Abstract
The optimisation of the relation between quality of outcome and burden of care is
difficult in the treatment of cleft lip and palate. We analysed long-term outcome
after one-stage repair of clefts to assess the benefits and limitations of this form
of treatment. Thirty-three patients aged 6–18 years who had had lip repair, two-flap
palatoplasty, and corticocancellous alveolar bone grafts at 6 months of age were divided
into three age groups (6–11, 12–14, and 15–18 years) and compared with mean outcome
data from the Eurocleft centres and with cephalometric standards of healthy people.
Fifteen of the 33 patients were assessed for nasalance. Maxillary protrusion (SNA)
and intermaxillary relation (ANB) in the one-stage groups differed significantly from
those of healthy people, but not from corresponding means in the Eurocleft study.
In 61% the Bergland score for alveolar ossification was grade I or II, and in 15%
it was grade III; 24% had secondary alveolar bone grafting. No palatal fistulas occurred
and nasalance did not differ significantly from that of healthy controls. As each
patient generally had a primary operation and one secondary procedure, they benefited
from half the number of surgical steps of multistage procedures. However, one-stage
procedures led to significant disturbance in growth, but the degree of this was similar
to mean values of multistage procedures in the Eurocleft study. Primary alveolar bone
grafting led to inconsistent alveolar ossification and was suspected to interfere
with anterior maxillary growth so it has been abandoned.
Keywords
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Article info
Publication history
Published online: May 01, 2012
Accepted:
February 4,
2012
Identification
Copyright
© 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
