Sequential cleft management with the sliding sulcus technique and alveolar extension palatoplasty.
Conventional methods of cleft lip repair deprive the anterior (buccolingual) alveolar mucoperiosteum of blood supply from the facial-internal maxillary arcade. Six months later, at palatoplasty, lingual incisions permanently isolate the lingual mucoperiosteum from its blood supply--the greater palatine artery. The osteogenic alveolar mucoperiosteum is thus converted from a richly supplied boundary zone between the two angiosomes into an isolated tissue dependent on osseus backflow. Cleft-sided growth disturbance is considered from this perspective. Subperiosteal techniques that preserve the blood supply to this tissue are considered in a sequential plan of cleft management.
Carstens
M H
MH
Children's Hospital Oakland, CA 94609, USA.
D000539:Alveolar Process / Q000098:blood supply* / Q000254:growth & development / Q000601:surgery; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D008445:Maxillofacial Development; D019647:Oral Surgical Procedures / Q000379:methods*; D010159:Palate / Q000098:blood supply / Q000601:surgery; D010521:Periosteum / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply