The Impact of Facial Growth in Unilateral Cleft Lip and Palate Treated With 2 Different Protocols

Ann Plast Surg. 2020 May;84(5):541-544. doi: 10.1097/SAP.0000000000002232.

Abstract

Background and aim: It is well known that palatoplasty can often cause disturbances in maxillary growth. The use of a single-layer vomer flap for the early closure of the hard palate is controversy among surgeons. The aim of this study is to compare the 10-year facial growth of 2 surgical protocols in the treatment of patients with unilateral cleft lip and palate performed by a single surgeon.

Methods: This retrospective analysis includes 43 nonsyndromic patients with complete unilateral cleft lip with or without a vomer flap for the closure of the hard palate during cleft-lip repair. Lateral cephalograms were obtained at the age of 5, 7, and 9 years old, and angular measurements were used to assess patient's facial growth. The Mann-Whitney U test was used to compare 2 treatment protocol groups.

Result: A total of 23 patients in protocol 1 group (16 male, 7 female) and 20 patients in protocol 2 group (10 male, 10 female) were included. At the age of 5 and 7, there was no significant difference of maxillary and mandibular growth in both groups. At the age of 9 years, all the angular measurement revealed statistical significance with SNA (P = 0.02), SNB (P = 0.05), ANB (P < 0.01), and SNPg (P = 0.05).

Conclusions: The present study has shown that early anterior palate repair for 3-month-old cleft patients have better maxillary growth and less mandibular prognathism.

MeSH terms

  • Cephalometry
  • Child
  • Child, Preschool
  • Cleft Lip* / surgery
  • Cleft Palate* / surgery
  • Female
  • Humans
  • Infant
  • Male
  • Maxilla / surgery
  • Palate, Hard
  • Retrospective Studies