Facial growth and the need for orthognathic surgery after cleft palate repair: literature review and report of 28 cases.
OBJECTIVE
Controversy still exists regarding the optimal timing and surgical technique for primary cleft lip and palate (CLP) repair, and treatment protocols vary considerably. This study reviews the literature on timing and technique for primary repair and reports on the outcome for a consecutive group of patients treated by a single surgical protocol at the Sunnyview Cleft Palate Clinic.


METHODS
Twenty-eight patients treated by a standardized clinical protocol from infancy through adolescence were evaluated with respect to the need for orthognathic surgery to correct jaw size discrepancy. For each patient, data was collected regarding type of cleft deformity, total number of surgical procedures from infancy, surgeon performing the primary repair, and the need or indication for orthognathic surgery.


RESULTS
Twenty-five percent of patients treated by this protocol required orthognathic surgery because of anteroposterior jaw size discrepancy. The number of prior operations was not a significant factor. The need for orthognathic surgery was seen in all types of CLP deformity. Different primary surgeons varied considerably in the percentage of their patients who ultimately required orthognathic surgery.


CONCLUSIONS
The results of this study parallel other larger cohort studies with respect to the percentage of patients requiring orthognathic surgery. The number of prior operations does not significantly affect the later need for orthognathic surgery.
DeLuke
D M
DM
Cleft Palate Clinic, Sunnyview Hospital, Schenectady, NY 12308, USA.
Marchand
A
A
Robles
E C
EC
Fox
P
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000543:Alveoloplasty; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery*; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008445:Maxillofacial Development; D056948:Orthognathic Surgical Procedures; D010027:Osteotomy; D012189:Retrospective Studies