Indian Journal of Plastic Surgery
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Year : 2016  |  Volume : 49  |  Issue : 3  |  Page : 336--339

Pre-maxillary complex morphology in bilateral cleft and hypothesis on laterality of deviated pre-maxilla

1 Department of Plastic Srugery, Sri Ramachandra University, Chennai, India
2 Cleft and Craniofacial Center, Sri Ramachandra University, Chennai, India

Correspondence Address:
Jyotsna Murthy
Villa 50, Bougainvillea, Sairam Nagar, Sreenivaspuram, Iyyappanthangal, Chennai - 600 056, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-0358.197247

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Introduction: Pre-maxillary complex (pre-maxilla [PMX] + vomer) morphology in bilateral complete cleft of primary and secondary palate (BCLCP) is very complex and less reviewed in literature. Materials and Methods: In this retrospective cross-sectional study, 200 consecutive BCLCP patients were selected. Their pre-operative clinical photographs and dental casts were evaluated by a single investigator at two different points of time, to study the morphology of PMX and vomer with special emphasis on deviation of vomer and rotation of PMX. Results: It is found that in above 70% of patients, PMX and vomer both displaced or deviated towards left side in horizontal plane and PMX rotated anticlockwise at PMX vomerine suture (PVS). In 10% of cases, both PMX and vomer are displaced towards the right side, PMX rotated clockwise at PVS. In 11% of cases, vomer is displaced towards the left side, but PMX rotated clockwise at PVS. In 5% of cases, vomer is displaced towards the right side, but PMX rotated anticlockwise at PVS. Both PMX and vomer are in midline in 4% of cases. Conclusion: Specific morphological deviation of vomer and PMX has been studied. We put forward the probable hypothesis to explain the deviation and rotation of PMX.


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