One-stage Surgical Closure of Complete Unilateral Cleft Lip and Palate: Acc. to HONIGMANN

Surgical treatment is often substantially based on physical parameters like restoration of the normal anatomy. But often there is no space for functional and biopsychosocial individual-related factors, which also have a huge influence on the treatment result for the patient. Overall, in the stages of several operations with concomitant fears, a network of severe problems emerges thatinfluences the whole life of an affected patient. The one-stage cleft closure takes care not only of an optimized functional treatment but also of the psychologic function. It is based on a real center of medicine with dedicated specialists, especially in the fields of surgery, pediatrics, anesthesiology, orthodontics, ear nose and throat (ENT)-surgery, and/or pedaudiology and speech therapy. A directly postnatal performed orthodontic therapy with an active palatal plate reduces the need for later speech therapy as well as surgical alveolar osteoplasty. Being performed by a routine surgeon, the time of surgery is about 90 min and there are no special or major complications. By effective pediatric postoperative analgetic management, the postoperative burden is reduced and postoperative stay in the hospital is reduced to 3–5 days until there is no more pain and sufficient feeding has started. In 80% of cases, the insertion of grommets is needed. Regarding the long-time follow-up, it could be shown that only every second patient on average needed secondary corrective surgery until the age of 16. Hereby, only 7.31% of secondary osteoplasty had to be performed. The results after the end of growth are not yet available, but the rate of Le Fort I osteotomy seems not to be higher than in multiple-stage treatment concepts.