title: A randomized controlled trial comparing two techniques for unilateral cleft lip and palate: Growth and speech outcomes during mixed dentition.
abstract: OBJECTIVE
  To study the growth and speech outcomes in children who were operated on for unilateral cleft lip and palate (UCLP) by a single surgeon using two different treatment protocols.
  
  
  METHODS
  A total of 200 consecutive patients with nonsyndromic UCLP were randomly allocated to two different treatment protocols. Of the 200 patients, 179 completed the protocol. However, only 85 patients presented for follow-up during the mixed dentition period (7-10 years of age). The following treatment protocol was followed. Protocol 1 consisted of the vomer flap (VF), whereby patients underwent primary lip nose repair and vomer flap for hard palate single-layer closure, followed by soft palate repair 6 months later; Protocol 2 consisted of the two-flap technique (TF), whereby the cleft palate (CP) was repaired by two-flap technique after primary lip and nose repair. GOSLON Yardstick scores for dental arch relation, and speech outcomes based on universal reporting parameters, were noted.
  
  
  RESULTS
  A total of 40 patients in the VF group and 45 in the TF group completed the treatment protocols. The GOSLON scores showed marginally better outcomes in the VF group compared to the TF group. Statistically significant differences were found only in two speech parameters, with better outcomes in the TF group.
  
  
  CONCLUSIONS
  Our results showed marginally better growth outcome in the VF group compared to the TF group. However, the speech outcomes were better in the TF group.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra, Bangalore, Karnataka, 560099, India. Electronic address: prgfacsurg@gmail.com.
authors.forename: Praveen
authors.initials: P
authors.lastname: Ganesh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sri Ramachandra University, Chennai, India.
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Murthy
authors.affiliation: Department of Speech, Language & Hearing Sciences, Sri Ramachandra University, Chennai, India.
authors.forename: Navitha
authors.initials: N
authors.lastname: Ulaghanathan
authors.affiliation: Department of Speech, Language & Hearing Sciences, Sri Ramachandra University, Chennai, India.
authors.forename: V H
authors.initials: VH
authors.lastname: Savitha
mesh_terms: D002648:Child; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D002985:Clinical Protocols; D003724:Dental Arch / Q000254:growth & development; D003818:Dentition, Mixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008310:Malocclusion / Q000145:classification; D008437:Maxilla / Q000254:growth & development*; D009666:Nose / Q000601:surgery; D024343:Open Bite / Q000145:classification; D057887:Overbite / Q000145:classification; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D010781:Photography / Q000379:methods; D011446:Prospective Studies; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000145:classification; D013524:Surgical Flaps / Q000601:surgery; D055172:Vomer / Q000601:surgery
keywords: Growth; Mixed dentition; Speech outcomes; Two-flap technique; Vomer flap