New guiding principles in the treatment of clefts.
Breathing through the nose with the mouth shut is essential for the normal development of the facial region related to the mouth and nasal cavities and for the normal development of the two cavities named. Surgical treatment of unilateral total cleft practised hitherto calls for the closure of a cleft in the lip and a cleft in the alveolar ridge at the same surgical intervention. In the great majority of cases a combined intervention closes the respiratory pathway, which was established through the cleft nasal floor and alveolar ridge after birth. From the first surgical intervention on, the child is forced to breathe through the mouth. The disruption of the normal functional development mechanism causes the formation of the characteristic physiognomy of a child with a cleft. The correct treatment as presented in this paper, must consistently observe, in addition to other no less important principles, the primary principle: it is essential for a child with cleft to be made to breathe through the nose with the mouth shut, as soon as possible. The operative plan of treatment must help a child with a cleft to create, by utilizing the natural development abilities, and with minimal application of trauma, the same conditions for the functional development mechanism as are possessed by a healthy child of the same age. The enclosed evidence proves the validity of the described guiding rules, and affirms again the well known principle that only normal function produces normal form.
D000539:Alveolar Process / Q000002:abnormalities* / Q000601:surgery; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery; D008445:Maxillofacial Development; D009058:Mouth Breathing / Q000209:etiology; D012119:Respiration