[Alveolar and hard palate repair by tibial periosteal graft in complete unilateral cleft lip and palate. Long-term follow-up of 51 cases].
OBJECTIVE
The purpose of this study was double: appreciate the osteogenic and growth capacities of the free tibial periosteal graft concerning the alveolar and hard palate repair in the complete unilateral cleft lip and palate, and evaluate long-term follow-up concerning maxillo-mandibular morphology and palatal air-tight.


METHODS
This retrospective study concerns 51 patients, of more than 13 years of age, treated for complete unilateral cleft lip and palate. The treatment included a Skoog type cheiloplasty, a tibial periosteal graft between 4 and 6 months (as described by M. Stricker) and a staphyloraphy between 8 and 18 months. Our documentation was: figures, pictures and precise description of the initial cleft, dental casts, teleradiographies, dental panorams performed at different stages of treatment, orthodontic, orthophonic and otologic follow-up. Growth was evaluated using casts during the first 6 years then by profil teleradiographies after puberty. Ossification was evaluated quantitatively by CT scan in 18 patients.


RESULTS
Results confirm an ossification of the periosteal graft in 72% of cases and the advantage of periosteal graft in palatal air-tight. 85% of cases show equilibrated squeletal growth with good occlusion, and 13.7% of cases needed deferral osteotomy.


CONCLUSIONS
We propose a method for long-term cleft results evaluation, with the use of periosteal graft.
Raphaël
B
B
Service de chirurgie plastique et maxillo-faciale, centre hospitalier universitaire de Grenoble, BP 217, 38043 Grenoble, France. braphael@chu-grenoble.fr
Morand
B
B
Bettega
G
G
Lesne
C
C
Lesne
V
V
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D010521:Periosteum / Q000637:transplantation*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013977:Tibia / Q000637:transplantation*