Sigler MA, Borquez S, Suenaga T, Vergara Z, Perea M

Language: Spanish
References: 15
Page: 78-87
PDF size: 829.93 Kb.

ABSTRACT

At present, there is still the dilemma regarding the optimal moment for palatoplasty. The early palate closure before patients are one-year old avoids speech problems; however, it causes a maxillary alteration that appears with facial collapse, cross bite, and pseudoprognatism. If we delay the palate repair so as not to affect maxillary growth, then there is a risk of speech problems. For this report, there were two groups of randomly chosen patients that were analyzed, those who were operated by complete cleft of the palate (72 patients), by the same surgeon, at one year of age. The control group (which consisted of 36 patients) with complete cleft palates which were repaired with the Wardill Kilner or Von Langenbeck techniques. The study group, which consisted of 36 patients with complete palate clefts which were repaired at one year of age by the same surgeon and only the posterior part of their palate was repaired leaving the anterior part open for a second stage repair at 3 years of age. Patients were evaluated clinically regarding facial growth, occlusion and dental arches and the results were documented by plastic surgery and dentistry. The evaluations were clinical, documented by photographs and dental models. The results, although preliminary, were convincing, considering what is observed of the maxillary growth and the dental arches. In the patients who had complete palate closure, 32 (90%) showed anterior and posterior cross bite (malocclusion) required maxillary orthopedic treatment at the age of two and has continued up until now. Patients who only had the posterior palate closure and the anterior palate was open, posterior cross bite was not found nor transverse collapse of the maxilla at the age of two. Only 4 patients (10%) had anterior cross bite. The anterior palate cleft that was left open in the study group got narrower as time went by in most patients and in those that had the edges of the cleft were so close together that the undermining of the mucoperiosteal flaps was minimal. Speech problems in both groups will be reported, when a more reliable assessment can be obtained.

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