Prise charge des fentes labio-velo-palatines

Abstract

Objective : Labial-alveolar-velopalatine cleft is a common congenital dysmorphose of craniofacial region. It represents 65% of malformations of the cephalic extremity and the second malformation of the human. Their management must be multidisciplinary. It doesn't exist at the present hour a standard in management of this pathology and the therapeutic
calendar was specified to surgeons and their teams. Our subject was to study epidemiological and clinical chartacteristics and to evaluate our results.
Materials and methods : It is about a retrospective study of 38 patient colliged on 14 years (1994- 2008). All patients benefitted of a clinical examination, audiometric test and orthophonic evaluation. Abdominal and cardiac sonography has been performed in order to search an associated malformation.
Results : The middle age was 6 years and the sex-ratio 1,37. An associated malformation has been noted in 21% of cases. Disorders language have been recovered in 71% of cases and a tubal dysfunction in 26% of cases. It was about a cleft of lip and palate in 72% of cases, unilateral complete cleft in 10% of cases and bilateral complete cleft in 5% of cases.. The surgical treatment consisted in a closing in one operative time of the veil, the hard palate and the lip, associated to a nasal correction according to the technique of Malek. We got a satisfactory aesthetic and functional result in 89% of cases.
Conclusion : The management of the cleft of lip and palate must be multidisciplinary to assure the child's better functional and aesthetic rehabilitation and to minimize sequels. A standard managementl with a pre-established therapeutic calendar is the only guarantor of the therapeutic success.

Keywords : Labial-alveolar-velopalatine cleft , associated malformation, surgery, sequels