title: Early hard palate closure using a vomer flap in unilateral cleft lip and palate: effects on cleft width.
abstract: OBJECTIVE
  Although no universal consensus exists on treatment of cleft palates, early hard palate closure is commonly performed. The aim of the present study was to determine the influence of a vomer flap for early hard palate closure on residual palatal cleft width in patients with a unilateral complete cleft lip and palate (UCLP).
  
  
  METHODS
  Forty-seven UCLP patients were retrospectively divided into two groups. Group A consisted of 25 patients who underwent early lip closure and simultaneous hard palate closure using a vomer flap. Group B included 22 patients who had lip closure only at first surgery. Palatal cleft widths of both groups were measured at two time points and were compared using the Mann-Whitney U test to examine the influence of vomerplasty in this very early stage.
  
  
  RESULTS
  No significant difference of baseline characteristics between the groups was found, and comparison of age at the time of surgeries was not significantly different. Mean age at the time of vomerplasty was 4.0 months. After the first surgery, a significantly greater total cleft width reduction of 5.0 mm average was found in group A compared to only 1.5 mm reduction in group B. This reduction took place after an average of 7.1 and 7.0 months, respectively.
  
  
  CONCLUSIONS
  Lip closure accompanied by early hard palate closure using a vomer flap is associated with a significant postoperative reduction of the residual cleft when compared to lip closure only.
  
  
  CONCLUSIONS
  This study shows another great advantage of performing early hard palate closure using a vomer flap.
authors.affiliation: Division of Pediatric Plastic Surgery KE.04.140.5, Wilhelmina Children's Hospital, University of Utrecht, P.O. 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: Johanna P
authors.initials: JP
authors.lastname: de Jong
authors.affiliation: Division of Pediatric Plastic Surgery KE.04.140.5, Wilhelmina Children's Hospital, University of Utrecht, P.O. 85090, 3508 AB, Utrecht, The Netherlands. c.c.breugem@umcutrecht.nl.
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
mesh_terms: D002971:Cleft Lip / Q000473:pathology / Q000601:surgery*; D002972:Cleft Palate / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D021362:Palate, Hard / Q000601:surgery*