Influence of isolated cleft palate and palatoplasty on the face

Abstract

IntroductionThe literature has demonstrated that alterations in craniofacial morphology characterizing individuals with cleft palate are observed in both operated and unoperated patients.ObjectiveThis study evaluated the influence of isolated cleft palate and palatoplasty on the face, based on facial analysis.Material and methodsLateral facial photographs of the right side of 85 young adult patients with cleft palate were analyzed, of whom 50 were operated on and 35 had never received any previous surgical treatment. The nasolabial angle and zygomatic projection were used to define the maxillary position in the face. Mandibular positioning was classified as Pattern I, II and III.ResultsPatients were distributed into 54.12% as Pattern I, 32.94% Pattern II and 12.94% Pattern III. Distribution of facial patterns did not show statistically significant differences between groups (p>0.05). Although palatoplasty did not influence the facial pattern, the zygomatic projection was vulnerable to plastic surgeries. Twenty-eight percent of the patients in the operated group showed zygomatic deficiency, compared to only 8.5% in the unoperated group.ConclusionsIn patients with isolated cleft palate, palatoplasty may influence negatively the sagittal behavior of the maxilla, according to the zygomatic projection of the face, though without compromising the facial pattern.

Comparison of the effects of maxillary protraction using facemask and miniplate anchorage between unilateral and bilateral cleft lip and palate patients

“…[1][2][3][4][5][6] In addition, cleft patients are known to have an increased vertical growth pattern compared to that of noncleft patients 1,[7][8][9][10][11][12][13] and to maintain their initial vertical pattern during growth. 14 Facemask therapy for maxillary protraction has been regarded as an effective tool for producing orthopedic change in cleft patients.…”

Influence of palatoplasty on occlusion of patients with isolated cleft palate

“…The larger number of Class II malocclusions may be explained by the condition of the mandible, which exhibits a predominantly vertical growth in cases of cleft as well as morphological, spatial and dimensional abnormalities. 6,8,14 Cephalometric data on the mandible showed a clockwise rotation, 25,28 an increased mandibular plane angle, a retrusion in relation to the cranial base 14 and a reduction on the dimensions of the body and ramus. 8,27,30 The clockwise rotation of the mandible can help to explain the increased incidence of Class II malocclusion in patients with isolated cleft palate.…”

“…23,24 The treatment of a cleft palate begins with a primary palatoplasty at 12 months of age. 25,28 From that point on, non-surgical therapy is then directed mainly towards vocal quality and hearing competence.…”

“…6,8,14 A study on facial morphology through a clinical analysis of the face confirms the cephalometric diagnosis and the small influence of palatoplasty on the final configuration of the face. 28 It can be concluded that the facial morphology of patients with isolated cleft palate is inherent to the individual and undergoes little influence from palatoplasty.…”

Dental concerns of children with lip cleft and palate - a review

“…The anterior part of the palate is repaired at the same time as the lip the main palatal defect is repaired between 15 and 18 months at a time when it will shortly be required for development of speech . 22,23…”