AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesHumanitiesNamed GroupsHealth Care
Cleft PalateCleft LipPalateLipPalate, HardPalate, SoftLip NeoplasmsLip DiseasesAbnormalities, MultipleMouth AbnormalitiesPierre Robin SyndromeVelopharyngeal InsufficiencyPalatal MusclesPalatal NeoplasmsCraniofacial AbnormalitiesTransforming Growth Factor beta3MaxillaMSX1 Transcription FactorOral Surgical ProceduresLingual FrenumSyndromePalatal ObturatorsMaxillofacial DevelopmentMicrognathismCongenital AbnormalitiesTooth AbnormalitiesTongueAlveoloplastyFaceAnodontiaTeratogensInterferon Regulatory FactorsUvulaInfant, NewbornFacial AsymmetrySyndactylyAbnormalities, Drug-InducedPregnancyEctodermal DysplasiaFacial MusclesMaxillofacial AbnormalitiesChoanal AtresiaMandibulofacial DysostosisDental ModelsRetrognathiaUltrasonography, PrenatalCephalometryMandibleReconstructive Surgical ProceduresEstheticsAlveolar ProcessPolychloroterphenyl CompoundsLimb Deformities, CongenitalNoseDental ArchOral FistulaDental Impression TechniqueSpeech Disorders
Hard palateSoft palatePrimary palatePatients with cleft lip anTypes of cleftType of cleftRoof of thSubmucous cleft palateOccursOccurGeneral anesthesiaNostrilNonsyndromicVelopharyngeal insufficiencySeverityAlveolusDeformitiesUltrasoundAnomalyMicroform cleftAnomaliesEtiologyAlveolar ridgeNoseOrofacial cleftsInvolveOpening in the upper lipBaby'sSecondary palateFrequent Ear InfectionsSurgeryDeformitySurgical proceduresNewbornSurgeriesSpeechMidlineNormal palatePrevalenceFuseIncidenceClassificationNotchGumsScarBabiesSides of the lipChild'sMalesMicroformsDefectsFetalIncisiveMouthCorrectionMillard's
Hard palate9
  • Six-month-old girl before going into surgery to have her unilateral complete cleft lip repaired The same girl, one month after the surgery The same girl, age eight, the scar almost gone Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. (wikipedia.org)
  • Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). (wikipedia.org)
  • Submucous cleft palate can also occur, which is a cleft of the soft palate with a split uvula, a furrow along the midline of the soft palate, and a notch in the back margin of the hard palate. (wikipedia.org)
  • A cleft palate can involve some or all of the soft palate and may extend into some or all of the hard palate in the roof of the mouth. (gosh.nhs.uk)
  • 3) Cleft Lip and Palate - The clefts extends from the upper lip to the hard palate or even the soft palate inside the buccal cavity. (cleftlip.org.hk)
  • Therefore, we have "L;I" corresponding to the lip, "A;a" for alveolus, "H;h" representing the hard palate (from the English, hard) and "S;s" for the soft palate (from the English, soft). (arquivosdeorl.org.br)
  • The clefts that involve the lip and the dental alveolus, as well as the hard palate frontal portion, are classified as pre-foramen clefts, and may be unilateral or bilateral. (arquivosdeorl.org.br)
  • The incisive post-foramen clefts involve the remaining parts of hard palate and soft palate. (arquivosdeorl.org.br)
  • The epithelium is mostly non-keratinised, except over the lips, gums and hard palate where slight keratinisation occurs. (clinicalgate.com)
Soft palate7
Primary palate7
  • It is due to the failure of fusion of the maxillary prominence and medial nasal processes (formation of the primary palate). (wikipedia.org)
  • The image below depicts embryonic formation of the primary palate. (medscape.com)
  • Illustration depicts fusion of the lateral nasal, medial nasal, and maxillary prominences to form the primary palate. (medscape.com)
  • The overall development of the palate involves the formation of the primary palate followed by the formation of the secondary palate.At approximately 30-37 days' gestational age (GA), the primary palate forms by the growth and fusion of the medial nasal, lateral nasal, and maxillary processes (see the image below). (medscape.com)
  • General opinion holds that mesodermal penetration underlies the formation of the primary palate. (medscape.com)
  • The condition is due to insufficient mesenchymal migration during primary palate formation in the fourth through seventh week of intrauterine life. (medscape.com)
  • The clefting anterior to the incisive foramen (ie, lip and alveolus) is also defined as a cleft primary palate. (medscape.com)
Patients with cleft lip an1
Types of cleft4
  • The incidence of the various types of cleft lip (CL) with or without cleft palate (± CP) is 1 per 700~1000 live births worldwide [ 1 , 2 ]. (springeropen.com)
  • An universal technique for primary closure and revision of all types of cleft lips. (esprasshare.org)
  • It is applicable for all types of cleft lips. (esprasshare.org)
  • Besides being involved in scientific work concerning all aspects of the development of the different types of cleft lips, in his clinic he was confronted with a vast number of primary and secondary repairs of patients who had been operated for cleft lips during the time of suboptimal conditions after the World War II. (esprasshare.org)
Type of cleft3
  • Regarding the oral health of the individual with CLP, regardless of the type of cleft, there is greater risk of dental caries, periodontal disease, and malocclusion 3,19,35 . (bvsalud.org)
  • Therefore, the Spina's (4) classification is predominantly found, which uses as a reference point the incisive foramen to limit the area affected and name the type of cleft. (arquivosdeorl.org.br)
  • This type of cleft is caused by a separation of the speech muscle under the surface of the palate. (kidshealth.org)
Roof of th12
Submucous cleft palate10
Occurs15
Occur18
  • Lip cleft can occur as a one-sided (unilateral) or two-sided (bilateral) condition. (wikipedia.org)
  • Clefts of the lip and palate can occur separately or together. (gosh.nhs.uk)
  • Cleft lips and palates occur during the first weeks of development in the womb. (gosh.nhs.uk)
  • Two thirds of all cases of clefting involve the lip with or without involvement of the palate, whereas one third of all cases occur as an isolated deformity of the palate. (medscape.com)
  • These developmental deformities occur in the first trimester of a woman's pregnancy - cleft lip in week seven and cleft palate in week nine. (valleydentalpediatrics.com)
  • Cleft lip and cleft palate occur simultaneously in about half of all cases and separately in approximately a quarter of all cases. (valleydentalpediatrics.com)
  • Unfortunately, this does not cure the dental problems that occur as a result of cleft lip and cleft palate defects. (valleydentalpediatrics.com)
  • As seen in figure 2, clefts of the lip may may occur on one or both sides, with varying degrees of severity. (facesfoundation.org)
  • When clefts of the lip and palate occur together they can involve one side (unilateral) or both sides (bilateral) of the palate (Figure 4). (facesfoundation.org)
  • Isolated unilateral clefts occur twice as frequently on the left side as on the right and are 9 times more common than bilateral clefts. (medscape.com)
  • It may occur on its own or with a cleft palate. (lawplasticsurgery.com)
  • The openings occur on both sides of the upper lip. (lawplasticsurgery.com)
  • [ 3 , 4 ] Typical and atypical clefts can both occur as an isolated anomaly, as part of a sequence of a primary defect, or as a multiple congenital anomaly (MCA). (medscape.com)
  • Cleft lip can occur as a unilateral (on the left or right side) or as a bilateral anomaly. (medscape.com)
  • Cleft lip may occur with a wide range of severity, from a notch located on the left or right side of the lip to the most severe form, bilateral cleft lip and alveolus that separates the philtrum of the upper lip and premaxilla from the rest of the maxillary arch (see the image below). (medscape.com)
  • [ 7 ] Most often these cleft lip microforms occur unilaterally. (medscape.com)
  • The labiopalatine clefts are the most common craniofacial congenital malformations, and they occur in 1 at each 757,5 births and in 1 at each 923,53 newborn alive (1) Especially the lip clefts, with palate commitment or not, affect more the masculine sex and have a variable incidence among the different ethnic groups, and the Asian have major risk. (arquivosdeorl.org.br)
  • The clefts palates without lip commitment have homogeneous incidence among the ethnics and occur more in the feminine sex (2). (arquivosdeorl.org.br)
General anesthesia4
  • Cleft palate repair requires general anesthesia and takes about 2-3 hours. (kidshealth.org)
  • We conclude that dental care under general anesthesia was an alternative treatment for the reported child in this clinical case that had a high prevalence of caries, cariogenic diet, loss of lip elasticity due to corrective surgeries, difficult access for oral hygiene and caregiver's fear to toothbrush near to the cleft. (bvsalud.org)
  • While the infant sleeps under general anesthesia, the tissue and muscles are repositioned and the cleft is closed with absorbable stitches. (lawplasticsurgery.com)
  • Several studies have reported the use of infraorbital block combined with a general anesthesia as postoperative pain management in cleft lip correction surgery.³⁻⁵ Currently, general anesthesia combined with an infraorbital block is the recommended anesthesia procedure for cleft lip correction surgery for patients in both hospitals and remote areas. (ui.ac.id)
Nostril7
Nonsyndromic3
  • A literature review by Munabi et al indicated that congenital heart disease (CHD) is more prevalent in patients with nonsyndromic cleft lip and/or palate than in the general population and that the likelihood of CHD is higher in cleft palate than in cleft lip. (medscape.com)
  • [ 7 ] The investigation was carried out in 153 families of probands with nonsyndromic cleft lip with or without cleft palate. (medscape.com)
  • In an attempt to unravel the genetic architecture of nonsyndromic cleft lip and/or palate (NSCL/P), it can be useful to focus on the phenotype of nonaffected first-degree relatives of these patients since they have a high chance to carry genetic susceptibility loci for NSCL/P. This can result in identifiable characteristics, so-called endophenotypes [ 3 ]. (hindawi.com)
Velopharyngeal insufficiency2
Severity4
  • It is advised to have newborn infants with a microform cleft checked with a craniofacial team as soon as possible to determine the severity of the cleft. (wikipedia.org)
  • According to the severity of the cleft, is must have a multidisciplinary approach with speech therapy, psychology, dentistry, and different surgical interventions 13 . (bvsalud.org)
  • In general, the risk to subsequent siblings increases with the severity of the cleft. (medscape.com)
  • Which surgical procedures a patient who needs cleft lip (aka orofacial cleft) repair receives depends on the type and severity of the deformity. (lawplasticsurgery.com)
Alveolus1
  • The line of cleft always starts on the lateral part of the upper lip and continues through the philtrum to the alveolus between the lateral incisor and the canine tooth, following the line of sutura incisiva up to the foramen incisivum. (medscape.com)
Deformities4
  • The cleft deformities are categorized according to their location in the mouth and the size of the defect. (valleydentalpediatrics.com)
  • Cleft lip and cleft palate are highly treatable deformities, though it may take a whole team of different specialists to fully treat the condition. (valleydentalpediatrics.com)
  • Cleft lip is among the most common of congenital deformities. (medscape.com)
  • Lenny is internationally renowned for his work in the treatment of children with craniofacial abnormalities, jaw deformities, jaw tumors, TMJ deformities, salivary gland disease, secondary cleft lip/palate deformities, obstructive sleep apnea, micrognathia and facial trauma. (issuu.com)
Ultrasound4
Anomaly4
  • Relatives of children with isolated cleft palate also have a higher risk of this anomaly, without an increased risk of the cleft lip and palate deformity. (medscape.com)
  • The correct diagnosis of a cleft anomaly is fundamental for treatment, for further genetic and etiopathological studies, and for preventive measures correctly targeting the category of preventable orofacial clefts. (medscape.com)
  • In an MCA, the cleft anomaly could be part of a known monogenic syndrome, part of a chromosomal aberration, part of an association, or part of a complex of MCA of unknown etiology (see the image below). (medscape.com)
  • An accurate prenatal diagnosis of the lip and palate anomaly is critical for establishing adequate long-term treatment planning, prediction of prognosis, and proper counseling with the parent [ 4 ]. (springeropen.com)
Microform cleft1
  • Unilateral incomplete Unilateral complete Bilateral complete A mild form of a cleft lip is a microform cleft. (wikipedia.org)
Anomalies5
  • Cleft lip may be associated with syndromes that include anomalies involving multiple organs. (medscape.com)
  • Patients may have impaired facial growth, dental anomalies, and speech disorders (if a cleft palate is present), and they may experience late psychosocial difficulties. (medscape.com)
  • A study by Datana et al indicated that the prevalence of upper cervical vertebrae anomalies is more than three times greater in persons with cleft lip/palate than in those without the condition. (medscape.com)
  • With rapidly advancing knowledge in medical genetics and with new DNA diagnostic technologies, more cleft lip and palate anomalies are diagnosed prenatally and more orofacial clefts identified as syndromic. (medscape.com)
  • The group of orofacial cleft anomalies is heterogeneous. (medscape.com)
Etiology2
Alveolar ridge2
Nose11
  • A cleft lip contains an opening in the upper lip that may extend into the nose. (wikipedia.org)
  • Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip (partial or incomplete cleft), or it continues into the nose (complete cleft). (wikipedia.org)
  • The top shows the nose, the lips are colored pink. (wikipedia.org)
  • It can be a small gap in the lip (incomplete cleft lip) or it can extend into the base of the nose (complete cleft lip). (gosh.nhs.uk)
  • Improve the shape and symmetry of the upper lip and nose. (kidshealth.org)
  • If the cleft lip is wide, special procedures like lip adhesion or nasal alveolar molding (NAM) might help bring the parts of the lip closer together and improve the shape of the nose before the cleft lip repair. (kidshealth.org)
  • Cleft lip repair leaves a small scar under the nose in place of the cleft. (kidshealth.org)
  • Figure 1 illustrates a normal lip and labels the parts of the lip and base of the nose. (facesfoundation.org)
  • cleft lip can range from a slight notch in the vermilion (red portion of the lips) to a complete separation of the lip extending into and distorting the tip and side (ala) of the nose. (facesfoundation.org)
  • This results in disfigurement and distortion of the upper lip and nose. (medscape.com)
  • a nasopharyngoscopy (nay-so-fair-en-GOS-kuh-pee): The doctor inserts a flexible tube called a scope through the nose to see the back of the throat and how the palate moves during speech. (kidshealth.org)
Orofacial clefts5
  • These orofacial clefts are some of the most common birth defects. (kidshealth.org)
  • Classification of orofacial clefts. (medscape.com)
  • The phrase "possible carriers" was used to search in families afflicted with orofacial clefts. (medscape.com)
  • Orofacial clefts are among the most common birth defects with a prevalence of approximately 1 in 700 live births [ 1 ]. (hindawi.com)
  • Orofacial clefts can be responsible for major social and psychological burden in the lives of the patients and their family and require a long and multidisciplinary follow-up, including several surgical procedures, orthodontics, and speech therapy [ 2 ]. (hindawi.com)
Involve3
Opening in the upper lip2
Baby's5
  • This happens when the baby's lip doesn't form properly early in pregnancy, resulting in a split. (kidshealth.org)
  • Doctors usually find a cleft palate when they look and feel inside a baby's mouth during the first newborn exam . (kidshealth.org)
  • A plastic surgeon will repair the baby's cleft lip first, usually when the baby is about 3 months old. (kidshealth.org)
  • Doctors don't always know why the muscles don't form as they should in the unborn baby's palate. (kidshealth.org)
  • The baby's parents were very happy to have the cleft lip defect corrected with very negligible scar. (smbalaji.com)
Secondary palate1
  • Clefts of the secondary palate alone are far more likely to be associated with syndromes than are clefts involving the lip alone or the lip and palate. (medscape.com)
Frequent Ear Infections2
Surgery16
  • A cleft lip or palate can be successfully treated with surgery. (wikipedia.org)
  • In some cases muscle tissue in the lip underneath the scar is affected and might require reconstructive surgery. (wikipedia.org)
  • As the palate plays an important role in speech it is important the cleft is repaired with surgery to reduce speech problems when the child is older. (gosh.nhs.uk)
  • It's important to correct a cleft palate with cleft lip with surgery while a child is young. (kidshealth.org)
  • A cleft palate usually is repaired with surgery called palatoplasty (PAL-eh-tuh-plass-tee) when the baby is 10-12 months old. (kidshealth.org)
  • Additionally, cleft patient can have a poor mismatch of their upper jaw and lower jaw resulting in a malocclusion that cannot be corrected by orthodontics alone which may require corrective jaw surgery. (midlandoralsurg.com)
  • Surgery to repair cleft lip and/or palate in infants can correct nursing, feeding and speech problems, and reduce future problems with ear infections. (lawplasticsurgery.com)
  • After cleft lip correction surgery, children go on to live relatively normal lives. (lawplasticsurgery.com)
  • Kids who have more serious symptoms (like hypernasality or nasal air emissions) usually will have their palate corrected with surgery. (kidshealth.org)
  • In Germany and Austria the Wave Line Incision Method , developed by Prof. Dr. Dr. Gerhard Pfeifer in the 1960s, Director of the Maxillofacial Surgery Department of the University of Hamburg/Germany (died in 2003) is a widely performed procedure for the closure of cleft lips, whereas it is hardly exercised in the Anglo-American countries due to a lack of corresponding publications in the English speaking literature. (esprasshare.org)
  • However one should always remember that in cleft lip surgery, the imminent result does not distinguish the surgeon, but the long-term outcome, after termination of facial and bone development truly distinguishes the surgeon. (esprasshare.org)
  • Pfeifer first tried to use this technique for the primary closure of cleft lips during his time as head of the Department of Maxillofacial Surgery at theUniversityofTuebingen,Germany. (esprasshare.org)
  • In Indonesia, cleft lip correction surgery is often done as a social program in remote areas with limited resources. (ui.ac.id)
  • This was a randomized controlled trial in children aged 2 months to 5 years who underwent cleft lip correction surgery at Cipto Mangunkusumo Hospital in 2016. (ui.ac.id)
  • Its effectiveness in managing postoperative pain is an advantage, considering that it overcomes the risk in cleft lip correction surgery.²⁻⁴ In developing countries such as Indonesia, cleft lip correction is often performed as a social charity program in remote areas where medicine, equipment, and resources are limited. (ui.ac.id)
  • Also, special thanks are extended to my stalwart collaborator, John F. Teichgraeber, MD, FACS, professor and director of the division of plastic and reconstructive surgery in the department of pediatric surgery at UTHealth McGovern Medical School, with whom I have been privileged to serve as co-director of the Texas Cleft-Craniofacial Clinic. (issuu.com)
Deformity4
  • Cleft lip and palate deformity can be distinguished from an isolated cleft palate (CP) on the basis of epidemiologic, embryonic, and genetic factors. (medscape.com)
  • Cleft Lip and Palate is a very common but most curable congenital deformity. (cleftlip.org.hk)
  • Speech - Children born with cleft deformity are likely to experience speech problems unless treatment is sought. (valleydentalpediatrics.com)
  • If your child was born with any cleft deformity, we strongly encourage you to contact our office to schedule a consultation. (valleydentalpediatrics.com)
Surgical procedures2
  • Possible treatment options include speech therapy, prosthetics, augmentation of the posterior pharyngeal wall, lengthening of the palate, and surgical procedures. (wikipedia.org)
  • These additional surgical procedures may include cleft palate repair and a cleft rhinoplasty. (lawplasticsurgery.com)
Newborn2
  • After birth, the newborn was confirmed to have bilateral complete CL + CP, which was much more severe than that had been predicted (Fig. 2 ). (springeropen.com)
  • After birth, the newborn was confirmed to have isolated incomplete CL (Fig. 4 ). (springeropen.com)
Surgeries2
  • Cleft lip and palate surgeries have greatly improved in recent years. (kidshealth.org)
  • 1,2 Cleft lip correction and other surgeries involving the lower eye lid, cheek, upper lip, and nostrils may cause intense intraoperative and postoperative pain in children. (ui.ac.id)
Speech7
  • Help create a palate that works well for speech. (kidshealth.org)
  • Cleft lip can cause problems with feeding, nursing and speech. (lawplasticsurgery.com)
  • Cleft lip and palate are common congenital abnormalities with typical functional disorders on speech, deglutition and middle ear function. (arquivosdeorl.org.br)
  • Velopharyngeal sphincter plays a central role in speech, swallowing and middle ear physiology in patients with labiopalatine cleft. (arquivosdeorl.org.br)
  • We are not only faced with a visible change in the palate, which makes the newly-born child's feeding difficult, nor even with an evident aesthetic change in the lip cleft: there is a whole complex network of functional changes in the deglutition, speech, hearing standards, craniofacial development and growth, nasal breathing. (arquivosdeorl.org.br)
  • a videofluoroscopy (vid-ee-oh-flore-AH-skuh-pee): The doctor uses X-rays to see how the palate moves during speech. (kidshealth.org)
  • Children with "cleft palate speech" might benefit from speech-language therapy to help correct any speech sound errors. (kidshealth.org)
Midline1
  • Midline indentation or cleft of the scrotum. (nih.gov)
Normal palate2
Prevalence1
  • The prevalence was 20.3% in the cleft group overall, compared with 6.4% in the control group. (medscape.com)
Fuse2
Incidence9
Classification1
  • Despite the Kriens' classification allows for a fast understanding of the cleft type and facilitates the communication among the multidisciplinary team professionals, it's not commonly used in the researches about the theme. (arquivosdeorl.org.br)
Notch1
Gums2
Scar2
  • In these patients, scar tissue often had to be excised, a narrowing of the upper lip had to be corrected, and falsely adapted orbicularis oris muscles had to be rejoined in an anatomically correct way. (esprasshare.org)
  • His parents feel very happy to have the cleft lip treated with negligible scar formation. (smbalaji.com)
Babies4
Sides of the lip2
Child's2
  • This fact is related to the presence of mutans microorganisms transmitted vertically from mother to child 7,9,20,23 , because of the close contact with the child's food and affection demonstrations, like kiss on the lips 33 . (bvsalud.org)
  • Initially, surgeons will work to close the cleft openings in the first six months of the child's life. (valleydentalpediatrics.com)
Males3
  • Cleft lip is about twice as common in males as females, while cleft palate without cleft lip is more common in females. (wikipedia.org)
  • Males predominate within the cleft lip and palate (CLP) group (60-80% of cases), whereas females constitute the majority within the cleft palate (CP) group. (medscape.com)
  • Siderius-type syndromic intellectual developmental disorder (MRXSSD) is an X-linked disorder in which affected males have mildly impaired intellectual development, mild dysmorphic features, and bilateral or unilateral cleft lip/palate (summary by Koivisto et al. (nih.gov)
Microforms1
  • It is a system composed by seven digits that allows for the description of the cleft shape, including microforms, by using capital letters to describe the complete forms and small letters for the incomplete ones. (arquivosdeorl.org.br)
Defects4
  • Cleft lip and cleft palate are two common but markedly different birth defects that affect about one in every 700 newborns. (valleydentalpediatrics.com)
  • A study by Michalski et al found that among isolated, noncardiac birth defects, cleft lip had one of the highest male-to-female ratios. (medscape.com)
  • The study involved 25,952 infants from the National Birth Defects Prevention Study (1997-2009), with male preponderance among isolated, noncardiac birth defects being greatest for craniosynostosis (2.12), cleft lip with cleft palate (2.01), and cleft lip alone (1.78). (medscape.com)
  • A spectrum of rib gap defects have been reported ranging from a few dorsal rib segments to complete absence of ossification. (nih.gov)
Fetal3
  • Presence of abnormal findings of the fetal lip or palate can be detected by the imaging professionals. (springeropen.com)
  • Oral and maxillofacial surgeons can use ultrasonographic imaging of fetal cleft lip with or without cleft palate to provide information regarding treatment protocols and outcomes to the parent. (springeropen.com)
  • Cleft lip with or without cleft palate (CL ± CP) is the most common fetal craniofacial malformation that is screened during prenatal ultrasonographic examination [ 3 ]. (springeropen.com)
Incisive1
  • Both pre-foramen incisive and the transforamen incisive clefts can still be classified as unilateral, bilateral, and median. (bvsalud.org)
Mouth3
  • If the cleft does not affect the palate structure of the mouth, it is referred to as cleft lip. (wikipedia.org)
  • This is so your baby can't put any fingers or hard objects into the mouth, which could make the cleft palate repair come open. (kidshealth.org)
  • Children with clefts have difficulty of gaining weight, so parents are encouraged to offer food more often, thus leading to an accumulation of food debris in the mouth 10 . (bvsalud.org)
Correction2
  • Infraorbital block with 1% ketamine 0.5 mg/kg was similarly effective for intraoperative and postoperative analgesia but had a longer duration than that with 0.25% bupivacaine 0.5 ml in ambulatory cleft lip correction. (ui.ac.id)
  • A 3-months-old baby boy born with unilateral cleft lip and palate defect from West Bengal was brought to our hospital by his parents for surgical correction of cleft lip defect. (smbalaji.com)
Millard's1
  • Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cleft lip repair using modified Millard's technique. (smbalaji.com)