The need for maxillary osteotomy after primary cleft surgery: A systematic review framing a retrospective study

Abstract

ObjectiveThis study assessed the rate of maxillary osteotomies after cleft palate surgery following a standardized two-stage palatoplasty protocol. In order to improve our treatment strategy, the results were compared with the data extracted from the literature by means of a systematic review. DesignRetrospective cohort study. PatientsNon-syndromic cleft lip, alveolus, and palate patients with complete records who underwent primary cleft palate surgery. InterventionThe incidence of midface hypoplasia after primary cleft surgery that required surgical intervention was retrospectively evaluated. ResultsOf the final 51 patients included in our retrospective analysis, two required a maxillary repositioning osteotomy. The frequency was lower than reported in the literature. In the literature, there was no difference between patients treated according to a one-stage protocol (21%) and patients treated according to a two-stage protocol (20.8%), but a higher incidence of pharyngeal surgery was noted in the two-stage closure group. Only the cleft type, timing of hard palate closure, and orthodontic treatment proved to influence the need for maxillary osteotomy. ConclusionOur protocol shows promising results and needs more validation.