Management of the impaired adult cleft patient: the last chance

The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
J Felemovicius, F Ortiz-Monasterio

Abstract

Unfortunately, not all patients receive the benefits of a well-trained, experienced, multidisciplinary cleft team, and a significant number of patients reach adulthood with severe neglected cleft related problems. The vast majority of this group have made their way through several surgical procedures, usually performed by different surgeons in different centers, and still carry the original cleft stigmata aggravated by variable degrees of maxillary hypoplasia, fistulae, scarring, muscle pull, soft tissue tension, lost teeth, dental adaptation, and instability of bony fragments. Adult patients who reach this stage with their original deformities have, in most instances, lost their best opportunity to be properly treated. With this assumption in mind, an aggressive surgical plan focused mainly on the deformities that can objectively achieve functional and aesthetical improvement should be individualized for each patient. In this article, experience with 38 consecutive adult patients with cleft managed following a two-stage protocol used at our cleft clinic for the last 4 years is presented. An algorithm to help definitively solve these deformities is suggested.

References

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Citations

Oct 30, 2008·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Cher Bing ChuoRona Slator
Oct 29, 2009·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Jacobo Felemovicius, Jesse A Taylor
Oct 31, 2014·Plastic and Reconstructive Surgery·Joseph T HardwickeBruce M Richard
Sep 17, 2019·The Journal of Craniofacial Surgery·Katharine A ConnollyStephen P Beals
Mar 14, 2019·Scientific Reports·Xiangyou LuoJingtao Li
Jun 11, 2019·Annales de chirurgie plastique et esthétique·H BénateauA Veyssière

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