Long-term evidence for favorable midfacial growth after delayed hard palate repair in UCLP patients

Objective: To investigate whether delayed hard palate repair resulted in be tter midfacial growth in the long term than previously achieved with "conve ntional" surgical methods of palatal closure. Design and Setting: Long-term cephalometric data from patients with unilate ral cleft lip and palate were available from two Scandinavian cleft centers . The patients had been treated by different regimens, particularly regardi ng the method and timing of palatal surgery. Patients were analyzed retrosp ectively, and one investigator digitized all radiographs. Patients: Thirty consecutively treated subjects from each center, with ceph alograms taken at three comparable stages between 10 and 16 years of age. Results and Conclusions: Patients whose hard palates were repaired late (ea rly soft palate closure followed by delayed hard palate repair at the stage of mixed dentition) had significantly better midfacial development than pa tients in whom the hard palate was operated on early with a vomer flap, and then during the second year of life, the soft palate was repaired with a p ush-back procedure. As the growth advantage in the delayed hard palate repa ir group was accomplished without impeding long-term speech development, th e delayed repair regimen proved to be a good alternative in surgical treatm ent of patients with unilateral cleft lip and palate.