Early Dimensional Changes in Maxillary Cleft Size and Arch Dimensions of Children with Cleft Lip and Palate and Cleft Palate.

Abstract

Abstract Objective: To study changes in cleft size and maxillary arch dimensions from infancy to 5 years and evaluate these changes in relation to performed surgical procedures. Design: Retrospective longitudinal study. Setting: The Cleft Palate Centre, University Hospital Uppsala, Sweden. Patients: Dental study models of 79 consecutive children, 28 with unilateral cleft lip and palate (UCLP), 39 with cleft palate (CP) and 12 with Pierre Robin Sequence (PRS) were analyzed. Interventions: Lip repair at 3-4 months, soft palate repair at 6-10 months and hard palate repair at 25-26 months of age. Main Outcome Measures: Cleft size was measured before each surgical intervention up to 2 years and arch dimensions were measured before each surgical intervention and at 5 years. Results: Cleft widths decreased from infancy up to 2 years in all groups. The antero-posterior cleft length in CP was unchanged between 6 months and 2 years. Arch widths at C-C1and T-T1 and also the change over time in C-C1 and T-T1 differed significantly between the groups. Conclusions: Cleft widths decreased after lip closure and/or soft palate closure. The UCLP children had wider maxillary arch dimensions than the CP and PRS children during the first years of life, but after hard palate closure the transverse growth was reduced in the UCLP children. At 5 years the UCLP children had smaller maxillary widths than the CP and PRS children especially at the level of the cuspids. Key words: cleft lip and palate, cleft palate, cleft size, maxillary arch dimensions and two-stage palatal repair.