Free periosteal graft repair of maxillary clefts in adolescents.

Free periosteal grafting of the maxillary cleft in adolescents is an alternative, simplified method of reconstructing secondary maxillary cleft deformities, particularly the sunken nostril sill. The historical background of bone grafting, periosteal flaps, and free periosteal grafts in infants, along with recent studies of adolescent growth patterns of the maxilla and cleft side dentition, provides the rationale for our protocol. Fourteen patients were operated on ranging in age from 9 to 30. They were studied clinically by Panorex x-rays and some by CT scans. New bone bridging the maxillary cleft with resultant improvement in the cleft deformities was found routinely in patients under 15 years of age. Some patients exhibited greater cosmetic improvement than others.