The Influence of Different Types of Hard-Palate Closure in Two-Stage Palatoplasty on Maxillary Growth: Cephalometric Analyses and Long-term Follow-up

Tanino, Ryuzaburo; Akamatsu, Tadashi; Nakagawa, Masaki; Miyasaka, Muneo; Osada, Mitsuhiro

doi:10.1097/00000637-199709000-00005

Cited by 26 publications

(4 citation statements)

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“…Vomer resection resulted in severe developmental deterioration in the antero-posterior length of the maxilla in dogs (Wada et al, 1980(Wada et al, , 1990. It is well-known that palatal surgical procedures with involvement of the vomer negatively influence maxillary development (Delaire and Precious, 1985;Friede and Lilja, 1994;Tanino et al, 1997). These investigations have supported the notion that the vomer-premaxilla suture is a developmental center of forward development of the maxilla.…”

Section: Discussionmentioning

confidence: 59%

“…It has been reported that, in beagle pups, partial or entire resection of the vomer significantly reduces antero-posterior maxillary growth (Squier et al, 1985). Several studies have revealed that surgical procedures for cleft palate with the use of a vomer flap have a worse influence on the maxillary growth than those without a vomer flap (Delaire and Precious, 1985;Friede and Lilya, 1994;Tanino et al, 1997). Based on these investigations, we hypothesized that the bilateral cleft configuration in the secondary palate of persons with UCLP negatively influences palatal development.…”

Section: Introductionmentioning

confidence: 99%

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An Uncommon Cleft Subtype of Unilateral Cleft Lip and Palate

et al. 2008

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The finding that the vomer plays a crucial role in maxillary growth suggests that the bilateral cleft configuration of unilateral cleft lip and palate (UCLP), in which the vomer is detached from the non-cleft-side secondary hard palate, negatively influences palatal development, and this hypothesis was tested. Sixty persons with complete UCLP, including those with the vomer detached from (n = 30, b-UCLP) and attached to (n = 30, u-UCLP) the secondary hard palate, were analyzed morphologically, with the use of cast models taken at 10 days, 3 mos, and 12 mos of age. The anterio-posterior palatal length at 12 mos of age in those with b-UCLP was significantly shorter than that in those with u-UCLP, by 8.7% (p < 0.05). In addition, palatal width development in the first year in those with b-UCLP was also significantly retarded. These results suggest that the uncommon bilateral cleft subtype in UCLP should be included in the cleft classification.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

An Uncommon Cleft Subtype of Unilateral Cleft Lip and Palate

et al. 2008

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“…Numerous studies have shown that a push-back technique, particularly if it leaves large areas of denuded palatal bone, will result in scar tissue that restricts subsequent maxillary growth. Though not so often used by surgeons who advocate the DHPC concept, the push-back method of repair of the residual cleft has also been tested in a study of this protocol [13]. Outcome of midfacial growth of patients treated by push-back of mucoperiosteal flaps after a previous velar repair was compared with the result of those who had had their residual clefts closed by use of vomer flaps covered by fullthickness skin grafts.…”

Section: Discussionmentioning

confidence: 99%

Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair

Friede

Lohmander

Hagberg

et al. 2006

Scandinavian Journal of Plastic and Reconstructive Surgery and

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We wanted to find out if growth of the maxilla in 26 patients with unilateral cleft lip and palate (UCLP) was adversely affected by having the residual cleft of the hard palate repaired earlier than had been done previously in a 2-stage palatal closure protocol. The ages at repair of the hard palate of the present patients ranged from 38 to 89 months. Dental casts from ages about 3 years (before any repair of the hard palate), 5, 7, and 10 years of age were analysed. The results indicated that earlier repair of the cleft in the hard palate did not influence maxillary growth differently from the later repair.

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“…The psychosocial and functional effects of this defects are profound; therefore, the need for intervention is paramount [3]. Closure of palatal clefts has been done by a range of surgical techniques, which include von Langenbeck, Veau/Wardill/Kilner and Furlow techniques [4][5][6]. Despite these myriad of surgical techniques aimed at repair, dehiscence or flap necrosis with consequent development of fistulae may occur [4].…”

Section: Introductionmentioning

confidence: 99%

Buccal Fat Pad: A Useful Adjunct Flap in Cleft Palate Repair

Adeyemo

Ibikunle

James

et al. 2018

J. Maxillofac. Oral Surg.

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Aim The aim of the study is to describe the technique and also the outcome of using buccal fat pad (BFP) as an adjunct flap in cleft palate repair and to report the surgical outcome. Materials and Methods All the surgical repairs with BFP were done under general anaesthesia. The use of BFP was indicated in patients who needed a secondary palatal cleft repair, those with wide palatal clefts or patients whose primary palatal cleft repair was complicated intraoperatively by inadvertent tearing of the nasal mucosa. The raw wound surfaces were dressed with Vaseline gauze instilled with Framycetin. All subjects 4 years of age and below had oral toileting with warm saline-soaked gauze after each meal. The other patients had oral toileting with warm saline mouth bath in addition to conventional toothbrushing. Results Eight patients were included in this study with an age range of 1-26 years (mean ± SD = 6.1 ± 8.6 years). Three patients presented with wide palatal clefts, another three presented with dehiscence after a primary repair which necessitated a secondary repair, while the remaining two patients had inadvertent iatrogenic tear of the nasal mucosa during the primary surgical repair. For the latter set of patients, repair was completed by the use of BFP as an adjunct at the same surgery. Post-operative evaluation was satisfactory in all cases, with healing of the flaps and complete epithelialization of the BFP in 1 month. All the patients experienced post-operative cheek swelling, signifying the post-operative oedema due to BFP harvest. However, this was usually resolved within 48 h. Healing was satisfactory with full epithelialization, and no complications were observed. Conclusions Successful application of BFP as an adjunct flap in palatal cleft closure is demonstrated in these series. It is recommended that cleft surgeons add this technique to their armamentarium in difficult cases, especially in wide palatal cleft repair, secondary palatal cleft repair and in cases of inadvertent tearing of nasal mucosa during primary cleft palate repair.

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The Influence of Different Types of Hard-Palate Closure in Two-Stage Palatoplasty on Maxillary Growth: Cephalometric Analyses and Long-term Follow-up

Cited by 26 publications

References 0 publications

An Uncommon Cleft Subtype of Unilateral Cleft Lip and Palate

An Uncommon Cleft Subtype of Unilateral Cleft Lip and Palate

Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair

Buccal Fat Pad: A Useful Adjunct Flap in Cleft Palate Repair

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