Long-term results of the two-stage palatoplasty/Hotz’ plate approach for complete bilateral cleft lip, alveolus and palate patients

Abstract

Purpose: To investigate the effects of the two-stage palatoplasty combined with the Hotz’ plate on craniofacial development in patients with bilateral complete clefts. Material and methods: Lateral and frontal cephalograms of two-stage palatoplasty/Hotz’ plate group ( n=10), one-stage palatoplasty group ( n=11), and a non-cleft group ( n=11), were evaluated at 6, 8, 10 and 12 years of age. The unpaired Student's t-test and Scheffe's F test ( p<0.05) were applied. Results: At 6 years the posterior upper facial height (PUFH) and PUFH/PFH ratio were greater in the two-stage group. At 10 years the PUFH, maxillary depth, convexity and ANB angle were greater in the same group. At 12 years, maxillary depth and ANB angle were also greater in this group. In the one-stage group, the L1/Mp. angle, PUFH and PUFH/PFH ratio were smaller when compared with the non-cleft group, whereas the palatal plane/SN angle was greater. In both cleft groups, the I.I. angle and tongue-PTM′ distance were greater, and the U1/SN angle was smaller when compared with non-clefts. The UC–UC′ and the ratios UC/MAX and UC/LC of both cleft groups were also smaller when compared with non-clefts. The ratio UM/MAX of the one-stage group was smaller when compared with the non-cleft group. Conclusion: The two-stage palatoplasty in combination with application of the Hotz’ plate had good effects on the maxillary growth up to the age of 12 years.