The Influence of Lip Repair on the Growth of Craniofacial Structures in Bilateral Cleft Lip and Palate Patients With Unoperated Palate From Childhood to Adulthood

J Craniofac Surg. 2020 Jul-Aug;31(5):1218-1222. doi: 10.1097/SCS.0000000000006368.

Abstract

Purpose: Surgical treatment of complete bilateral cleft lip and palate (BCLP) is the most difficult procedure among common cleft lip and palate. This study was to research the long-term effect of lip surgery by localizing the craniofacial growth pattern of BCLP patients in the Han people in western China compared with normal healthy people from childhood to adulthood.

Patients and methods: A cross-sectional study included a sample of 43 BCLP patients who have received lip repair and a control group of 55 normal healthy people with Angle Class I occlusion at the similar age, gender and ethnicity, and all participants were obtained from the Department of Oral and Maxillofacial Surgery, Sichuan University. Sixteen linear and 14 angular bony landmarks were identified on lateral cephalometric radiographs at the average age of 5.6-year-old, 10.7-year-old, and 24.2-year-old. The measurements were used to represent the growth changes of cranial base, bony nasopharynx, maxillary, mandibular and maxilla-mandibular relationship. Between-group differences were assessed by using the Independent-Sample t test.

Result: Lip repair has a slow and long-term effect on the craniofacial morphology. The tension from repaired orbicularis oris muscle would cause a decrease in maxillary sagittal length and the retroposition of maxilla combined with the mandibular functional displacement, which would cause a positive change in the postoperative facial morphology of BCLP patients in the long run.

Conclusion: BCLP patients who have undergone lip repair at an early age have the potential to develop better facial convexity.

MeSH terms

  • Cephalometry / methods
  • Child
  • Child, Preschool
  • China
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Cross-Sectional Studies
  • Humans
  • Lip / surgery*
  • Mandible / growth & development
  • Maxilla / growth & development
  • Maxillofacial Development*
  • Skull Base / growth & development
  • Young Adult