Morphology of Adult Face After Repair of Isolated Cleft Palate in Childhood

Abstract

Many cephalometric studies have been made of patients with isolated cleft palate (22, 23, 2'7, 28) but no papers report measurements of the surface of the face to identify morphological changes in the soft tissues of the face. The purpose of this paper is: 1) to complete the data about facial morphology in dults after cleft palate surgery in childhood, 2) to determine whether the extent of the cleft palate had a significant influence on the development of the face, 3) to discover minor morphological changes on the face and head which may escape attention in a routine examination. Materials and Methods We studied 42 patients, 17 men and 25 women between 16 and 20 years of age, whose isolated cleft palates (12 severe and 30 incomplete) had been repaired at The Hospital for Sick Children. The palates were repaired by a modified Dorrance pushback operation at the age of approximately two years (19). Nineteen patients had ortho— dontic treatment. Nine patients had had a secondary repair, a palatal fistula had been closed in eight patients and the palate had been completed by pharyngeal flap in the ninth. Our controls were 100 healthy Canadians, 50 men and 50 women. Our measurements of the facial surface and of the head were those Widely used in anthropometry (15, 21, 33) but adapted for the purpose of assessing results of plastic surgery (3, 6, 12, 13). This paper presents 14 measurements, eight of the face in general and six of the nose and upper lip in detail, and seven qualitative signs, the methods of examination being as described in a previous paper (7'). Measurements 1. Bitragion diameter (t—t) 2. Bizygomatic diameter (zy-zy)