Bilateral cleft lip with severe projection of the premaxilla and absence of columella: case report with a modification of the Mulliken technique

• DOI: https://doi.org/10.22533/at.ed.1595262514071

• Palavras-chave: cleft lip, cleft lip and palate, complex cheiloplasty

• Keywords: cleft lip, cleft lip and palate, complex cheiloplasty

• Abstract:

  Cleft lip and palate are the most common congenital facial malformations. According to the WHO, the current global prevalence for cleft lip is 0.3 and for cleft lip and palate, 0.45-1 per 1,000 live births. (1)(2) In Brazil, according to DATASUS, the prevalence of cleft lip and palate is 1 per 1,858 live births. (3)
  Approximately 70% of cleft palate cases occur in isolation, while 30% are syndromic clefts. Children with cleft lip and palate can suffer serious impairments to their speech, hearing, nutrition and psychosocial development.(2)(4)

  Surgical correction of complete bilateral cleft lip and palate is challenging, with satisfactory results only in the hands of more experienced surgeons. (5) The operative techniques frequently used are Millard, Mulliken, Trott, Cutting and Dr. Percy Rossel's double advancement and lateral rotation technique. (6)(7)(8)
  We report the case of a pediatric patient with complete bilateral cleft lip and palate, with a large maxillary and nasal deficiency, no early conservative treatment and advanced age, leading to a complex approach.