Modern Approach to the Treatment of Congenital Unilateral Cleft Lip of the Upper Lip

Abstract. The birth of children with cleft lip is quite common today; according to the latest data, the rate reaches 1 in 1000 of all children born. Since this pathology causes significant developmental disorders of the craniomaxillofacial area, doctors have been trying to optimize the treatment process for this category of patients since the last millennium. Despite significant successes in this direction, children with cleft lip often retain residual facial deformities. That is why the current task of pediatric maxillofacial surgeons is to develop and implement the most effective treatment protocols for children with a cleft lip of the upper lip. Purpose: Analyze literary sources regarding modern approaches to the treatment of upper lip nonunions. Material and methods. An information search and analysis of scientific sources on approaches to treating upper lip nonunions was conducted using the scientometric databases PubMed, ResearchGate, Google Scholar, and Cochrane. Results. Firstly, the treatment of patients with upper lip nonunion begins with establishing nutrition, as children with this pathology often cannot eat adequately. Consequently, their growth and development are disrupted. It is due to the lack of adequate weight gain that it is sometimes impossible to perform surgery due to the child’s unwillingness to undergo surgery under general anesthesia. After establishing nutrition, the child can be prepared for surgery. The main task of surgical intervention is to minimize the degree of deformation of the craniomaxillofacial area in the future. Today, one of the standard surgical methods for treating upper lip nonunion is the Fisher intervention. Treatment of patients with upper lip nonunion does not end with the surgical part but requires full postoperative rehabilitation, which is primarily intended to preserve the results of surgical intervention and eliminate residual phenomena of facial deformation. Primary postoperative rehabilitation consists of reducing scar tissue deformation. More distant rehabilitation involves performing orthognathic surgery, which patients with nonunions typically require. Conclusions. Only a correctly selected, comprehensive concept, which encompasses all stages of treating patients with nonunions, can ensure the maximum possible rehabilitation of this category of individuals. The involvement of related specialists is necessary for both preoperative and postoperative treatment of patients with nonunions of the upper lip. Therefore, the task of a pediatric maxillofacial surgeon in introducing patients with nonunions is to create conditions for the correct preparation of the child for surgical intervention, as well as to ensure the maximum possible full rehabilitation of these patients in the postoperative period.