Chirurgische behandeling lip- en verhemeltespleet

Abstract

Surgical treatment of cleft lip and palate Children with cleft lip and/or palate often undergo multiple surgical procedures to repair the lip and/or palate. The lip closure is usually done between the ages of 3 and 6 months, which may or may not be preceded by presurgical orthopedic treatment. The techniques used for cleft lip repair vary between different teams and surgeons. In addition to a correct alignment of the lip parts, the restoration of the continuity of the orbicularis oris muscle and the correct positioning of the base of the nostril are important. The timing and sequence of the hard and soft palate repair vary and are a trade-off between the beneficial effect of early palate repair on the velopharyngeal function and speech development, and the possible negative effect of palate repair on maxillary growth. The hard and soft palate can be closed simultaneously or in 2 operating times. Again, several techniques are available, always with the aim of achieving a complete closure of the mucosa without oronasal fistulas and with a functional velopharyngeal sphincter. For the latter, repositioning the palatine levators and restoring their continuity are crucial.