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“The influence of four different treatment protocols on maxillofacial growth in patients with unilateral complete cleft lip, palate, and alveolus”

Xu, Xue Ph.D, Dr.1; Cao, Congcong MD2; Zheng, Qian Ph.D, Dr.2; Shi, Bing Ph.D, Dr.2

Plastic and Reconstructive Surgery: April 11, 2019 - Volume PRS Online First - Issue - p
doi: 10.1097/PRS.0000000000005711
Original Article: PDF Only
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Background: To evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7-8 years with UCCLPA.

Methods: 61 patients with non-syndromic unilateral complete cleft lip, palate and alveolus were selected into this study. Patients with UCCLPA who had a repaired lip and unrepaired palate were placed in group 1. Patients with UCCLPA who received one-stage palatoplasty were placed in group 2. Patients with UCCLPA who received two-stage palatoplasty were placed in group 3. Patients with UCCLPA who received lip adhesion and two-stage palatoplasty were placed in group 4. The control group was composed of 16 patients with unilateral incomplete cleft lip. Kolmogorov-Smirnov test was used to test the nature of data distribution. Bonferroni test and Kruskal-Wallis H test were used for multiple comparisons.

Results: Group 5 showed more protruding maxilla (Ba-N-A, Ba-N-ANS, S-N-ANS, p<0.05), longer maxillary sagittal length (ANS-PMP, p<0.05), maxillary basal sagittal length (A-PMP, p<0.05), and a better jaw relationship (ANB, p<0.05) than groups 2, 3, and 4. Group 2 had higher anterior facial height (ANS-N, ANS-Me, N-Me, p<0.05) and posterior facial height (R-PMP, p<0.05) than groups 3 and 4. Groups 2 and 3 had better maxillary position (S-Ptm, p<0.05) and deeper bony pharynx (Ba-PMP, p<0.05) than group 4.

Conclusions: In patients aged 7-8 years with UCCLPA, both one- and two-stage palatoplasty inhibited maxillary sagittal growth. Vomer flap repair with denuded bone inhibited maxillary vertical growth. Lip adhesion did adversely affect maxilla position.

1. Department of Oral and Maxillofacial Plastic and Traumatic Surgery, Beijing Stomatological Hospital of Capital Medical University, Beijing.

2. Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu.

Financial Disclosure Statement: No funding was received for this article.

Corresponding author: Bing Shi, Ph.D, Dr., West China College of Stomatology, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China.wydhzjnksbd@sina.com; xuxue2008hx@163.com.

©2019American Society of Plastic Surgeons