Abstract
ObjectivesThe objective of this study was to compare maxillary dimensions and growth in newborns with Complete Unilateral Cleft Lip and Palate (UCLP) to healthy newborns before and after cheiloplasty. Additionally, a palatal growth curve is constructed to give more information about the natural growth before surgical intervention.MethodsTwenty-eight newborns with complete UCLP were enrolled in this study. Multiple plaster-casts of each child during their first year were collected and grouped in before and after cheiloplasty. A previous developed semi-automatic segmentation tool was used to assess the maxillary dimensions and were compared to a healthy control group. Z-scores were calculated to indicate differences between the two populations and if cheiloplasty had influence on maxillary growth. Furthermore, the prediction model created in a previous study was used to indicate differences between predictions and the outcome in UCLP measurements. The analysis was tested for inter- and intra-observer variability.ResultsResults show differences in alveolar and palatal shape in UCLP patients in comparison with healthy controls. Prior to cheiloplasty an increased width and alveolar length was observed while the palatal depth was decreased. After cheiloplasty the widths moved towards normal but were still significantly larger.ConclusionInfants with unilateral cleft lip and palate show a wider maxillary arch in comparison with the control population. Initial treatment has most influence on the width of the arch, which decreased towards normal.
Highlights
Orofacial clefts are one of the most common congenital disorders with a prevalence in Europe about 0.9 cases per 1,000 livebirths (Calzolari et al, 2004)
It is known that corrective surgery for Unilateral cleft lip and palate (UCLP), e.g., lip closure and palate closure, has influence on normal maxillary growth (Kuijpers-Jagtman & Long, 2000)
An additional three patients were excluded for comparing the effect of cheiloplasty as they missed a pre- or post-cheiloplasty cast
Summary
Orofacial clefts are one of the most common congenital disorders with a prevalence in Europe about 0.9 cases per 1,000 livebirths (Calzolari et al, 2004). Unilateral cleft lip and palate (UCLP) is the most common type of orofacial cleft (Jagomagi, Soots & Saag, 2010; Rusková et al, 2014; Yilmaz, Ozbilen & Ustun, 2019). It is known that corrective surgery for UCLP, e.g., lip closure (cheiloplasty) and palate closure (palatoplasty), has influence on normal maxillary growth (Kuijpers-Jagtman & Long, 2000). Multiple studies report that timing, surgical technique and expertise of the surgeon all may have impact on craniofacial development (Kuijpers-Jagtman & Long, 2000; Peltomäki et al, 2001)
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