Comparisons of facial growth in patients with unilateral cleft lip and palate treated by different regimens for two-stage palatal repair.

The aim of this study was to compare facial development, particularly growth of the maxilla, of two groups of patients with unilateral cleft lip and palate in whom palatal surgery had been done slightly differently, particularly the timing of the procedures. Two-stage palatal repair had been used at 8 (velar closure) and 102 months (hard palate surgery) at one cleft centre and at 20 and 62 months at another centre. Lateral roentgencephalograms were used to analyse the first sample of 20 patients, who were followed longitudinally from 7-16 years of age. The other group comprised 17 subjects in the same age range, who were investigated cross-sectionally, also by cephalometry. Generally, the outcome of the two surgical regimens was similar and equally satisfactory, with no evident difference in facial or maxillary morphology between the two samples. From the midfacial growth point of view, it might be questioned whether it is necessary to delay closure of the cleft in the hard palate until the mixed dentition stage as was done at the first cleft centre.