Maxillary growth in patients with complete cleft lip and palate, operated on around 4-6 months of age

Background: The controversy about timing of cleft palate repair has been focused on early closure for improved speech versus delayed repair for enhancing maxillary growth. Early palatal repair enhances phonological development decreasing the frequency of articulation disorders associated with velopharyngeal insufficiency (VPI). In contrast, it has been described that early surgery adversely affects maxillary growth. Objective: The purpose of this paper is to study maxillary growth in a group of cleft palate patients operated on around 4-6 months of age, and receiving further orthodontic treatment. Materials and methods: A group of 20 cleft palate patients, who were subjected to early minimal incision palatopharyngoplasty around 4-6 months of age, were followed for a minimum of 10 years (range: 10-14 years). All patients received the same orthodontic management, starting at 4 years of age. None of the patients had orthognatic surgery or alveolar bone grafting. After orthodontic treatment, their cephalometric data were compared with a group of subjects without cleft lip and palate, matched by gender and who were within the age range of the cleft palate group. Results: SNA, SNB, ANB, and WITS cephalometric measures were compared. A non-significant difference was found in all measurements between the two groups. Conclusion: Early cleft palate repair enhances phonological development. Although maxillary growth is affected in cleft palate patients, appropriate orthodontic treatment can achieve normal maxillary growth as measured during adolescence. (C) 2010 Elsevier Ireland Ltd. All rights reserved.