Craniofacial growth in subjects with unilateral complete cleft lip and palate, and unilateral incomplete cleft lip, from 2 to 22 months of age

This paper reports a longitudinal quantitative cephalometric analysis of th e craniofacial growth in subjects with unilateral complete cleft lip and pa late (UCCLP), and unilateral incomplete cleft lip (UICL), from 2 to 22 mont hs of age. The purpose of the study was to determine the amount and direction of growt h in UCCLP compared to UICL (control group) from 2 months of age (just prio r to lip repair) to 22 months of age, 20 months later. The sample comprised of 49 subjects with UCCLP (37 males and 11 females) an d 45 with UICL (29 males and 16 females). The cephalometric analysis of the craniofacial morphology included lateral, frontal, and axial projections. The data were presented as mean plots of the craniofacial region including the calvaria, cranial base, orbits, nasal bone, maxilla, mandible, cervical column, pharynx, and soft-tissue profile. A valid common coordinate system (registration according to the n-s line in the lateral projection, latero-orbitale line in the frontal projection, an d meatus acusticus externus line in the axial projection for the landmark p ositions at examination 1 and 2) was ascertained. The growth at a specific anatomical location in a patient was defined as the displacement vector fro m the coordinate of the corresponding landmark in the X-ray at examination 1 to its coordinate at examination 2, corrected for X-ray magnification. Th e growth of an anatomical region in a patient was assessed by investigating the growth pattern formed by a collection of individual growth vectors in that region. The amount of growth in the UCCLP and UICL group was very similar. The gene ral craniofacial growth pattern, in terms of the direction of growth, was a lso fairly similar in the UCCLP group and the control group. However, the m axilla and mandible showed a more vertical growth pattern than that observe d in the control group. This study confirms that UCCLP is a localized deviation, and not a craniofa cial anomaly, due to the fact that a normal growth potential has been obser ved in all craniofacial regions, except where the growth had been directly influenced by surgical intervention. Furthermore, the vertical growth patte rn of the maxilla and mandible supports the hypothesis of a special facial type in cleft lip and palate individuals, and the facial type as a liabilit y factor increasing the probability of cleft lip and palate.