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This study reviews the results after 18 years of our surgery and follow-up for children born in our hospital with a cleft palate (CP). Evaluation of 18-year-old youngsters born with CP, operated at the time by the same surgeon following the same primary surgical procedure (von Langenbeck). We analyzed the files of children born from 1997 to 2001 with a CP and operated in our hospital. Operations were performed by the same surgeon, following the von Langenbeck procedure adapted according to the children's age or weight. The evaluation was based on the results of the primary surgeries, final phonatory results, otorhinolaryngology interventions, maxillofacial surgery, and psychological needs. All syndromic children were excluded. Seventy-nine files from children born with a cleft were reviewed: 34 were taken into consideration and among them five Pierre Robin Sequence (PRS) were removed. Children were operated at a median age of 5,2 months (3-6). Eighteen percent had a fistula, 45% had grommets, 14% were operated for a pharyngeal flap following the Sanvenero-Rosselli technique to improve the phonatory score. Thirty-six (36) percent had a final phonation I, 32% a phonation I/II and 32% a phonation IIb. None had an osteotomy. All children were seen by our psychologist. A median of 5.5 multidisciplinary consultations were affected with a median number of general anesthesia of 2.4 (1-6).This retrospective study is based on one primary surgical technique used by the same surgeon. It shows that the von Langenbeck procedure done at six months entails a certain risk of fistula but shows good long-term phonatory results. The number of grommets used is low and must be seen in relation with otitis media and our follow-up. A few complements to our investigations and follow-up are proposed concerning grommets, surgical procedures, and sleep disorder.

The international economic regime has entered a new phase of reassertion of sovereignty by States. While States continue to show respect for the values of international (economic) law, the institutionalization of these values has devolved from the international (to the regional) to the domestic level of governance. A new form of ‘unilateral economic law’ is thus gaining importance in the development of international and domestic laws and institutions. However, it remains largely understudied. This article discusses the development and proliferation as well as the importance of special economic zones as a new form of unilateral economic law in the overall system of international economic law. This article identifies four types of economic unilateralism: classical unilateralism, embedded unilateralism, sustainability unilateralism, and national security unilateralism. The new special economic zone unilateralism represents a middle ground between the two extremes of unilateral liberalization and aggressive unilateralism. Accordingly, special economic zone unilateralism introduces a new layer in the overall system of international economic law. First, special economic zones embody a new compromise between the State and the market. The State-controlled promotion of trade and investment taking place through special economic zones represents a complex compromise between the liberalization and protection of economic sovereignty. Second, the spatiality of trade and investment promotion through special economic zones is different from that of international economic law. The liberalization of trade and investment does not take place for the whole country but for an isolated jurisdiction within the broader national jurisdiction, while the focus is on the supply side rather than the traditional input factors of production. Overall, the new special economic zone unilateralism provides insights into the future of international economic law as envisaged by States. Special economic zones have been employed by States both as an alternative and as a complement to trade and investment promotion through the instruments of international economic law.

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