**Serhat Şibar**

**Chapter 1**

**Abstract**

PSIO

**1. Introduction**

**2. Discussion**

outcomes at various other centers.

Protocols in Presurgical Infant

*Nikita Khillon, Amine Fattal and Mohammad Zeinalddin*

Presurgical infant orthopaedic (PSIO) protocol is applied prior to cleft Lip and/cleft palate surgical intervention to facilitate the repair by restoring the alar base and maintaining the skeletal, soft tissue harmony. The objective of this review is to assess the literature on the presurgical infant orthopaedic protocol most widely used and accepted. Searches were made in PubMed, Cochrane and Google Scholar on cleft lip and/palate. A large number of articles documented approaching PSIO for cleft treatment with the intent to provide a satisfactory treatment for cleft patients, requiring far more than just correctional surgery and its ability to do so is unique. Craniofacial Orthodontists can choose from a wide array of treatment options for their patients and can learn from the outcomes attained by applying a combination of

**Keywords:** Systematic review, cleft lip, cleft palate, presurgical, infant orthopaedics,

Pre-Surgical Infant Orthopaedic (PSIO) protocol indisputably has a valuable impact in the management of cleft lip and palate infants, showing approximation and alignment of alveolar segments and narrowing the gap between lip components, with the intent of separating oral cavity from nasal and maintaining the tongue position. However, nasal cartilage symmetry and increase in the columella length results remain distinctive [1], with long term benefits still under speculations. Although the popularity of NAM has grown by leaps and bounds in the last one decade, it has become essential to annotate the outcome of both NAM and other PSIO protocols. Studies regarding NAM have been either case studies or single center retrospective comparisons of before-and-after clinical features on small samples with no control non-NAM cases.

An evidence-based approach to cleft lip and palate management in the last two decades has led many craniofacial orthodontists to show great enthusiasm

Orthopaedic Treatment—An

Evidence Based Review

Gazi University Medical Faculty, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Türkiye
