Shape changes in the cleft palate maxilla: A longitudinal study

Objective: The purpose of this study was to compare the shape of the maxill a in Norms lateralis of cleft lip and palate (CLP) patients with non-CLP co ntrols matched for sex and age. This study utilized elliptical Fourier func tions to assess the presence of residual shape changes in the cleft palate maxilla after treatment, compared with controls. Design: Longitudinal data (n = 25) were available from the Miami Craniofaci al Anomalies Foundation, From these data, two samples were selected: group I (mean age and SD, 5.06 +/- 1.82 years) after lip surgery and the initiati on of palate surgery and group II (16.58 +/- 2.42 years) well after the con clusion of surgery. Twenty-two of these patients were matched with controls (5.11 +/- 1.33 and 15.91 +/- 2.25 years, respectively), The maxillary outl ine as seen on the lateral radiograph was (1) traced, (2) fitted with a ser ies of 48 closely placed points, (3) digitized, and (4) submitted to a spec ially written routine that computes elliptical Fourier functions (EFFs), Th ese EFFs are close analogs of the bounded maxillary outline as judged by th e residual or difference between the observed points and the predicted poin ts generated by the Fourier function. Each maxillary outline was subsequent ly standardized for size and corrected for positioning in two-dimensional s pace. Results and Conclusions: Utilizing a three-way multivariate analysis of var iance, statistically significant shape differences were obtained for both y oung and older groups, as well as between the CLP and controls. No signific ant gender differences were found, Morphological differences consisted of a posterior repositioning of the nasal crest aspect in the CLP cases. These results suggest that although a clinically satisfactory treatment result wa s obtained, differences in maxillary shape remain.