<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922017000400313</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922017000400013</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Protocolo para la planificación quirúrgica en las clínicas de labio y paladar hendidos en la zona noroeste de la República Mexicana]]></article-title>
<article-title xml:lang="en"><![CDATA[Guidelines for the surgical planning at the cleft lip and palate clinics located in the northwest of Mexican Republic]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sigler]]></surname>
<given-names><![CDATA[Alicia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Clínica de Labio y Paladar y de Craneofacial de Shriners  ]]></institution>
<addr-line><![CDATA[Tijuana Baja California]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>43</volume>
<numero>3</numero>
<fpage>313</fpage>
<lpage>325</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922017000400313&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922017000400313&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922017000400313&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y Objetivo Las fisuras de labio y paladar son las malformaciones craneofaciales más frecuentes. Su tratamiento debe ser multidisciplinario y secuencial. Generalmente los pacientes requieren más de una cirugía reconstructiva durante su infancia y a veces es indispensable, en la edad adulta, el tratamiento dental, de audición, lenguaje, crecimiento facial y psicológico. Es necesaria la colaboración de múltiples profesionales de la salud que se mantendrán al tanto del progreso del paciente en su especialidad y se apoyarán para lograr un resultado exitoso y con buena calidad de vida. El objetivo del presente trabajo es estandarizar el manejo quirúrgico de las fisuras de labio y paladar en los pacientes atendidos en las clínicas ubicadas en Tijuana y Ensenada, y próximamente Mexicali y Hermosillo, ciudades localizadas al noroeste de México.  Material y Método En las clínicas de Labio y Paladar Hendido de Tijuana y Ensenada, la colaboración de profesionales en Cirugía Plástica, Odontología Pediátrica, Ortodoncia, Otorrinolaringología, Terapia de Lenguaje, Terapia Familiar, Psicología Pediátrica y otras disciplinas, ha logrado un seguimiento del tratamiento multidisciplinario de hasta 10 años. Los resultados estéticos y funcionales han sido óptimos cuando la cirugía reconstructiva se ha complementado con estas otras disciplinas.  Resultados Las fisuras de labio y paladar hendidos deben ser atendidas desde el nacimiento, apoyando psicológicamente a los padres, instruyéndolos sobre la alimentación y cuidados especiales de estos pacientes, preparando al niño para su primera cirugía que en muchos casos es la queiloplastia, y para la segunda, la palatoplastia, y enfatizando el apoyo por Odontopediatría y Ortodoncia para la salud dental y moldeamiento de los segmentos maxilares y de los cartílagos alares, así como la terapia del lenguaje cuando el paciente empieza a estructurar su habla. La evaluación audiológica es importante desde el nacimiento y la colocación de tubos de ventilación evitará problemas de audición y del habla si está indicada.  Conclusiones A lo largo de la infancia y hasta la edad adulta, los pacientes pueden requerir correcciones labiales y nasales, colocación de injertos óseos alveolares, faringoplastias, colgajos faríngeos, distracción maxilar y finalmente, cirugía ortognática para los problemas de oclusión o de crecimiento facial. Antes de llevarse a cabo cualquiera de estas cirugías, es indispensable la evaluación conjunta por el equipo multidisciplinario para lograr los mejores resultados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and Objective The lip and palate clefts are the most frequent congenital craneofacial malformations. Their treatment must be multidisciplinary and sequential. Most cases need more than one reconstructive surgery during the patient&#8217;s childhood and can extend to additional surgery in adulthood. Dental, auditory, speech, facial growth and psychological management are required. This is why all of the professionals that work in a cleft team should always communicate to obtain the most successful results. The objective of the present study is to standardize the management of lip and palate fissures in patients treated at the clinics located in Tijuana and Ensenada, and soon Mexicali and Hermosillo, cities located in the Northwest of Mexico.  Methods The patients involved have been treated in clinics for clefts in Tijuana, Ensenada, and very soon in Mexicali and Hermosillo, cities located in the Northwest of Mexico. In the cleft lip and palate clinics in Tijuana and Ensenada, the collaboration between Plastic Surgery, Pediatric Odontology, Orthodontics, Otorhinolaryngology, Speech Therapy, Family Therapy, Child Psychology and other disciplines has been crucial to treat and follow up on patients during the past 10 years. The esthetic and functional results have been optimal when the surgery is complemented by these other disciplines.  Results For this approach, the cleft lip and palate patient has to be evaluated as early as possible, and parents must be instructed in nutrition and other special needs, and in getting the patient ready for the first surgery which in most cases is the lip repair and the second, if needed, is the palate repair. It always has to be emphasized that the pediatric odontologist and the orthodontist play an important role in molding the nasal cartilages as well as the maxillary segments before the surgery, as well as dental health. The speech therapist will have an important role when the patient&#8217;s speech development starts and an early audiologic assessment will guide the treatment with ear tubes placed by the otorhinolaryngologist in order to avoid auditory and speech problems.  Conclusions During their lifetime, these patients may need other surgical procedures such as lip and nasal revisions, alveolar bone graft, pharyngoplasties, pharyngeal flaps, maxillary distraction or orthognatic surgery; this last one when there have been facial growth problems or malocclusions. Before any of these surgeries, the exchange of assessment and therapeutic plans by the multidisciplinary team is necessary to obtain the best results.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fisuras palatinas]]></kwd>
<kwd lng="es"><![CDATA[Labio leporino]]></kwd>
<kwd lng="es"><![CDATA[Protocolos]]></kwd>
<kwd lng="es"><![CDATA[Guías clínicas]]></kwd>
<kwd lng="es"><![CDATA[Labor social]]></kwd>
<kwd lng="en"><![CDATA[Cleft palate]]></kwd>
<kwd lng="en"><![CDATA[Cleft lip]]></kwd>
<kwd lng="en"><![CDATA[Protocols]]></kwd>
<kwd lng="en"><![CDATA[Clinical guidelines]]></kwd>
<kwd lng="en"><![CDATA[Sotial action]]></kwd>
</kwd-group>
</article-meta>
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