Characteristics of asymmetric cleft lip and palate surgical treatment

Relevance. The correct choice of the surgical technique for the treatment of the congenital asymmetric cleft lip and palate ensures the effectiveness of rehabilitation of patients with this pathology. The purpose is to present the results of the authors’ techniques for the surgical treatment of children with asymmetric cleft lip and/or palate.
Materials and methods. Medical records of 687 children treated in 2015-2019 years were retrospectively analyzed at the clinic of maxillofacial surgery “Bonum” MСMC. The prevalence of asymmetric cleft lip and palate in children was determined. The prospective observation group included 84 patients with asymmetric cleft lip and/or palate. Clinical, anthropometric, statistical methods as well as patient photograph analysis and computer technologies were used during the research.
Results. Prevalence of congenital asymmetric cleft lip and / or palate was determined (8.59%), classification and novel surgical techniques were offered and the results were evaluated.
Conclusions. The prevalence of asymmetric cleft lip and palate is 86 per 1000 newborns with cleft lip and/ or palate. Scientific knowledge about the prevalence of asymmetric cleft lip and palate, as well as the systematization of this type of lesion in classifications, should be present in the practice of a maxillofacial surgeons and rehabilitation physicians who treat patients with this pathology. The proposed surgical techniques for the treatment of asymmetry in bilateral cleftlip and cleft palate provide positive results, excluding the need for further surgery. The reasonable choice of a surgical technique for the treatment of asymmetric cleft lip and palate is individual and may involve the use of additional nanomaterials. The authors’ techniques for the surgical treatment of asymmetric cleft lip and palate can be considered promising and aesthetically justified in view of good cosmetic results and full restoration of functions.

1. Rogozhina Yu.S., Blohina S.I., Bimbas E.S. Issue of detailing the classifications of congenital cleft lip and palate. Dental problems. 2019;15(4):162-169. (In Russ.). https://doi.org/10.18481/2077-7566-2019-15-4-162-169.

2. Chuykin S.V., Dzhumartov N.N., Chuykin O.S., Kuchuk K.N., Grin E.A., Chuykin G.L., Muratov А.М., Gil'manov М.V. Clinical and anatomical forms of congenital cleft lip and palate in the region with ecotoxicants. Dental problems. 2019;15(3):127-132. (In Russ.). https://doi.org/10.18481/2077-7566-2019-15-3-127-132.

3. Rogozhina Yu.S. Blohina S.I., Bimbas E.S. Surgical tactics for eliminating complex variants of congenital cleft palate. Dental problems. 2020;16(1):121-126. (In Russ). https://doi.org/10.18481/2077-7566-20-16-1-121-126.

4. Bubanale S.C., Kurbet S.B., De Piedade Sequeira L.M. A rare case of cleft number nine associated with atypical cleft number two. Indian Journal of Ophthalmology. 2017;65(7):610-612. https://doi.org/10.4103/ijo.ijo_914_16.

5. Mazzola R.F., Mazzola I.C. Facial clefts and facial dysplasia: revisiting the classification. The Journal of Craniofacial Surgery. 2014;25(1):26-34. https://doi.org/10.1097/scs.0b013e3182a2ea94.

6. Rossell -Perry P., Gavino-Gutierrez A.M. Asymmetric bilateral cleft lip: classification and a surgical technique. The Journal of Craniofacial Surgery. 2012;23(5):1367-1372. http://dx.doi.org/10.1097/SCS.0b013e31824f6480

7. Rogozhina Yu.S., Blohina S.I., Bimbas E.S. Methodological algorithm for eliminating congenital asymmetric cleft of the upper lip and palate. Pediatric dentistry and prevention. 2020;20(2):116-122. (In Russ.). https://doi.org/10.33925/1683-3031-2020-20-2-116-122.

8. Balaji S M. Single stage correction of bilateral tessier 4 clef. Indian Journal of Dental Research. 2017;28:105-108. Avaliable at: https://www.ijdr.in/text.asp?2017/28/1/105/203616

9. Schwenzer-Zimmerer K., Chaitidis D., Berg-Boerner I., Krol Z., Kovacs L., Schwenzer N.F., Zimmerer S., Holberg C., Zeilhofer H.F. Quantitative 3D soft tissue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). Journal of Cranio-Maxillofacial Surgery. 2008;36(8):431-438. https://doi.org/10.1016/j.jcms.2008.05.003.

10. Davydov B.N., Bessonov S.N. Treatment of bilateral cleft lip. Dentistry. 2013;92(2)60-64. (In Russ.). Avaliable at: https://elibrary.ru/item.asp?id=19034126.

11. Supiev T.K., Mamedov A.A., Negametzyanov N.G., Nurmaganov S.B., Utepov D.K., Katasonova E.S, Kotzabekov E.M. The experience of complex treatment of children with bilateral cleft lip and palate. Dentistry. 2014;93(5):69-74. (In Russ.). Avaliable at: https://elibrary.ru/item.asp?id=22880269.