Treatment of Bilateral Complete Cleft Lip and Palate with Latham Appliance: A Case Report

Cleft lip and palate is one of the most common craniofacial deformities that have physical and psychological influences on patients’ lives. In 1950, the concept of presurgical infant orthopedics (PSIO) was introduced because surgery alone can be aggressive and less controlled treatment in patients with wide cleft or severely protruded premaxilla. Latham appliance is a kind of PSIO which can make an active forces for alignment and approximation of alveolar segments. The newborn with bilateral complete cleft lip and palate was referred from the department of Neonatology to the department of Oral & Maxillofacial Surgery (OMFS) for evaluation and further treatment. The Latham appliance was applied 10 weeks after birth and activated for 1 month. After the resting period, the operation of primary lip and nose repair was performed with removal of the Latham appliance at 6 months after birth. Through the activation of the Latham appliance, minimizing the scar tissue and reducing tension was possible, and a successful result in esthetics and function can be made.

[1]  E. Ruas,et al.  Clinical Outcomes Utilizing a “Modified Latham” Appliance for Presurgical Infant Orthopedics in Patients With Unilateral Complete Cleft Lip and Palate , 2018, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[2]  J. Daskalogiannakis,et al.  Active Presurgical Infant Orthopedics for Unilateral Cleft Lip and Palate , 2018, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[3]  M. Schwartz,et al.  Dynamic Cleft Maxillary Orthopedics and Periosteoplasty , 2017, Annals of plastic surgery.

[4]  Carlos Cruz,et al.  Presurgical Orthopedics Appliance: The Latham Technique. , 2016, Oral and maxillofacial surgery clinics of North America.

[5]  Shinji Kobayashi,et al.  Maxillary growth after maxillary protraction: Appliance in conjunction with presurgical orthopedics, gingivoperiosteoplasty, and Furlow palatoplasty for complete bilateral cleft lip and palate patients with protruded premaxilla. , 2015, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[6]  R. Rajendra,et al.  Diversities in presurgical orthopedics: A review , 2015 .

[7]  J. Mulliken,et al.  Current Surgical Management of Bilateral Cleft Lip in North America , 2012, Plastic and reconstructive surgery.

[8]  R. Ruiz,et al.  Cleft lip and palate surgery: an update of clinical outcomes for primary repair. , 2010, Oral and maxillofacial surgery clinics of North America.

[9]  J. Mulliken,et al.  REPAIR OF BILATERAL CLEFT LIP AND NOSE: PRINCIPLES AND METHODS OF MULLIKEN , 2009 .

[10]  K. Bitter.  Repair of bilateral cleft lip, alveolus and palate. Part 3: Follow-up criteria and late results. , 2001, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[11]  K. Gundlach,et al.  Analysis of primary gingivoperiosteoplasty in alveolar cleft repair. Part I: Facial growth. , 1997, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[12]  S. Berkowitz.  A comparison of treatment results in complete bilateral cleft lip and palate using a conservative approach versus Millard-Latham PSOT procedure. , 1996, Seminars in orthodontics.

[13]  C Turner,et al.  Maxillary orthopedics in the presurgical management of infants with cleft lip and palate. , 1995, Pediatric dentistry.

[14]  K. Bitter.  Latham's appliance for presurgical repositioning of the protruded premaxilla in bilateral cleft lip and palate. , 1992, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[15]  S. Berkowitz,et al.  A discussion of presurgical orthodontics in patients with clefts. , 1988, The Cleft palate journal.

[16]  J. Bardach,et al.  Lip Pressure Changes Following Lip Repair in Infants with Unilateral Clefts of the Lip and Palate , 1984, Plastic and reconstructive surgery.

[17]  R A Latham,et al.  Orthopedic advancement of the cleft maxillary segment: a preliminary report. , 1980, The Cleft palate journal.

[18]  R. Kusy,et al.  An extraorally activated expansion appliance for cleft palate infants. , 1976, The Cleft palate journal.

[19]  W. H. van der Wel.  The treatment of cleft lip. , 1958, Archivum chirurgicum Neerlandicum.

[20]  C. K. McNeil.  Orthodontic procedures in the treatment of congenital cleft palate. , 1950, The Dental record.