Part Ⅰ Pre-Surgical Treatment of Cleft Lip and Palate 1
1 The Role of Nasoalveolar Molding in the Presurgical Management of Infants Born with Cleft Lip and Palate 3
1.1 Introduction 3
1.2 Treatment Objectives and Clinical Indications of NAM 3
1.3 NAM Plate Fabrication 6
1.4 Alveolar Molding 10
1.5 Nasal Molding 16
1.6 Potential Complications and Clinical Pearls 22
1.7 Controversy to Conclusion 30
References 31
Part Ⅱ Primary Repair of Unilateral Cleft Lip 35
2 Feature of Complete Unilateral Cleft Lip 37
References 42
3 Geometric Analysis of Classic Cheiloplasty 43
3.1 Geometric Analysis of Marking in Cheiloplasty 44
3.2 Analysis of Tennison's Technique and Millard's Technique 46
3.3 The Geometric Correlation between Tennison's Technique and Millard's Technique 48
References 50
4 West China Technique of Unilateral Cleft Lip Repair 51
4.1 Reconstruction Principles 51
4.2 Marking(Using a Complete Cleft Lip as an Example) 53
4.3 Incisions 55
4.4 Surgical Manipulation 55
4.5 Suturing 59
4.6 Basic Theory ofthe Technique 72
References 74
5 Sommerlad's Technique of Unilateral Cleft Lip Repair 77
5.1 Introduction 77
5.2 Patient 77
5.3 Design 79
5.4 Prolabium Incision 79
5.5 Lateral Incision 80
5.6 Vomerine Flap 81
5.7 Dissection of Lip 83
5.8 Closure of Lip 85
5.9 Suture Technique of Nasal Deformity 88
5.10 Conclusion 89
References 90
6 Cutting's Technique of Unilateral Cleft Lip Repair 93
6.1 Evolution of Cutting's Variant of the Mohler Repair 93
6.2 Statement on Nasoalveolar Molding 97
6.3 Markings 98
6.4 Surgical Technique 99
References 101
7 Chang Gung Technique of Unilateral Cleft Lip Repair 105
7.1 Introduction 105
7.2 Integrated Approach 108
7.3 Surgical Refinements 112
7.4 Postoperative Care and Maintenance 150
7.5 Summary 154
References 155
Part Ⅲ Primary Repair of Bilateral Cleft Lip 159
8 Features of Bilateral Cleft Lip 161
References 164
9 West China Technique of Bilateral Cleft Lip Repair 167
9.1 Characteristic Deformities of Patients with Bilateral Cleft Lip Before and After Primary Cheiloplasty 167
9.2 Presurgical Treatment for Patients with Bilateral Cleft Lip 168
9.3 Surgical Principles of Treating Patients with Bilateral Cleft Lip 168
9.4 Incision Design for Patients with Bilateral Cleft Lip 171
9.5 Surgical Procedures 173
9.6 Tips on Cheiloplasty for Bilateral Cleft Lip 178
References 180
10 Sommerlad's Technique of Bilateral Cleft Lip Repair 183
10.1 Introduction 183
10.2 Design 184
10.3 Vomerine Flap for Hard Palate Cleft 185
10.4 Prolabium Incision 186
10.5 The Lateral Incision for the Vomerine Flap 187
10.6 Closure of Vomerine Flap 188
10.7 Dissection of the Lip 189
10.8 Closure of Alar Base,Muscle,Mucosa and Skin 190
10.9 Suture Technique of Nasal Deformity 193
10.10 Follow-up 194
10.11 Conclusion 195
References 195
11 Cutting's Technique of Bilateral Cleft Lip Repair 197
11.1 The Upper Lip Deformity 197
11.2 The Nasal Deformity 198
11.3 Presurgical Molding Options 198
11.4 Nasoalveolar Molding 199
11.5 Alveolar Molding and Gingivoperiosteoplasty 199
11.6 Nasal Molding 200
11.7 Early Principles of Lip and Nasal Reconstruction 201
11.8 Current Principles of Lip and Nasal Reconstruction 201
11.9 Technique 203
References 208
12 Chang Gung Technique of Bilateral Cleft Lip Repair 211
12.1 Introduction 211
12.2 The Integrated Approach 211
12.3 Presurgical Management 213
12.4 Surgical Refinements 217
12.5 Conclusion 241
References 242
Part Ⅳ Primary Repair of Cleft Palate 245
13 Biological Basis and Geometry in Cleft Palate Repair 247
13.1 Exploit the Maximum Muscular Potential in Velopharyngeal Closure 248
13.2 Histological Changes of the Levator Veli Palatini Muscle Caused by Reconstruction in Primary Palatoplasty 256
13.3 Geometrical Basis of Using Palatal Mucoperiosteal Flaps to Close the Cleft without Leaving a Denuded Surface 262
References 264
14 Sommerlad's Technique of Cleft Palate Repair 265
14.1 Introduction 265
14.2 Design 266
14.3 Closure of Nasal Mucosa 267
14.4 Dissection of Velo Palatine Levator 271
14.5 Closure of Oral Mucosa 274
14.6 Conclusion 275
References 275
15 West China Technique of Cleft Palate Repair 277
15.1 The Correlation between the Objectives of Palatoplasty and Surgical Technique 277
15.2 The Need to Change the Concept of Palatoplasty 278
15.3 Geometric Basis of Modified Palatoplasty 279
15.4 Reconstruction of the Levator Veli Palatine Muscle is Central to Modern Palatoplasty 279
15.5 Complementary Approaches to Improve Palatoplasty Outcomes 283
References 284
Part Ⅴ Bone Grafting of Cleft Palate 285
16 Cutting's Technique of Cleft Palate Repair 287
16.1 Introduction 287
16.2 Technique 289
References 294
17 The Foundation of a Finite Element Model for Cleft Palate and Analysis of Biomechanical Properties 297
17.1 Introduction to the Biomechanics of the Cleft Maxilla 297
17.2 Conclusions and Controversies 309
References 309
18 West China Technique of Alveolar Bone Grafting 311
18.1 The Clinical Manifestations of Alveolar Cleft 312
18.2 The Goals of Bone Grafting in Cleft Alveolar Repair 312
18.3 Timing 313
18.4 Presurgical Orthodontic Management of Alveolar Cleft 314
18.5 The Choice of Graft Source 315
18.6 Bone Grafting in Unilateral Alveolar Cleft 315
18.7 Bone Grafting in Bilateral Alveolar Cleft 319
18.8 Simultaneous Surgical Retraction of Premaxilla and Bone Grafting in Bilateral Alveolar Cleft Repair 320
References 322
19 Chang Gung Technique of Alveolar Bone Grafting 323
19.1 Introduction 323
19.2 Timing of Alveolar Bone Grafting 324
19.3 Presurgical Preparation 325
19.4 Indications for Presurgical Orthodontic Treatment 325
19.5 Surgical Technique 326
19.6 Flap Design 327
19.7 Source of Bone Graft 327
19.8 Operative Techniques for Unilateral Clefts 328
19.9 Operative Techniques for Bilateral Clefts 331
19.10 Post-operative Care 334
19.11 Evaluation ofResults 334
19.12 Results 334
19.13 Complications 336
19.14 Discussion 339
19.15 Summary 341
References 341
Index 343