Secondary cleft deformities: case report and review of literature

Abstract

The aim of this paper is to highlight the iatrogenic aspect of secondary cleft deformity, methodologies to treat them and the importance of reporting such cases. Secondary deformities are common in cleft lip and palate patients. Primary aim of treatment in cleft patients is to enhance their normal growth and development and minimize morbidity and number of operative procedures. Meticulous diagnosis, treatment planning and execution of primary surgery are of utmost importance in such cases to prevent majority of secondary deformities. Treatment of secondary deformity depends on the degree of deformity and the severity of impact on normal functions and growth. Following is a case of 16-year-old female patient who incurred secondary cleft deformities after undergoing multiple surgical interventions for congenital bilateral cleft lip alveolus and palate, last of which was conducted at the age of 6 years. Lip revision and tongue flap surgeries to close the palatal fistula were performed to address the patient's complaint and improve quality of life. Performing a tongue flap for anterior palatal fistula was more successful than Bardach's palatoplasty technique. It is important that each case encountered at various congenital defect care facilities is reported in literature to make the masses aware of probably outcomes and also help maintain a database to have more accurate data of such cases.

Costochondral Graft Rejection or Foreign Body Reaction 55 Years After Cleft Lip Revision: Case Report and Review of Literature

“…Moreover, unplanned secondary procedures might have to be performed for any secondary deformity such as vermillion notching, poorly de ned philtrum, lateral lip bulging, drooping lip, volume de ciency at the upper vermilion, and whistle deformity. [3] These procedures might involve the placement of grafts that serves as a foreign object and could incite a reaction within the surrounding tissues leading to a series of in ammatory changes, and ultimately graft rejection.…”