Cleft Treatment Protocol in Korea

Cho, Byung Chae

Abstract

The current author surveyed cleft treatment protocol for 15 surgeons in Korean Society of Plastic and Reconstructive Surgeon. Survey items were operative age, techniques in incomplete cleft lip and isolated cleft palate, types of preoperative orthopedics in complete cleft lip and palate, correction ages of cleft lip nasal deformity and alveolar cleft. In incomplete cleft lip only, operative age ranged 10 weeks to 6 months(most common in 3 months), and most common operative technique was modified Millard method. In isolated cleft palate, operative age ranged 8 months to 24 months(most common in 12 months), Furlow-Z plasty or push-back procedure or two-flap palatoplasty was used or combined. In unilateral complete cleft lip and palate, eleven of fifteen surgeons used preoperative orthopedics. Preoperative orthopedics started between within 1 week and 2 months. Types of preoperative orthopedics were active appliance or combined with lip adhesion, passive appliance combined with lip adhesion, and nasoalveolar molding with skin tape. The definitive cheiloplasty was done between 3 months and 7 months old. In bilateral complete cleft lip and palate, all surgeons used preoperative orthopedics, and one-stage lip repair. The operative techniques were Millard method in 6 surgeons, modified Mullikin method in 4 surgeons, modified Noordhoff method in 3 surgeons, and Veau III operation in 2 surgeons. The operative age was between 10 weeks and 6 months old. The correction of cleft lip nasal deformity was at primary cheiloplasty in 3 surgeons, age 4 to 6 in 2 surgeons, age 4 to 6 in 9 surgeons, age 4 to 6 and age 9-16 in 2 surgeons. The alveolar bone graft was done at age 9 to 11(mixed dentition period) in all surgeons.