This book intends to cover cleft-related topics which are mainly focused on the current concept of balancing excellence in outcome and burden of cleft care. The wide spectrum of covered topics includes the understanding challenges and needs to deliver the modern surgical cleft care worldwide and comprehending multidisciplinary-based longitudinal life-changing concept.

The chapters are focused on professional-friendly technical descriptions from diagnosis to execution such as nasoalveolar molding, cleft lip repair, cleft palate repair, myringotomy tube insertion, primary and secondary rhinoplasties, oronasal fistula reconstruction, velopharyngeal insufficiency management, virtual-aided alveolar reconstruction, surgery-first approach in cleft orthognathic surgery, 3D computer-assisted orthognathic surgery, revisionary surgeries, and postoperative care.Traditional and current principle-based methods are itemized into many algorithms and protocols to aid in diagnosing, planning, and selecting the best therapeutic approach in order to balance excellence in outcome and burden of care. Many surgical-, orthodontic-, speech-, and postoperative care-related technical examples, intraoperative photos, and full-colour illustrative drawings can guide the professionals working in multidisciplinary teams through each traditional and newer hybrid operative procedure in a detailed step-by-step fashion with emphasis on how to perform each procedure, rather than on theoretical-only descriptions.
This book provides time- and scientifically-tested treatment algorithms to guide multidisciplinary teams during decision making process for each clinical scenario of the longitudinal cleft care


Rafael Denadai is a Professor Lo-trained Brazilian board-certified plastic and craniofacial surgeon who offers specialist cleft-craniofacial and plastic surgical care in Brazil. Dr. Denadai's clinical focus is on pediatric plastic surgery with special expertise in cleft lip and palate surgery, craniofacial surgery, management of velopharyngeal dysfunction, orthognathic surgery, rhinoplasty, and 3D medical imaging. Dr Denadai is passionate about using patient-focused, family-based, and data-driven elements to implement changes in surgical practice over the care cycle. Dr. Denadai is committed with a broad range of research pathways in the plastic and cleft-craniofacial fields, targeting the delivery of high-level surgical care. His research activities include meticulous and in-depth measurement of cleft-craniofacial deformities, computer-assisted craniofacial morphometrics, patient-reported and clinician-centered outcome assessments, identifying predictors of outcomes, perioperative care, patient-specific surgical planning and execution, and the decision-making process. He is international associate editor and member of reviewer board of many scientific journals in the fields of plastic surgery, pediatrics, outcome, and surgical education. He has published more than 230 peer-review scientific articles, authored several chapters of pediatric surgical textbooks, and a made dozens of scientific presentations on a full range of plastic and craniofacial surgery-related topics. He has received several awards from many organizations and societies.



Lun-Jou Lo is an internationally recognized board-certified plastic and craniofacial surgeon leader in aesthetic and plastic surgery, cleft lip/palate surgery, management of velopharyngeal dysfunction, craniomaxillofacial surgery, orthognathic surgery, facial contouring surgery, rhinoplasty, 3D medical imaging, surgical simulation, 3D printing, and outcome assessment. He is Professor in Plastic and Reconstructive Surgery and Director of the Image Lab and Craniofacial Research Center, Chang Gung Memorial Hospital and Chang Gung University, Taiwan. Professor Lo is International Associate Editor of Plastic & Reconstructive Surgery, Editor of Biomedical Journal, and Executive Editor of Journal of the Formosan Medical Association. He is the senior council member of Taiwan Cleft Palate-Craniofacial Association. He has published more than 250 peer-review scientific articles, authored several book chapters, and made dozens of presentations worldwide on a full range of plastic and cleft-craniofacial surgery-related topics. He trained many surgeons who are delivering plastic and cleft-craniofacial surgical care around the world. He has been invited by international societies and centers for lecturing and surgical demonstration. He has received honorable awards and honored professorship from many centers across the globe.



Part I Key Concepts in Surgical Cleft Care

Chapter 1 Epidemiological Features in Cleft Lip and Palate
Chapter 2 The Burden of Orofacial Clefts: Global Trends and Focus on Underresourced Regions
Chapter 3 The Unmet Need for Primary Cleft Lip and Palate Surgery: Demand for Levering Surgical Cleft Care in Underresourced Settings
Chapter 4 Treating Cleft-Related Deformities from Initial Diagnosis to Rehabilitation into Society at Maturity: Key Concepts of Burden of Cleft Care
Chapter 5 Longitudinal Life-Changing Concept Toward Reducing Cleft Stigmata, Dysfunction and Burden of Surgical Care
Chapter 6 Patient-Reported Outcome Measures as Driving Factors To Transform Surgical Cleft Care
Chapter 7 Leveraging Data Collection and Analysis To Optimize Outcomes in Surgical Cleft Care: Deciphering the Quality Improvement Puzzle
Chapter 8 Classifying the Wide Clinical Spectrum of Cleft Lip and Palate
Part II Surgical Cleft Care in the Growing Age

Chapter 9 Modern Unilateral Cleft Lip and Nasal Repair: Controversies from Presurgical Orthopedics to Surgical Techniques to Postoperative Care
Chapter 10 Current State of the Art in Unilateral Cleft Lip Repair with Primary Nasal Overcorrection: Lo's Modified Noordhoff's Procedure
Chapter 11 Modern Bilateral Cleft Lip and Nasal Repair: Controversial Features and Guiding Principles
Chapter 12 Current State of the Art in Bilateral Cleft Lip Repair with Primary Nasal Overcorrection: Lo's Modified Noordhoff's Procedure
Chapter 13 Modern Cleft Palate Repair: Controversies, Surgical Techniques, and Postoperative Care
Chapter 14 Comprehensive Appraisal of Outcome in Cleft Palate Repair
Chapter 15 Current State of the Art in Cleft Palate Repair: Technical Description and Outcome of Lo's Modified Furlow's Double Opposing Z-Plasty Procedure
Chapter 16 State of the Art in Surgical Management of Velopharyngeal Insufficiency
Chapter 17 Current State of the Art in Alveolar Cleft Reconstruction: Lo's Modified Secondary Alveolar Bone Grafting
Part III Surgical Cleft Care After Maturity

Chapter 18 Three-Dimensional Computer-Assisted Single-Splint Two-Jaw Cleft Orthognathic Surgery: Revisiting the Traditional Care
Chapter 19 Outcome of Three-Dimensional Computer-Assisted Single-Splint Two-Jaw Cleft Orthognathic Surgery
Chapter 20 Surgical Management of Oronasal Fistula after Primary Cleft Palate Repair: Condition-Specific Protocol and Outcome
Chapter 21 Treating Secondary Cleft Lip Deformity: Surgical Technique and Outcome
Chapter 22 State of the Art in Secondary Cleft Rhinoplasty: Comprehensive Technical Details and Deformity-Specific Approach