FACIAL GROWTH IN PATIENTS WITH UNILATERAL CLEFTS OF THE LIP AND PALATE - A 2-CENTER STUDY

Two groups of 10-year-old patients with complete unilateral clefts of the lip and palate were examined in this study, Two centers; Bristol, U.K. and Oslo, Norway, who had different treatment regimens were used, The groups comprised 40 patients from Oslo and 32 from Bristol, The g roups were matched, in proportion to the size of the groups, for age, sex, and presence of Simonart's bands, In Oslo, a Millard lip repaired was performed at 3 months of age with a von Langenbeck palatal repair at 18 months, no presurgical orthopedics was employed and there was n o primary nasal correction. The Bristol center also repaired the lip a t 3 months with a Millard type repair but also performed a radical nas al correction at the same time. The palate was repaired at 6 months wi th a Veau repair, and presurgical orthopedics using a pinned arch orth opedic plate was carried out, In addition, the volume of primary repai rs per surgeon was much higher in Oslo, and a much stricter treatment protocol was used compared with Bristol, Lateral cephalograms obtained within 1 year of the child's tenth birthday were digitized, and the c raniofacial morphology of the two groups was compared, Significant dif ferences in maxillary growth and soft tissue profile were noted with a much more retruded mid-face and flatter nasiolabial angle in the Bris tol group, The main factors for the better results in Oslo are suggest ed to be the absence of presurgical orthopedics, no radical nasal corr ection, the high volume of operations performed per surgeon, and the s tricter protocol.