Midfacial morphology in children with unilateral cleft lip and palate treated by different surgical protocols

Three-dimensional craniofacial morphology in unilateral cleft lip and palate

“…Because of this rotation, anteroinferior face height was significantly greater. The gonial angle was significantly larger in the UCCLP group, which supports the findings of earlier investigations (2,23). We hypothesize that the shorter mandible is caused by the shorter cranial base and mandibular adaptation to underdeveloped maxilla.…”

Comparative Cephalometric Study of 10-year-old Patients with Complete Unilateral Cleft Lip and Palate

“…The posterior rotation of the mandible in cleft patients described by various authors [5,18,22] and confirmed in the present collective might be interpreted as compensatory adaptation to the reduced vertical midface growth. The international comparison study by Swennen et al [32] showed unequivocally that the decreased posterior vertical midface growth in the Brussels cleft sample, which had undergone surgery considerably earlier than the Hanover cleft sample, correlated with a more posterior rotation of the mandible. The simultaneously reduced bony chin prominence and the significantly shorter mandibular length (Co-Gn) are typical features of UCLP patients and explain why the lower facial height is not significantly increased in these patients despite the posterior rotation of the mandible.…”

“…Die von mehreren Autoren [5,18,22] beschriebene und auch im vorliegenden Patientengut bestätigte Retroinklination der Mandibula bei Patienten mit einer Spaltbildung könn-te als kompensatorische Anpassung an das verminderte Vertikalwachstum des Mittelgesichtes verstanden werden. Die internationale Vergleichsuntersuchung von Swennen et al [32] zeigte eindeutig, dass das geringere posteriore Vertikalwachstum des Mittelgesichts der wesentlich früher operierten Spaltpatienten aus Brüssel im Vergleich zu den Hannoveraner Patienten mit der größeren kompensatorischen Retroinklination der Mandibula zusammenhing. Die gleichzeitig bestehende geringere knöcherne Kinnprominenz und die signifikant verkürzte Unterkieferlänge (Co-Gn) sind Besonderheiten bei Patienten mit unilateraler Lippen-Kiefer-Gaumen-Spalte, die erklären, warum die untere Gesichtshöhe dieser Patienten trotz der Retroinklination der Mandibula nicht signifikant vergrößert ist.…”

Correction of Alveolar Arch Malalignment After Total Correction in Unilateral and Bilateral Gr Iii Clefts

“…(9) Silva Filho, O. G., Calvano, F., Assuncao, A. G., and Cavassan., in 2001, compared their own protocol (lip repair at a mean age of 9 months and palate repair 19 months of age on an average) with the modified Malek protocol (lip and palate repair at 20 months of age) .They found that results of maxillofacial evaluation were comparable in both complete unilateral cleft lip and palate groups in the age range of 4 to 7 years. Silva Filho, O. G., Calvano, F., Assuncao, A. G., and Cavassan ) ., also revealed that cleft patients had aesthetically acceptable facies despite their maxillary retrognathism Swennen (10) et al, in 2002, published a study that compared the craniofacial morphology of two unilateral cleft lip and palate groups treated by different surgical protocols, One of the protocols belonged to the Hannover group (Closure of the lip, hard palate, and soft palate was performed at a mean age of 8, 29, and 32 months, respectively) .and other belonged to the Brussels group (Malek protocol) repairing the soft palate at 3months of age, and consequently repairing the lip and hard palate at 6months of age); assessment of maxillary growth was done between 8.8 to 11.1 years in both groups. Despite the great differences between the timing of both protocols, interestingly, there was no significant difference in the results regarding anteroposterior midfacial measurements.…”