Vertical maxillary growth in unilateral cleft lip and palate. A comparison of two surgical protocols

Abstract

Objective: The aim of the present study was to compare vertical maxillofacial growth in patients born with unilateral cleft lip and palate (UCLP) who were treated with one of two different surgical protocols. Design: A retrospective cohort study. Subjects: One hundred seventy-six consecutive patients with complete UCLP treated at Sahlgrenska University Hospital in Gothenburg, Sweden, were divided into two groups: (1) the W-K group, consisting of 60 patients born 1965 to 1974 who were treated surgically according to a Wardill-Kilner (WK) protocol, and (2) the Gothenburg DHPC group, consisting of 116 patients born 1975 to 1995 who were treated surgically according to the Gothenburg delayed hard palate closure (DHPC) protocol. Methods: Cast models and lateral cephalograms obtained at 10 years of age were analyzed. Results: Patients treated according to the Gothenburg DHPC protocol had significantly increased palatal vault height, anterior upper facial height, anterior maxillary height, overbite, and maxillary inclination than patients treated according to the W-K protocol. There were no differences in posterior upper facial height or in posterior vertical maxillary height between the two groups. Conclusion: There is increased palatal vault height, anterior upper facial height, anterior maxillary vertical height, and overbite - and therefore increased maxillary inclination at 10 years of age - in patients with complete UCLP who were treated surgically according to the Gothenburg DHPC protocol rather than the W-K protocol. The Gothenburg DHPC protocol can therefore be considered to result in more favorable anterior vertical maxillary growth compared to the W-K protocol.