Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study

Background:The goals of successful palate repair include optimization of speech and feeding, avoidance of fistula formation, and mitigation of adverse maxillary growth. However, the effects of scar formation on maxillary growth have not been discussed in detail.Methods:Between November 2010 and December 2011, the palateplasty was performed for 24 patients with cleft palate (median age, 12 months; range, 11–18 months). In the velum, a symmetrical intravelar veloplasty with mucosal Z-plasty was performed on both the nasal and oral sides. In the hard palate, instead of lateral relaxing incisions, a 1-line mucoperiosteal incision along the cleft margins was designed with subperiosteal undermining in the entire palatine bone. The palatal mucoperiosteum was sutured together in the middle of the cleft, and the cleft was directly closed without lateral relaxing incisions. The patients were monitored for 6 months to 1.6 years.Results:None of the cases had issues concerning flap viability, and all palate repairs healed well. Postoperative results were satisfactory, without any complications such as dehiscence, perforation, or palatal fistula.Conclusions:The method presented in this article was effective, with successful palatal closure and without scar formation or mucosal defects along the alveolus. We conclude that minimum contracture of the hard palate was useful for not only mitigating adverse maxillary growth but also for orthodontics.

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“…This exposed palatal bone is theoretically associated with the risk of increased anteroposterior maxillary growth restriction. 14,15 …”

Section: Discussionmentioning

confidence: 99%

Cleft Palate Repair without Lateral Relaxing Incision

Ogata

Sakamoto

Kishi

2017

Plastic and Reconstructive Surgery - Global Open

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“…These findings accord with the results of this study. However, other studies found significant differences in craniofacial growth when comparing different surgical techniques of hard palate repair, indicating that the surgical technique is of major importance for the craniofacial development (Kulewicz and Dudkiewicz, 2010). At the age of 10 years patients who underwent palatoplasty using a single layer vomer flap showed maxillary growth superior to those who were treated using Veau's technique (Veau, 1931).…”

Section: Discussionmentioning

confidence: 98%

“…They consider appropriate orthodontic treatment to be of major importance in achieving normal maxillary growth. Analysis of the craniofacial morphology of children with unilateral clefts of lip, palate and alveolus at the age of 10 years showed differing facial growth depending on the technique of palatal repair (Kulewicz and Dudkiewicz, 2010). The literature reports improved speech outcomes and early maxillary growth in cleft patients after onestage palate repair (Pradel et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Sagittal maxillary growth in children with unilateral cleft of the lip, alveolus and palate at the age of 10 years: An intercentre comparison

Zemann

Kärcher

Drevenšek

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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“…Any surgical procedures in cleft treatment may lead to maxillary growth impairment, as reported by several authors. 36,37 To our knowledge, there are no published investigations concerning a possible influence of free flaps on midface growth in children with cleft.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Tissue Transfer in Cleft Palate Patients

Zemann

Kruse

Luebbers

et al. 2011

Journal of Craniofacial Surgery

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The closure of wide palatal clefts and recurrent oronasal fistulae may be challenging. After repeated failure of conventional techniques, microvascular tissue transfer may be indicated in the closure of such fistulae. Depending on the location and the size of the palatal fistula, different tissues are required to sufficiently close the palatal gaps. A subdivision of common flaps into mucosa, muscular, bony, skin, and fascia flaps was carried out to analyze their suitability for alveolar, hard, and soft palate reconstruction. Furthermore, the bulk of flaps and the length of the vascular pedicle were analyzed to rate the suitability of different flaps for palatal closure. Based on a new classification of oronasal fistulae, all these factors were taken into consideration to introduce a decision guidance of what microvascular flap fits a particular clinical situation. The radial free forearm flap was found to be sufficient in the closure of all classes of oronasal fistulae.

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Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study

Cited by 42 publications

References 35 publications

Cleft Palate Repair without Lateral Relaxing Incision

Cleft Palate Repair without Lateral Relaxing Incision

Sagittal maxillary growth in children with unilateral cleft of the lip, alveolus and palate at the age of 10 years: An intercentre comparison

Microvascular Tissue Transfer in Cleft Palate Patients

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