METHOD FOR STAGED INTEGRATED TREATMENT OF CHILDREN WITH CLEFT LIP AND PALATE Russian patent published in 2024 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention relates to medicine and is intended for use in the integrated treatment of sick children with congenital cleft lip and palate, speech disorders, swallowing. At age of 1-3 months, primary cheilorinoplasty is performed, eliminating areas of pathological attachment and displacement of muscle fibres and cartilages of nose by means of subperiosteal mobilization of soft tissues of lip and cheek along anterior surface of upper jaw and edges of piriform aperture. Mobilized lateral crus of the greater nasal cartilage is modelled in accordance with the position and contours of the cartilage of the opposite side – moving to the midline of the anterior part of the quadrangular cartilage of the nasal septum. At the same time performing complete reconstruction of anatomy of muscle bundles, and with bilateral clefts – bilateral modelling of lateral leg, its movement upwards with change of projection of arch, formation of vestibule of nasal cavity and directed traction of muscles by means of reconstruction of nasal muscles of lateral fragment – their fixation to connective tissue in area of anterior nasal spine to anterior part of base of nasal septum cartilage. Cleft of the soft palate is eliminated at age of 6-8 months by a single-stage functional plastic repair of the soft palate with narrowing of the pharyngeal ring and with isolated clefts of the soft and partially hard palate with the width of the defect within the range of not more than 5 mm, and a congenital hard palate defect is eliminated at the age of up to 12 months with an assessment of the result of said complex surgical treatment at age of 2-3 years by means of speech therapy and examination. Reconstructive surgeries with carrying out support-contour plasty of large nasal cartilages and complete recovery of all muscular and cartilaginous structures of nasolabial region are performed at age of 5-6 years. Palatopharyngeal insufficiency is eliminated by surgery at age of 5-6 years, and upon reaching age of 7-11 years, bone grafting of the alveolar process of the upper jaw is performed. Throughout the whole stage of surgical treatment, hearing is monitored by audiological examination at least once every 6 months.

EFFECT: due to complete recovery of physiological functions of the child and its aesthetic rehabilitation, the method provides further adequate life activity in the community.

7 cl, 12 dwg, 1 ex