Recovering the personal identity of an elderly patient with cleft lip: a case report

Abstract

Instances of unoperated cleft lip and/or palate (CLP) in adult or elderly patients are still seen in developing countries. This paper presents the multidisciplinary management and the personal identity revival of a 72-year-old patient with unoperated unilateral complete cleft lip. The facial deformity was characterized by a protrusion of the excess of orbicularis oris muscle, irregularities of the upper lip, nose distortion, and septum deviation to the cleft side. The patient was edentulous with the maxillary alveolar ridge collapsed and an associated fistula. The cleft lip was repaired using the Tennison-Randall technique and complete dentures were delivered after the oroantral fistula had been closed. The patient was very pleased with the improvement in speech and eating and she approved of her facial esthetics. The existence of unoperated oral clefts in the elderly population highlights the need to improve policies in treating patients with CLP, mainly in developing countries.

Environmental factors related to the occurrence of oral clefts in a Brazilian subpopulation

“…The Craniofacial Rehabilitation Center in HGU/UNIC was implanted in 2004 in Cuiabá, capital of Mato Grosso, as the first specialized center for the care of oral cleft patients in the state. 21 22…”

Primary Cleft Lip Repair in Adults Under Local Anesthesia

“…In literature review, the oldest patient was 72 years old (Khalil et al, 2012) but in our study the oldest patient was 76 years of age (Figure 1).…”

“…The Facial profile with the un-operated complete cleft lip was associated with deviations of soft tissues only within the oro-nasal region (Figure 1). The deviations included a flattening of the nose; reduction of the height, concavity, and prominence of the upper lip; the increased height of the upper lip vermilion; and a more horizontal slope of the columella, leading to a reduction of the nasolabial angle, these are the common features in this type of oral cleft (Smahel et al, 1992; Capelozza et al, 1993; Olasoji et al, 2002; Khalil et al, 2012). However, these un-operated patients having good facial growth and collapse are extremely rare (Ortiz-Monasterio et al, 1966; Shetye, 2004; Sousa et al, 2009).…”

Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation

“…These findings have been corroborated by multiple groups [57,58] and translate to other forms of corrective facial surgery. For example, elder patients treated with cleft lip repair report experiencing a restored sense of personal identity [59]. Similarly, orthognathic surgery yields consistent improvements in patient quality of life through restoration of physical facial identity [4,60,61].…”