Review Article| Volume 35, ISSUE 1, P127-137, February 2023

Definitive Rhinoplasty and Orthognathic Surgery for Patients with Cleft Lip Palate

Published:November 03, 2022DOI:


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        • Olds C.E.
        • Sykes J.M.
        Cleft Rhinoplasty.
        Clin Plast Surg. 2022; 49: 123-136
        • Kaufman Y.
        • Buchanan E.P.
        • Wolfswinkel E.M.
        • et al.
        Cleft nasal deformity and rhinoplasty.
        Semin Plast Surg. 2012; 26: 184-190
        • Roy A.A.
        • Rtshiladze M.A.
        • Stevens K.
        • et al.
        Orthognathic surgery for patients with cleft lip and palate.
        Clin Plast Surg. 2019; 46: 157-171
        • Bardach J.
        • Cutting C.
        Anatomy of unilateral and bilateral cleft lip and nose.
        in: Bardach J. Morris H.L. Multidisciplinary management of cleft lip and palate. Saunders, Philadelphia1990: 154-158
        • Haddock N.T.
        • McRae M.H.
        • Cutting C.B.
        Long-term effect of primary cleft rhinoplasty on secondary cleft rhinoplasty in patients with unilateral cleft lip-cleft palate.
        Plast Reconstr Surg. 2012; 129: 740-748
        • Garfinkle J.S.
        • King T.W.
        • Grayson B.H.
        • et al.
        A 12-year anthropometric evaluation of the nose in bilateral cleft lip-cleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction.
        Plast Reconstr Surg. 2011; 127: 1659-1667
        • Allori A.C.
        • Mulliken J.B.
        Evidence-based medicine: Secondary correction of cleft lip nasal deformity.
        Plast Reconstr Surg. 2017; 140: 166e-176e
        • Saleh M.A.
        • Elshahat A.
        • Emara M.
        • et al.
        Objective Tools to Analyze the Lower Lateral Cartilage in Unilateral Cleft Lip Nasal Deformities.
        J Craniofac Surg. 2011; 22: 1435-1439
        • Allori A.C.
        • Marcus J.R.
        Modern tenets for repair of bilateral cleft lip.
        Clin Plast Surg. 2014; 41: 179-188
        • Cuzalina A.
        • Jung C.
        Rhinoplasty for the cleft lip and palate patient.
        Oral Maxillofac Surg North Am. 2016; 28: 189-202
        • Guyuron B.
        M.O.C.-P.S.(S.M.) CME article: Late cleft lip nasal deformity.
        Plast Reconstr Surg. 2008; 121: 1-11
        • Yoshimura Y.
        • Okumoto T.
        • Iijima Y.
        • et al.
        Reduced nasal growth after primary nasal repair combined with cleft lip surgery.
        J Plast Reconstr Aesthet Surg. 2015; 68: e159-e166
        • Susami T.
        • Kuroda T.
        • Amagasa T.
        Orthodontic treatment of a cleft palate patient with surgically assisted rapid maxillary expansion.
        Cleft Palate Craniofac J. 1996; 33: 445
        • Phillips J.H.
        • Klaiman P.
        • Delorey R.
        • et al.
        Predictors of velopharyngeal insufficiency in cleft palate orthognathic surgery.
        Plast Reconstr Surg. 2005; 115: 681-686
        • Brattstrom V.
        • McWilliam J.
        • Larson O.
        • et al.
        Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. I. Maxillary development.
        Scand J Plast Reconstr Surg Hand Surg. 1991; 25: 259-267
        • Good P.M.
        • Mulliken J.B.
        • Padwa B.L.
        Frequency of LeFort I osteotomy after repaired cleft lip and palate of cleft palate.
        Cleft Palate Craniofac J. 2007; 44: 396-401
        • Posnick J.C.
        • Tompson B.
        Modification of the maxillary Le Fort I osteotomy in cleft-orthognathic surgery: the bilateral cleft lip and palate deformity.
        J Oral Maxillofac Surg. 1993; 51: 2-11
        • Leshem D.
        • Tompson B.
        • Phillips J.H.
        Segmental LeFort I surgery: turning a predicted soft-tissue failure into a success.
        Plast Reconstr Surg. 2006; 118: 1213-1216
        • Semb G.
        Effect of alveolar bone grafting on maxillary growth in unilateral cleft lip and palate patients.
        Cleft Palate J. 1988; 25: 288-295
        • Daskalogiannakis J.
        • Ross R.B.
        Effect of alveolar bone grafting in the mixed dentition on maxillary growth in complete unilateral cleft lip and palate patients.
        Cleft Palate Craniofac J. 1997; 34: 455
        • Cassolato S.F.
        • Ross B.
        • Daskalogiannakis J.
        • et al.
        Treatment of dental anomalies in children with complete unilateral cleft lip and palate at SickKids hospital, Toronto.
        Cleft Palate Craniofac J. 2009; 46: 166
        • Aburezq H.
        • Daskalogiannakis J.
        • Forrest C.
        Management of the prominent premaxilla in bilateral cleft lip and palate.
        Cleft Palate Craniofac J. 2006; 43: 92-95
        • Geraedts C.T.
        • Borstlap W.A.
        • Groenewoud J.M.
        • et al.
        Long-term evaluation of bilateral cleft lip and palate patients after early secondary closure and premaxilla repositioning.
        Int J Oral Maxillofac Surg. 2007; 36: 788-796
        • Levy-Bercowski D.
        • DeLeon Jr., E.
        • Stockstill J.W.
        • et al.
        Orthognathic cleft-surgical/orthodontic treatment.
        Semin Orthod. 2011; 17: 197-206
        • Kalmar K.L.
        • Xu W.
        • Zimmerman C.E.
        • et al.
        Trends in Utilization of Virtual Surgical Planning in Pediatric Craniofacial Surgery.
        J Craniofac Surg. 2020; 31: 1900-1905
        • Lo L.-J.
        • Lin H.-H.
        Three-dimensional computer-assisted surgical simulation and intraoperative navigation in orthognathic surgery: a literature review.
        J Formos Med Assoc. 2015; 114: 300e-307e
        • Mazzoni S.
        • Bianchi A.
        • Schiariti G.
        • et al.
        Computer-aided design and computer-aided manufacturing cutting guides and customized titanium plates are useful in upper maxilla waferless repositioning.
        J Oral Maxillofac Surg. 2015; 73: 701-707
        • Denadai R.
        • Pai B.C.J.
        • Lo L.-J.
        Balancing the dental occlusion and facial aesthetic features in cleft orthognathic surgery: patientcentered concept for computer-aided planning.
        Biomed J. 2020; 43: 143-145
        • Borba A.M.
        • Borges A.H.
        • PS C.
        • et al.
        Mandible-first sequence in bimaxillary orthognathic surgery: a systematic review.
        Int J Oral Maxillofac Surg. 2016; 45: 472-475
        • Naran S.
        • Steinbacher D.M.
        • Taylor J.A.
        Current concepts in orthognathic surgery.
        Plast Reconstr Surg. 2018; 141: 925e
        • Wang Y.
        • Li J.
        • Xu Y.
        • et al.
        Accuracy of virtual surgical planning-assisted management for maxillary hypoplasia in adult patients with cleft lip and palate.
        JPRAS. 2020; 73: 134-140
        • Wu T.-J.
        • Lee Y.-H.
        • Chang Y.-J.
        • et al.
        Three-dimensional outcome assessments of cleft lip and palate patients undergoing advancement plast, 2019 maxillary advancement plast.
        Reconstr Surg. 2019; 143: 1255e
        • Heifetz-Li J.J.
        • Mechas N.
        • Deitrick P.
        How accurate are patient-specific osteotomy guides and fixation plates in orthognathic surgery?.
        Adv Oral Maxillofac Surg. 2021; 3: 100124
        • Posnick J.C.
        • Dagys A.P.
        Skeletal stability and relapse patterns after Le Fort I maxillary osteotomy fixed with miniplates: the unilateral cleft lip and palate deformity.
        Plast Reconstr Surg. 1994; 94: 924-932
        • Kloukos D.
        • Fudalej P.
        • Sequeira-Byron P.
        • et al.
        Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients.
        Cochrane Database Syst Rev. 2018; 8: CD010403
        • Tong H.
        • Gao F.
        • Yin J.
        • et al.
        Three-dimensional quantitative evaluation of midfacial skeletal changes after trans-sutural distraction osteogenesis for midfacial hypoplasia in growing patients with cleft lip and palate.
        J Cranio Maxill Surg. 2015; 43: 1749-1757
        • Liu C.
        • Liu C.
        • Gao Q.
        • et al.
        Transsutural distraction osteogenesis versus osteotemy distraction osteogenesis.
        J Craniofac Surg. 2012; 23: 464-471
        • Sykes J.
        • Senders C.
        • Wang T.
        • et al.
        Use of the open approach for repair of secondary cleft lip nasal deformity.
        Fac Plast Surg North Am. 1993; 1: 111-126
        • Lo L.J.
        Primary correction of the unilateral cleft lip nasal deformity: achieving the excellence.
        Chang Gung Med J. 2006; 29: 262-267
        • Welch T.B.
        Stability in the correction of dentofacial deformities: a comprehensive review.
        J Oral Maxillofac Surg. 1989; 47: 1142-1149
        • Janulewicz J.
        • Costello B.J.
        • Buckley M.J.
        • et al.
        The effects of Le Fort I osteotomies on velopharyngeal and speech functions in cleft patients.
        J Oral Maxillofac Surg. 2004; 62: 308-314
        • Witzel M.A.
        • Munro I.R.
        Velopharyngeal insufficiency after maxillary advancement.
        Cleft Palate J. 1977; 14: 176-180
        • Cheung L.K.
        • Chua H.D.
        A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis.
        Int J Oral Maxillofac Surg. 2006; 35: 14-24
        • Daskalogiannakis J.
        • Mehta M.
        The need for orthognathic surgery in patients with repaired complete unilateral and complete bilateral cleft lip and palate.
        Cleft Palate Craniofac J. 2009; 46: 498-502
        • Wang T.D.
        • Madorsky S.J.
        Secondary rhinoplasty in nasal deformity associated with the unilateral cleft lip.
        Arch Facial Plast Surg. 1999; 1
        • Ross R.B.
        Treatment variables affecting facial growth in complete unilateral cleft lip and palate.
        Cleft Palate J. 1987; 24: 5-77
        • Adlam D.M.
        • Yau C.K.
        • Banks P.
        A retrospective study of the stability of midface osteotomies in cleft lip and palate patients.
        Br J Oral Maxillofac Surg. 1989; 27: 265-276
        • Ince B.
        • Dadaci M.
        Base nasal bone resection versus oblique nasal bone resection: a comparative study of the outcome for the deviated nose.
        Plast Reconstr Surg. 2017; 139: 29e-37e
        • Cuzalina A.
        • Tolomeo P.G.
        Challenging rhinoplasty for the cleft lip and palate patient.
        Oral Maxillofacial Surg Clin N Am. 2021; 33: 143-159
        • Cuzalina A.
        • Tamim A.
        Cleft lip and palate patient rhinoplasty.
        in: Contemporary rhinoplasty. IntechOpen, London, UK2019
        • Liang Y.
        • Wang X.
        Application of diced autologous rib cartilage for paranasal augmentation in cleft nose.
        Aesth Plast Surg. 2021; 45: 1169-1175
        • Huang H.
        • Li Y.
        • Cheng X.
        • et al.
        Mechanical analysis of critical maneuvers in the correction of cleft lip nasal deformity.
        PLoS One. 2018; 13: e0195583