title: From birth to maturity: a group of patients who have completed their protocol management. Part III. Bilateral cleft lip-cleft palate.
abstract: BACKGROUND
  The optimal management of cleft lip-cleft palate patients presents a formidable challenge to the cleft surgeon. This is especially so in the case of bilateral cleft lip-cleft palate, and the long-term management in a multidisciplinary setting is essential. This study presents the results of the specific management protocol at the Australian Craniofacial Unit for patients with bilateral cleft lip-cleft palate who have completed their protocol treatment under the care of a single surgeon (D.J.D.) during the period 1974 to 2006.
  
  
  METHODS
  A retrospective study of the outcomes in relation to facial growth, speech, hearing, and occlusion is presented of patients with bilateral cleft lip-cleft palate.
  
  
  RESULTS
  Nineteen cases were identified from the departmental database, 12 male patients and seven female patients. Six patients with severe craniofacial deformities who had bilateral cleft lip-cleft palate were excluded. Cephalometric analysis at skeletal maturity identified that a majority of cases had midface hypoplasia requiring midface advancement in 14 cases. Speech and hearing outcomes were worse when compared with other clefting types.
  
  
  CONCLUSIONS
  Overall, these results demonstrate that facial growth is more affected in bilateral cleft lip-cleft palate patients than in either unilateral cleft lip-cleft palate or isolated cleft palate patients.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: North Adelaide, South Australia, Australia From the Australian Craniofacial Unit, Women's and Children's Hospital.
authors.forename: David John
authors.initials: DJ
authors.lastname: David
authors.forename: Ian
authors.initials: I
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Nugent
authors.forename: Christina
authors.initials: C
authors.lastname: Richards
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D001299:Audiometry; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D002985:Clinical Protocols; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008445:Maxillofacial Development / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult