Single-Stage Cheilorhinoseptognathoplasty and Uranisco-Plasty

Simultaneous Unilateral Cheilorhinoseptognathouranostaphyloplasty is a complex surgical procedure aimed at correcting multiple congenital deformations of the lip, nose, septum, jaw, and soft palate on one side of the face. This operation is particularly important for patients with conditions such as unilateral cleft lip and palate, where it is vital to restore both aesthetic appearance and functional capabilities – breathing, speaking, and feeding. Combining several corrective procedures into one helps minimize the need for multiple surgeries and improve outcomes in a shorter recovery time. At the "Dobrobut" Medical Center, a team of experienced surgeons employs modern techniques to achieve optimal results for patients who require this procedure.

When to See a Doctor

A child should be evaluated by doctors if the following changes are observed:

• Noticeable deformations in the form of pronounced asymmetry or structural deformities of the lip, nose, jaw, associated with congenital defects or complex injuries (less frequently encountered).
• Breathing problems, especially through the nose, which may indicate structural anomalies requiring surgical intervention.
• Infants with such complex deformations typically have issues with breastfeeding or bottle-feeding.
• Speech difficulties related to deformities of the lip, nose, and palate.
• Social and psychological issues.

Indications and Contraindications

Simultaneous unilateral cheilorhinoseptognathouranostaphyloplasty may be indicated in the following cases:

• Congenital deformities, including unilateral cleft lip and palate, that require surgical correction to restore functions and improve appearance.
• Acquired deformities, namely, injuries to the lip, nose, palate, and jaw that cause significant asymmetry or functional impairments.
• Aesthetic problems in the form of obvious facial asymmetry for cosmetic reasons.

Contraindications

The surgery may not be performed or may be delayed in cases of acute infection, inflammatory processes at the intervention site, as well as severe comorbidities that complicate any surgical maneuvers and anesthesia.

Diagnosis

To determine the need for complex surgical intervention, comprehensive diagnostics are conducted, including physical examination, during which the surgeon performs a thorough assessment, evaluating the deformities of the lip, nose, jaw, and possible functional impairments. The specialist pays attention to asymmetry, the condition of the tissues, and the overall health of the patient. Instrumental studies using imaging methods (X-ray, MRI) are also prescribed to obtain detailed images of internal structures, assisting in surgical planning. General laboratory tests allow assessment of the patient's overall health and detection of deviations that may affect the course of the procedure.

How the Surgery is Performed

In preparation for unilateral cheilorhinoseptognathouranostaphyloplasty, the surgical team discusses the details of the procedure, prospects, potential risks, and postoperative care, to ensure maximum results and safety. The day before the surgery, dietary instructions are provided regarding food and fluid intake. The doctor conducts a final examination of the patient to confirm the absence of contraindications and answers questions regarding postoperative care.

Surgical intervention is performed in several stages:

1. Administration of general anesthesia.
2. Making incisions on the affected side of the lip, nose, jaw, and, if necessary, the palate, using methods that allow scars to be hidden in the natural folds of the face.
3. Correcting the deformation, during which the surgeon moves tissues of the lip and nose, repairs the septum, and corrects the jaw deformation. The aim of the surgery is to achieve facial symmetry and restore normal functions.
4. Closing the incisions: After the necessary corrections are made, the surgeon carefully closes the incisions with sutures that minimize the visibility of scars.

Recovery

The recovery process after the surgical procedure includes:

• Postoperative monitoring in the recovery room, where doctors check the stability of vital signs and observe the patient's reaction to anesthesia.
• Prescribing appropriate pain relief medications to ensure comfort.
• Dietary restrictions. After the procedure, patients are placed on a soft or liquid diet, depending on their condition and the doctor’s recommendations.
• Physical activity should be limited in the first few days post-surgery to avoid excessive strain.
• Regular follow-up visits are important for tracking healing, assessing the surgical results, and discussing any issues.

Complications

Potential complications of the surgical intervention may include the occurrence of infection (swelling, redness, pain, discharge) at the site of the incision, which may require antibiotic treatment, the risk of noticeable scarring, particularly if healing is pathological, which may necessitate additional cosmetic corrections. There is also the possibility of bleeding during and after surgery, nerve damage, and recurrence of asymmetry.

Prevention

To reduce the risk of complications, the following preventive measures are taken: 

• A detailed preoperative assessment of the patient’s condition before the surgical intervention allows for the identification of potential risks and adjustment of the surgical plan.
• Adhering to postoperative wound care instructions, including keeping the operative area clean and dry, helps prevent infections.
• Being informed about symptoms of complications, such as increased pain, swelling, or signs of infection, enables prompt medical assistance.
• Attending all scheduled follow-up appointments for monitoring healing, identifying complications, and adjusting treatment processes.

At the "Dobrobut" Medical Center, a comprehensive approach and a multidisciplinary team focused on providing high-quality surgical assistance, even in complicated cases, are offered.