Surgical Techniques of Repositioning the Displaced Premaxilla in Patients with Bilateral Cleft Lip with or without Cleft Palate

Abstract

We previously reported the usefulness of surgical techniques performed with the labial approach for surgical repositioning of the displaced premaxilla in bilateral cleft lip and palate patients. However, it was found that this technique is needed to care for the osteotomy line and blood flow to the premaxilla, because it is not easy to see the operative field widely.
We performed repositioning of the premaxilla with the palatal approach for 17 patients with bilateral cleft lip with or without cleft palate to verify the utility of this technique during a 13-year period from April 1996 to March 2009.
We found that the palatal approach is an appropriate surgical technique for repositioning the displaced premaxilla in patients with bilateral cleft lip with or without cleft palate. The results were as follows:
1. The palatal approach facilitated the surgical procedure of repositioning the displaced premaxilla, and all cases were performed by this technique surely and safely.
2. It was possible to perform osteotomy quite a distance away from the apex of the incisor's roots.
3. Contact points of bone fragments could be reduced correctly by bending the patient's head back when moving the premaxilla into the new position.
4. We confidently recommend using this technique to reposition the displaced premaxilla in bilateral cleft lip and palate patients.