Surgical treatment of the nasal-maxillary complex in adolescents with cleft lip and palate.
Rather than treating nasal, maxillary, and soft tissue deformities as separate problems, the author has approached the deformities as a single aesthetic and functional unit, the nasal-maxillary complex. This complex includes the maxilla, nose, and overlying soft tissues, including the upper lip. Successful reconstruction is based on a thorough knowledge of the underlying anatomy and physiology of these structures. Treatment of nasal-maxillary complex deformities in adolescents represents the final stages in a lifetime of reconstructive procedures. A team approach is preferred that includes a craniofacial surgeon, orthodontist, dentist, prosthodontist, and speech and language pathologist. The author's personal philosophy is based on sequential reconstruction of the underlying nasal-maxillary bony base. This is followed by reconstruction of the internal/external nasal complex and final soft tissue reconstruction. These principles are presented along with case examples.
Burstein
Fernando D
FD
Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, Georgia, USA. fburstein@aol.com
D000293:Adolescent; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D009666:Nose / Q000002:abnormalities / Q000601:surgery*; D019340:Osteotomy, Le Fort / Q000295:instrumentation / Q000379:methods*; D053831:Surgical Fixation Devices