Bilateral Cleft Lip Repairs: The Manchester Method and Presurgical Orthodontic Treatment

Abstract

ABSTRACT  From 1974 to 1984 we have performed operations on 142 patients with bilateral cleft lip using the Manchester method. Presurgical oral orthodontics were given to 84 patients out of 142. We used a head cap with elastic band and oral appliance which was devised by Dr. J. H. Peat. Experience proves that the earlier presurgical oral orthodontics was begun, the more more satisfactory were the results. Treatment of our cases was started as early as at approximately 4‐6 weeks of age. The average length of treatment was 8 weeks, and the patients were opearated on at the age of 3‐5 months. Post operative results in almost all of our cases were satisfactory. The advantages were 1) lip with satisfactory lenght, 2) acceptable scar pattern, 3) free prolabium and deep gingiva‐labial sulcus. However, several problems to be overcome in our cases were remained. These problems appeared severely depending on the degree of congenital deformity. Secondary repair to the extremely depressed nose and short columella was performed at the age of 4‐6 years. In these cases we made a forked flap on the upper lip and elongated a short columella while at the same time repairing the wide cupid's bow. Copyright © 1984, Wiley Blackwell. All rights reserved