Occlusion at 5 Years of Age Following Hard Palate Closure With Vestibular Flap

Cleft Palate Craniofac J. 2020 Jun;57(6):729-735. doi: 10.1177/1055665619892474. Epub 2019 Dec 18.

Abstract

Objective: This study aims to assess occlusal relationships and frequency of oronasal fistula at 5 years of age following 2 hard palate closure techniques and to compare results.

Design: Retrospective longitudinal study.

Setting: Institutional study.

Patients: Study patients included 57 patients with nonsyndromic complete unilateral cleft lip and palate who were consecutively treated. All patients underwent our early 2-stage protocol for palatoplasty, which consisted of soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age. Twenty-nine patients underwent hard palate closure using vestibular flap (VF group) technique (2009-2011) and 28 patients underwent conventional hard palate closure with local palatal flap (LPF group) technique (2006-2008).

Main outcome measures: Occlusal relationships were assessed with 5-year-olds' index, and frequency of oronasal fistula was investigated.

Results: Average 5-year-olds' index scores for VF and LPF groups were 3.11 and 3.57, respectively (P < .001). Oronasal fistula occurred in approximately 7% of patients in the VF group and in 18% of patients in the LPF group.

Conclusion: Hard palate closure with VF technique may provide better occlusal relationships at 5 years of age than does conventional local closure with the LPF.

Keywords: 5-year-olds’ index; early 2-stage palatoplasty; oronasal fistula; unilateral cleft lip and palate; vestibular flap technique.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Cleft Lip* / surgery
  • Cleft Palate* / surgery
  • Humans
  • Infant
  • Longitudinal Studies
  • Palate, Hard / surgery
  • Palate, Soft / surgery
  • Retrospective Studies
  • Treatment Outcome