with the repositioning of the smaller maxillary segment using an obturator plate with a bent expansion screw. Subsequently, 3M Unitek Transpore adhesive strips were applied to derotate the larger segment and approximate the lip segments. A nasoalveolar molding device was used to shape and elevate the alar cartilage. Cheiloplasty was performed using the Tennison-Randall technique, followed by postoperative orthopedics with an extraoral nasal stent and a Freadman-type plate. Later, palatoplasty and gingivoperiosteoplasty were performed. At one month postoperatively, a more harmonious midfacial profile was observed, along with satisfactory palatal healing. In this case, presurgical orthopedics proved essential in correcting nasal asymmetry, reducing the labial cleft, and facilitating primary surgical procedures. Conclusions This highlights the importance of continuous patient follow-up to ensure optimal preparation for subsequent surgical interventions.