A comparison of craniofacial cephalometric morphology and the later need for orthognathic surgery in 6-year-old cleft children.
OBJECTIVE
To compare 6-year-old children with unilateral cleft lip and palate (UCLP) and children with unilateral cleft lip and a separate cleft palate (CL+CP), cephalometrically and to evaluate the need for orthognathic surgery of these children in later life.


METHODS
One hundred and seven cleft children (67 UCLP, 40 CL+CP) were compared retrospectively using lateral cephalograms taken at a mean age of 6.2 years (range 5.7-7.3). The need for maxillary or bimaxillary osteotomies in these patients was evaluated from the hospital records at the mean age of 18.1 years (range 15.6-20.5).


RESULTS
The craniofacial morphology of children with UCLP and CL+CP was similar except for a more retrusive maxilla in children with UCLP. The frequency of orthognathic surgery was 40% (27/67) in the UCLP group and 18% (7/40) in the CL+CP group. The patients who needed orthognathic surgery (UCLP and CL+CP combined) had smaller mean values of ANB angle at the age of 6 years when compared to those who did not (1.8 versus 3.9°). None of the children whose ANB angle was greater than 4.5 needed orthognathic surgery whereas all the children whose ANB angle was less than -1 needed osteotomies.


CONCLUSIONS
Six-year-old children with UCLP have more retruded maxillae and require orthognathic surgery later in life more often than the children with CL+CP.
Heliövaara
Arja
A
Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland. arja.heliovaara@mbnet.fi
Rautio
Jorma
J
D000293:Adolescent; D002508:Cephalometry; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D008437:Maxilla / Q000033:anatomy & histology*; D008445:Maxillofacial Development; D020380:Needs Assessment; D056948:Orthognathic Surgical Procedures; D012189:Retrospective Studies; D055815:Young Adult