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 growt h of the maxilla, of two groups of patients with unilateral cleft lip and p alate in whom palatal surgery had been done slightly differently, particula rly 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 we re used to analyse the first sample of 20 patients, who were followed longi tudinally from 7-16 years of age. The other group comprised 17 subjects in the same age range, who were investigated cross-sectionally, also by cephal ometry. Generally, the outcome of the two surgical regimens was similar and equally satisfactory, with no evident difference in facial or maxillary mo rphology between the two samples. From the midfacial growth point of view, it might be questioned whether it is necessary to delay closure of the clef t in the hard palate until the mixed dentition stage as was done at the fir st cleft centre.