The Influence of Palatoplasty and Cleft Length on Facial Development

Abstract

The purpose of this study is to evaluate the effect of palatoplasty and the extent of palatal clefts on facial development. A sample of Danish fe— male patients, all having an isolated cleft of the palate and operated with the same surgical procedure, were examined cephalometrically. The sample was divided into two groups; one with clefts involving the soft palate only (cleft type 1 and 2) and the other with clefts involving both the hard and soft palates (cleft type 3 and 4)—Figure 1. Literature Review Shibaski and Ross (8) in their review of the literature made note of the fact that in some respects morphological differences between cleft types are greater than between cleft and normal individuals. If this is true it is also conceivable that differences in facial morphology may exist between individuals with clefts involving both the hard and soft palate and those with clefts involving the soft palate only. Dahl (5) in a cephalometric study of young adult Danish males compared facial morphology of pa— tients with isolated clefts of the palate and that of a controlled normal group. His conclusions were that the maxilla was smaller in length and retrognathic in the cleft group. The maxilla was also more retruded in re— lationship to the mandible than in a normal group. He further examined the effects of the extent of the palatal cleft and the sequalae of surgical repair relating them to variations in facial morphology. The study utilized a total of 56 patients with isolated clefts of the palate in the age range between 18—33 years. The subjects were divided into two subgroups according to the extent of the cleft. The first subgroup included 18 persons in Whom the cleft was restricted to the soft palate and occasionally the most posterior part of the hard palate. The other subgroup was composed of 38 patients in whom the cleft involved one-fourth or more of the hard palate. In his comparisons between the two cleft groups Dahl found that all " maxillary " measurements with the exception of ANS-PTM and Point A—PTM showed but slight differences. Both groups exhibited simi