DISCUSIÓN

Results of the multidisciplinary handling of the lip and of paladar fisurado unilateral

Resultados del manejo multidisciplinario del labio y paladar fisurado unilateral

The processing of the lip and paladar cleaved has evolved throughout the centuries, becoming more and more complex and looking for every time higher objectives, with improvement of the surgical techniques and creation of equipment you will multidiscipline that they deal with all the facets this type of pathology from the moment of the birth to the adult age.

The different implied specialists have to be in connection from the moment of the birth, juxtaposing their performances in the time, being able to get to cause modifications in the performance protocol the results obtained by each one of the professionals of the equipment.

Thus, already from the moment of the birth the collaboration of the ortodoncista at the time of making a presurgical ortodóntico processing in search of the alignment of the alveolar arches could be necessary to facilitate the closing of the forcebody of the fissure and the reconstruction of the nasal ground. The moment of the closing of the lip and paladar, as well as the used surgical technique, it has been seen that also they are determining at the time of being able to obtain more positive results, aesthetic as as much functional.

The collaboration of logopeda begins in the first childhood, to use the fonatorios mechanisms of compensation suitably. This processing will stay until the adolescence, since the atrophy of the adenoid weave in the puberty will make an overhaul necessary of the phonation. The degree of velofaríngea incompetencia will be able to seat the indication of the necessity to make complementary surgical techniques on soft paladar o el cierre de fístulas oronasales. The ortodoncista will continue throughout being a fundamental collaborator this time, in order to control the appearance of compressions maxilares by inclination of the segment to maxilar fisurado, as much before as after alveoloplastia secondary and still later, in order to maintain a suitable coordination of the arches and to make a possible preortognático ortodóntico processing by hipoplasia or retrusión to maxilar.

The present article tries to present the results obtained thanks to the processing to multidiscipline of patients with labiopalatina fissure, but it does not reach its objective, since it is limited to present/display the aesthetic results of the repairs of the fissure, farragosa form and with contradictions in the statistical data.

In the section of Material and Method it makes reference to a ortodóncica valuation by means of cefalométricos studies with use of parameters solely of positioning of superior and inferior maxilar, without considering the possible secondary alterations to the palatal, so frequent compression in these patients.

But in addition it does not make reference to which were the findings, which was the planning nor which the results. The same takes place as far as the valuation of the logopédico processing.

The article could be understood like a exhibition of the accumulated experience by its authors, but without being able to obtain conclusions due to the diversity of used techniques, but of course it is not possible to be understood like development of the chosen title.

Almudena Alonso Ovies

Servicio de Cirugía Oral y Maxilofacial
Hospital Clínico San Carlos, Madrid, España