Effect on maxillary arch development of early 2-stage palatoplasty by modified furlow technique and conventional 1-stage palatoplasty in children with complete unilateral cleft lip and palate

Tadashi Yamanishi, Juntaro Nishio, Hiroshi Kohara, Yoshiko Hirano, Michiyo Sako, Yukiko Yamanishi, Tadafumi Adachi, Shigenori Miya, Takao Mukai
Journal of Oral and Maxillofacial Surgery 2009, 67 (10): 2210-6

PURPOSE: The purpose of this study was to evaluate the palatal morphology of patients with complete unilateral cleft lip and palate after early 2-stage palatoplasty (ETS) consisting of soft palate closure by a modified Furlow palatoplasty at 12 months of age and hard palate closure at 18 months of age. We compared the result with the palatal morphology obtained by Wardill-Kilner push-back palatoplasty (PB) at 12 months of age with that of children with noncleft palate. In the present study we investigated whether ETS can result in better palatal development than conventional PB.

MATERIALS AND METHODS: Thirty subjects were treated by ETS and 42 underwent PB. We also included cross-sectional data obtained from 66 children with noncleft palate as control. We measured the arch length, width, and cleft width using dental cast models that were consecutively taken at 3 months to 4 yrs of age and compared the results among the 3 groups.

RESULTS: At 4 years of age, the anteroposterior palatal length of ETS was significantly longer than that of PB by 9.8%, and the transversal palatal width of ETS was also markedly wider than that of PB at every point measured. Furthermore, ETS showed potential catch-up growth in the anteroposterior palatal length from 12 months to 4 years of age.

CONCLUSION: These results demonstrate that ETS has a considerable benefit for the palatal development of patients with complete unilateral cleft lip and palate compared with PB.

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