eMedicine Specialties > Plastic Surgery > Craniofacial

Craniofacial, Bilateral Cleft Lip Repair: Workup

Author: Pravin K Patel, MD, Associate Professor of Surgery, Division of Plastic Surgery, Northwestern University School of Medicine; Chief of Plastic and Craniofacial Surgery, Shriners Hospitals for Children; Head of Craniofacial Surgery, Children's Memorial Hospital
Coauthor(s): Raja Ramaswamy, MS, The Chicago Medical School; Mitchell F Grasseschi, MD, Assistant Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University; Private Practice, Plastic and Reconstructive Surgery; David E Morris, MD, Assistant Professor of Surgery, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago College of Medicine; Staff Surgeon, Shriner's Hospital for Children
Contributor Information and Disclosures

Updated: Apr 13, 2009

Workup

Laboratory Studies

  • Perform a thorough physical examination, not limited to the head and neck region, to uncover associated anomalies in the infant presenting with a unilateral cleft lip with or without a palatal cleft. Additional workup is determined by physical findings that suggest involvement of other organ systems.
  • The child's weight, oral intake, and growth and/or development are of primary concern and must be followed closely.
  • Routine laboratory studies typically are not required, other than a hemoglobin study shortly before the planned lip repair.
  • Routine imaging is not indicated in a healthy patient with isolated cleft lip.

More on Craniofacial, Bilateral Cleft Lip Repair

Overview: Craniofacial, Bilateral Cleft Lip Repair
Workup: Craniofacial, Bilateral Cleft Lip Repair
Treatment: Craniofacial, Bilateral Cleft Lip Repair
Follow-up: Craniofacial, Bilateral Cleft Lip Repair
Multimedia: Craniofacial, Bilateral Cleft Lip Repair
References
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References

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  2. Carstens MH. Functional matrix cleft repair: a common strategy for unilateral and bilateral clefts. J Craniofac Surg. Sep 2000;11(5):437-69. [Medline].

  3. Mulliken JB, Wu JK, Padwa BL. Repair of bilateral cleft lip: review, revisions, and reflections. J Craniofac Surg. Sep 2003;14(5):609-20. [Medline].

  4. Noordhoff MS, Cohen M, eds. Bilateral cleft lip. Mastery of Plastic and Reconstructive Surgery. 1994;1:566-80.

  5. Cragan JD. Epidemiology of Orofacial Clefts. Centers for Disease Control and Prevention Web site. Available at http://www.cdc.gov/ncbddd/bd/macdp/am_940_Cragan.pdf. Accessed April 13, 2009.

  6. Centers for Disease Control and Prevention (CDC). National Estimates of and Racial and Ethnic Variations Among Selected Birth Defects. CDC Web site. Available at http://www.cdc.gov/ncbddd/bd/keyfindings/race.htm. Accessed April 13, 2009.

  7. American Society of Plastic Surgeons (ASPS). 2007 Reconstructive Surgery Procedures and Reconstructive Breast Surgery. 2008. ASPS Web site. Available at http://www.plasticsurgery.org/Media/Press_Kits/Procedural_Statistics.html. Accessed March 10, 2009.

  8. American Cleft Palate-Craniofacial Association. Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies. 2000. ACPA Web site. Available at Available at: http://www.acpa-cpf.org/teamcare/Parameters00rev.pdf. Accessed March 10, 2009.

  9. McComb H. Primary repair of the bilateral cleft lip nose: a 15-year review and a new treatment plan. Plast Reconstr Surg. Nov 1990;86(5):882-9; discussion 890-3. [Medline].

  10. McComb H. Primary repair of the bilateral cleft lip nose: a 4-year review. Plast Reconstr Surg. Jul 1994;94(1):37-47; discussion 48-50. [Medline].

  11. Mulliken JB. Correction of the bilateral cleft lip nasal deformity: evolution of a surgical concept. Cleft Palate Craniofac J. Nov 1992;29(6):540-5. [Medline].

  12. Mulliken JB. Bilateral complete cleft lip and nasal deformity: an anthropometric analysis of staged to synchronous repair. Plast Reconstr Surg. Jul 1995;96(1):9-23; discussion 24-6. [Medline].

  13. Nakajima T, Yoshimura Y, Sakakibara A. Augmentation of the nostril splint for retaining the corrected contour of the cleft lip nose. Plast Reconstr Surg. Feb 1990;85(2):182-6. [Medline].

  14. Cutting C, Grayson B, Brecht L, et al. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg. Mar 1998;101(3):630-9. [Medline].

  15. Mulliken JB, Wu JK, Padwa BL. Repair of bilateral cleft lip: review, revisions, and reflections. J Craniofac Surg. Sep 2003;14(5):609-20. [Medline].

  16. Bardach J. Salyer and Bardach's Atlas of Craniofacial and Cleft Surgery: Cleft Lip and Palate Surgery. Vol 2. Lippincott-Raven Publishers; 1999.

  17. Bardach J, Salyer KE. Surgical Techniques in Cleft Lip and Palate. 2nd ed. Chicago: Mosby Yearbook; 1991.

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  19. Centers for Disease Control and Prevention (CDC). Cleft Lip and Cleft Palate. CDC Web site. Available at http://www.cdc.gov/ncbddd/bd/cleft.htm. Accessed April 13, 2009.

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  23. Fara M. McCarthy ed. Plastic Surgery: Cleft Lip & Palate and Craniofacial Anomalies. Vol 4. W B Saunders Company; 1990.

  24. Grabb WC, Rosenstein SW, Bzoch KR, eds. Cleft Lip and Palate. Boston: Little Brown & Company; 1971.

  25. Millard DR Jr. Cleft Craft. Vol 1, 2, 3. Little Brown & Company; 1976.

  26. Millard DR Jr, Latham RA. Improved primary surgical and dental treatment of clefts. Plast Reconstr Surg. Nov 1990;86(5):856-71. [Medline].

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Further Reading

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Keywords

bilateral cleft lip repair, bilateral cleft lip, cleft lip and palate, cleft lip, cleft palate, facial cleft, congenital deformities, hare lip, birth defect, cleft lip pictures, cleft lip treatment, cleft lip surgery, birth defect reconstruction

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Contributor Information and Disclosures

Author

Pravin K Patel, MD, Associate Professor of Surgery, Division of Plastic Surgery, Northwestern University School of Medicine; Chief of Plastic and Craniofacial Surgery, Shriners Hospitals for Children; Head of Craniofacial Surgery, Children's Memorial Hospital
Disclosure: Nothing to disclose.

Coauthor(s)

Raja Ramaswamy, MS, The Chicago Medical School
Raja Ramaswamy, MS is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Mitchell F Grasseschi, MD, Assistant Professor, Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University; Private Practice, Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

David E Morris, MD, Assistant Professor of Surgery, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago College of Medicine; Staff Surgeon, Shriner's Hospital for Children
David E Morris, MD is a member of the following medical societies: Chicago Medical Society and Illinois State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Larry Hollier, Jr, MD, Assistant Professor, Department of Plastic Surgery, Baylor University College of Medicine
Larry Hollier, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, AO Foundation, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

R Edward Newsome, MD, Program Director and Chief of Plastic Surgery, Henderson Chair in Surgery, Assistant Dean for Graduate Medical Education, Tulane University School of Medicine
R Edward Newsome, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic and Reconstructive Surgery, American Society of Plastic Surgeons, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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