Long-term craniofacial morphology in young adults treated for a non-syndromal UCLP: A systematic review

Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review

“…Future treatment research should be established with special attention towards methodology, well described study population, number of surgeons, grade of surgeon, technique of surgical closure and information on the undergoing of orthodontic or orthognathic treatments since early intervention may result in a better outcome. Kappen et al [4] proposed that a multidisciplinary and multicenter database of cleft children should be set up. If this would be the case, a prospective study could be conducted on these patients.…”

“…In patients with repaired UCLP, maxillofacial growth is often disturbed due to iatrogenic scar tissue caused by surgical closure of a cleft [4] . A retrusive midfacial region is characteristic of this population and becomes more obvious with age.…”

“…However, in unoperated UCLP patients, midfacial growth is comparable to that in healthy, noncleft children without apparent restriction of growth [2] . Therefore an important objective is to restrict the iatrogenic impact of cleft surgery on midfacial growth [4] . According to the Eurocleft study, there are 194 different protocols for the treatment of UCLP [5] .…”

Modified double-opposing Z-plasty for patients with Veau I cleft palate

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]27] However, there is a debate about the potential harms of these lateral relaxing incisions as the exposed raw surface, the healing by secondary intention, and the scarring process may impair the maxillary arch development and anteroposterior maxillary growth. [2,3,31] While there is no unanimity in the literature regarding the casual independent factor for maxillary growth disturbance after cleft palate repair, the lateral relaxing incisions remains as a likely factor among the multiple potential factors. [2,3,31,32] In this study, we evaluated the evolutionary experience of a senior surgeon in the treatment of patients with Veau I cleft palate.…”

“…Outcomes of cleft palate repairs have improved significantly with the evolution of technical refinements over the last decades, with increasing emphasis on a 2-layer, tension-free closure to decrease the risk of postoperative fistula formation, achieve a proper muscle repair (e.g., straight-line approaches with levator muscle retropositioning or Furlow double-opposing Z-plasty [DOZ] with muscle overlapping) to restore a mechanism for normal speech production, and also to reduce the bone exposure and scar formation to attenuate maxillary growth interference. [1][2][3][4][5] However, there still has been controversy in establishing consensus regarding an optimal surgical technique for all Veau cleft types. [6][7][8][9][10][11][12][13][14][15][16] After Dr Leonard Furlow described the DOZ for palatal repair in 1978, [17] this technique has been widely adopted for cleft palate repairs worldwide.…”