[Clinical management of cleft lip and palate in university hospital of Montpellier].
Management of labio-maxillo-palatine clefts has two major requirements: to constitute a multidisciplinary staff (surgical, phonological, orthodontical) intervening as soon as possible and determination of a precise therapeutical chronology not only for primary surgery but also for sequellae. Primary surgical protocol is in cases of total clefts these defined by Malek and Psaume; and for pure labial or incomplete clefts, we perform a neonatal surgery. Integration of interceptive correction of sequellae into thus protocol appears basic: correction of alveolar cleft by gingivoplasty (5 to 7 years) associated with secondary home-graft between 11 to 13 years; early nasal revision since 2 years for functional and aesthetic reasons. Early control of speech development, otologic problems and their management appears a very important point. Introduction of the concept of maxillary distraction appears to us a very important improvement for correcting orthognatic cases with major problems of squeletical growth. Recent introduction of the antenatal diagnosis introduces a new concept in psychological approach of these cases. It is necessary to establish a network for managing these cases since the antenatal period.
Montoya
P
P
Unité de chirurgie plastique pédiatrique, service de chirurgie orthopédique pédiatrique, CHU Lapeyronie, 34000 Montpellier, France. p-montoya@chu-montpellier.fr
Bigorre
M
M
Captier
G
G
Baylon
H
H
Pietrera
J
J
Delestan
C
C
Mattei
L
L
Golsmith
M C Alric
MC
Hervé
M J
MJ
D000046:Academic Medical Centers; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005602:France; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019651:Plastic Surgery Procedures / Q000379:methods*
Prise en charge des fentes labio-maxillo-palatines au centre hospitalier universitaire de Montpellier.