Premaxillary Setback With Posterior Vomerine Ostectomy: Outcomes of Single-Stage Repair of Complete Bilateral Cleft Lip With a Severely Protruding Premaxilla

Abstract

Objective:

Evaluating the safety and outcomes of premaxillary setback with posterior vomerine ostectomy in single-stage repair of complete bilateral cleft lip (CBCL) with severe premaxillary protrusion.

Design:

Retrospective case series.

Setting:

Multiple outreach surgical sites.

Patients/Participants:

From 2012 to 2016, 41 patients with CBCL and severe premaxillary protrusion underwent posterior vomerine premaxillary setback (PVPS) by a single surgeon in Brazil, Ecuador, and Peru. Patients 4 months to 18 years old undergoing primary or revision CBCL surgery were eligible for inclusion in the study. Patients with diagnosed syndromes were excluded.

Interventions:

Posterior vomerine premaxillary setback.

Main Outcome Measures:

Postoperative complications and postoperative aesthetic outcomes.

Results:

The mean age at surgery was 3.7 ± 3.8 years, with an average follow-up time of 17.0 ± 13.9 months. Patients underwent their procedures in Brazil (71%), Ecuador (22%), and Peru (7%). The majority of patients were aged 2 years or less (56%), were males (54%), had undergone prior surgery (56%), and had not undergone preoperative surgical orthopedics (95%). None of the patients developed major complications. All patients were able to undergo PVPS with concomitant required procedures and had good aesthetic outcomes.

Conclusions:

Few reports have evaluated single-stage CBCL repair or revision with severe premaxillary protrusion using PVPS. Our study shows that this technique is safe and results in good aesthetic outcomes. Further follow-up with anthropometric patient data is needed to evaluate long-term postoperative outcomes.