Presurgical Management

A wide spectrum of cleft lip and palate exists and complex forms require a cleft team management. Patients with complex skeletal deformities, such as bilateral cleft lip and palate, may require treatment to improve their skeletal condition using presurgical orthopedics prior to the primary lip and nose surgery. These methods have been used to reposition premaxilla and maxillary segments closer to facilitate primary lip and nose surgery and prevent nondesirable outcomes. Different methods have been described as tapes and elastic bandages, passive or active alveolar plates in combination with nasal stents (nasoalveolar molding) and surgical lip adhesion; they are classified as surgical and nonsurgical methods. The surgical lip adhesion is another orthopedic treatment and represents an alternative when nonsurgical methods fail; however, the surgical adhesion should also be performed at an early age. This chapter presents to the reader a description of the conventional presurgical methods used in cleft lip and palate patients.