Abstract
This case report illustrates the presurgical treatment of a patient having a median facial cleft and microcephaly, using a guidance appliance. The appliance was custom designed and modified with a pearl-like acrylic structure attached to its lingual surface for pushing the extremely protruded tongue back to its normal position to facilitate anesthesia and surgical lip closure. Total treatment time was 5weeks. Regaining normal tongue position, in turn, facilitated both intubation and extubation, preventing the postoperative respiratory distress the authors had experienced with similar cases.
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