Ninety-nine cases of cleft palate were studied with conventional and soft tissue cephalometric roentgenograms. The Type III cases (clefts of the entire palate, alveolar ridge and lip) were studied in detail and statistically evaluated. No gross differences were seen in bony growth of the postoperative and unoperated cases of cleft palate of this group. In the postoperative cases of cleft palate, where the lips had been repaired at an average age of 3 months, there was a significant lingual version of the incisor teeth, posterior displacement of the upper lip, and exaggerated fullness of the lower lip. This was not seen in the unoperated cases of cleft palate, where the lips were closed at an average age of 2 years. These contoural abnormalities are believed to be related to a tight, early, lip closure and not to the effects of palatal surgery. In general, facial contoural abnormalities in cases of cleft lip and cleft palate after conventional surgery are believed to be more the direct result of a tight lip following unsatisfactory surgical repair, resulting in a collapse of the supporting incisor teeth, than the result of interference with maxillary growth centers by palatal surgery. It is believed that surgical techniques developed in recent years will be most effective in helping to eliminate such results.
In view of the foregoing, it would appear that conventional palatal surgery can be carried out before the end of the second year of life without detriment to the facial contour, and with maximal opportunity for the development of good speech. It is most important to effect a loose lip-closure to obtain a more normal facial contour.
- Copyright © 1960 by the American Academy of Pediatrics