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BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Incision | Research

A comparison of maxillofacial growth in Chinese children with isolated cleft palate treated with two different palatoplasty techniques without relaxing incisions: a preliminary study

Authors: Sadam Ahmed Elayah, Jiayi Yin, Waseem Saleh Al-Gumaei, Hamza Younis, Karim Ahmed Sakran, Ziwei Tang, Mubarak Ahmed Mashrah, Grace Paka Lubamba, Min Wu, Yang Li, Bing Shi

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Objective

To assess the maxillofacial growth of patients with isolated cleft palate following the Sommerlad-Furlow modified technique and compare it with the effect of the Sommerlad technique.

Study design

A Retrospective Cohort Study.

Methods

A total of 90 participants, 60 patients with non-syndromic isolated soft and hard cleft palate (ISHCP) underwent primary palatoplasty without relaxing incision (30 patients received the Sommerlad-Furlow modified (S-F) technique and 30 received Sommerlad (S) technique). While the other 30 were healthy noncleft participants with skeletal class I pattern (C group). All participants had lateral cephalometric radiographs at least 5 years old age. All the study variables were measured by using stable landmarks, including 11 linear and 9 angular variants.

Results

The means age at collection of cephalograms were 6.03 ± 0.80 (5–7 yrs) in the S group, 5.96 ± 0.76 (5–7 yrs) in the S-F group, and 5.91 ± 0.87 (5–7 yrs) in the C group. Regarding cranial base, the results showed that there were no statistically significant differences between the three groups in S–N and S–N-Ba. The S group had a significantly shortest S-Ba than the S-F & C groups (P = 0.01), but there was no statistically significant difference between S-F and C groups (P = 0.80). Regarding skeletal maxillary growth, the S group had significantly shorter Co-A, S- PM and significantly less SNA angle than the C group (P =  < 0.01). While there was no significant difference between S-F & C groups (P = 0.42). The S group had significantly more MP-SN inclination than the C group (P =  < 0.01). Regarding skeletal mandibular growth, there were no statistically significant differences in all linear and angular mandibular measurements between the three groups, except Co-Gn of the S group had a significantly shorter length than the C group (P = 0.05). Regarding intermaxillary relation, the S-F group had no significant differences in Co-Gn—Co-A and ANB as compared with the C group. The S group had significantly less ANB angle than S-F & C groups (P = 0.01 & P =  < 0.01). In addition, there were no significant differences in all angular occlusal measurements between the three groups.

Conclusion

As a preliminary report, Sommerlad-Furlow modified technique showed that maxillary positioning in the face tended to be better, and the intermaxillary relationship was more satisfactory than that in Sommerlad technique when compared them in healthy noncleft participants.
Appendix
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Literature
1.
Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011;12(3):167–78.PubMedPubMedCentralCrossRef
2.
3.
Eppley BL, van Aalst JA, Robey A, Havlik RJ, Sadove AM. The spectrum of orofacial clefting. Plast Reconstr Surg. 2005;115(7):101e–14e.PubMedCrossRef
4.
Cheng X, Bo Z, Yin H, Yang K, Li J, Shi B. Age and Preoperative Velar Closure Ratio Are Significantly Associated With Surgical Outcome of Furlow Double-Opposing Z-Plasty in Palatal Re-Repair. J Oral Maxillofac Surg. 2020;78(3):431–9.PubMedCrossRef
5.
Xu X, Cao C, Zheng Q, Shi B. The Influence of Four Different Treatment Protocols on Maxillofacial Growth in Patients with Unilateral Complete Cleft Lip, Palate, and Alveolus. Plast Reconstr Surg. 2019;144(1):180–6.PubMedCrossRef
6.
7.
Li F, Wang HT, Chen YY, Wu WL, Liu JY, Hao JS, Luo DY. Cleft relapse and oronasal fistula after Furlow palatoplasty in infants with cleft palate: incidence and risk factors. Int J Oral Maxillofac Surg. 2017;46(3):275–80.PubMedCrossRef
8.
Sakran KA, Wu M, Alkebsi K, Mashrah MA, Al-Rokhami RK, Wang Y, Mohamed AA, Elayah SA, Al-Sharani HM, Huang H, Shi B. The Sommerlad-Furlow Modified Palatoplasty Technique: Postoperative Complications and Implicating Factors. Laryngoscope. 2023;133(4):822–9. https://​doi.​org/​10.​1002/​lary.​30385.
9.
10.
Shi B, Losee JE. The impact of cleft lip and palate repair on maxillofacial growth. Int J Oral Sci. 2015;7(1):14–7.PubMedCrossRef
11.
Liau JY, Sadove AM, van Aalst JA. An evidence-based approach to cleft palate repair. Plast Reconstr Surg. 2010;126(6):2216–21.PubMedCrossRef
12.
Lee YH, Liao YF. Hard palate-repair technique and facial growth in patients with cleft lip and palate: a systematic review. Br J Oral Maxillofac Surg. 2013;51(8):851–7.PubMedCrossRef
13.
Richard B, Russell J, McMahon S, Pigott R. Results of randomized controlled trial of soft palate first versus hard palate first repair in unilateral complete cleft lip and palate. Cleft Palate Craniofac J. 2006;43(3):329–38.PubMedCrossRef
14.
Campbell A, Costello BJ, Ruiz RL. Cleft lip and palate surgery: an update of clinical outcomes for primary repair. Oral Maxillofac Surg Clin North Am. 2010;22(1):43–58.PubMedCrossRef
15.
Zhang B, Yang C, Yin H, Zheng Q, Shi B, Li J. Preoperative velopharyngeal closure ratio correlates with Furlow palatoplasty outcome among patients with nonsyndromic submucous cleft palate. J Craniomaxillofac Surg. 2020;48(10):962–8.PubMedCrossRef
16.
Bruneel L, Luyten A, Bettens K, D’Haeseleer E, Dhondt C, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Delayed primary palatal closure in resource-poor countries: Speech results in Ugandan older children and young adults with cleft (lip and) palate. J Commun Disord. 2017;69:1–14.PubMedCrossRef
17.
Parwaz MA, Sharma RK, Parashar A, Nanda V, Biswas G, Makkar S. Width of cleft palate and postoperative palatal fistula–do they correlate? J Plast Reconstr Aesthet Surg. 2009;62(12):1559–63.PubMedCrossRef
18.
Sakran KA, Liu R, Yu T, Al-Rokhami RK, He D. A comparative study of three palatoplasty techniques in wide cleft palates. Int J Oral Maxillofac Surg. 2021;50(2):191–7.PubMedCrossRef
19.
20.
Dong Y, Dong F, Zhang X, Hao F, Shi P, Ren G, Yong P, Guo Y. An effect comparison between Furlow double opposing Z-plasty and two-flap palatoplasty on velopharyngeal closure. Int J Oral Maxillofac Surg. 2012;41(5):604–11.PubMedCrossRef
21.
Leenstra TS, Maltha JC, Kuijpers-Jagtman AM, Spauwen PH. Wound healing in beagle dogs after palatal repair without denudation of bone. Cleft Palate Craniofac J. 1995; 32(5):363–369. discussion 369–370.
22.
Kremenak CR Jr, Huffman WC, Olin WH. Maxillary growth inhibition by mucoperiosteal denudation of palatal shelf bone in non-cleft beagles. Cleft Palate J. 1970;7:817–25.PubMed
23.
Leenstra TS, Kuijpers-Jagtman AM, Maltha JC. The healing process of palatal tissues after operations with and without denudation of bone: an experimental study in dogs. Scand J Plast Reconstr Surg Hand Surg. 1999;33(2):169–76.PubMedCrossRef
24.
Yoshida H, Takahashi M, Yamaguchi T, Takizawa H, Takakaze M, Maki K. Comparison of Maxillofacial Morphology Between Modified Furlow's and Modified two-Flap Palatoplasty in Orofacial Clefts During the Primary Dentition Period. Cleft Palate Craniofac J. 2023;60(10):1313–20. https://​doi.​org/​10.​1177/​1055665622110437​4.
25.
Luyten A, Bettens K, D’Haeseleer E, De Ley S, Hodges A, Galiwango G, Bonte K, Vermeersch H, Van Lierde K. The impact of palatal repair before and after 6 months of age on speech characteristics. Int J Pediatr Otorhinolaryngol. 2014;78(5):787–98.PubMedCrossRef
26.
Barutca SA, Aksan T, Usçetin I, Sahin D, Akan M. Effects of palatine bone denudation repair with periosteal graft on maxillary growth: an experimental study in rats. J Craniomaxillofac Surg. 2014;42(1):e1–7.PubMedCrossRef
27.
28.
Xu X, Kwon HJ, Shi B, Zheng Q, Yin H, Li C. Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate. J Craniomaxillofac Surg. 2015;43(1):43–7.PubMedCrossRef
29.
Fudalej PS, Katsaros C, Dudkiewicz Z, Bergé SJ, Kuijpers-Jagtman AM. Cephalometric outcome of two types of palatoplasty in complete unilateral cleft lip and palate. Br J Oral Maxillofac Surg. 2013;51(2):144–8.PubMedCrossRef
30.
Cho BC, Kim JY, Yang JD, Lee DG, Chung HY, Park JW. Influence of the Furlow palatoplasty for patients with submucous cleft palate on facial growth. J Craniofac Surg. 2004; 15(4):547–554. discussion 555.
31.
Fan X, Liu W, Nie J, Chen X, Dong Y, Lu Y. Comparison of velopharyngeal morphology of two palatoplasty techniques in patients with hard and soft cleft palate. Front Surg. 2022;9:1080955.PubMedCrossRef
32.
33.
Grummons DC, Kappeyne van de Coppello MA. A frontal asymmetry analysis. J Clin Orthod. 1987;21(7):448–65.
34.
Liu Y, Huang H, Shi B, Wang Y. The influence of lip repair on the growth of craniofacial structures in bilateral cleft lip and palate patients with unoperated palate from childhood to adulthood. Journal of Craniofacial Surgery. 2020;31(5):1218–22.PubMedCrossRef
35.
Yoshida H, Nakamura A, Michi K, Wang GM, Liu K, Qiu WL. Cephalometric analysis of maxillofacial morphology in unoperated cleft palate patients. Cleft Palate Craniofac J. 1992;29(5):419–24.PubMedCrossRef
36.
Kato RM, Moura PP, Zechi-Ceide RM, Tonello C, Peixoto AP, Garib D. Comparison Between Treacher Collins Syndrome and Pierre Robin Sequence: A Cephalometric Study. Cleft Palate Craniofac J. 2021;58(1):78–83.PubMedCrossRef
37.
Wu RT, Peck CJ, Shultz BN, Travieso R, Steinbacher DM. Racial Disparities in Cleft Palate Repair. Plast Reconstr Surg. 2019;143(6):1738–45.PubMedCrossRef
38.
Madachi K, Takagi R, Asahito T, Kodama Y, Ominato R, Iida A, Ono K, Saito I. Cephalometric evaluation after two-stage palatoplasty combined with a Hotz plate: a comparative study between the modified Furlow and Widmaier-Perko methods. Int J Oral Maxillofac Surg. 2017;46(5):539–47.PubMedCrossRef
39.
Kulewicz M, Dudkiewicz Z. Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study. Int J Oral Maxillofac Surg. 2010;39(2):122–8.PubMedCrossRef
40.
Liao YF, Yang IY, Wang R, Yun C, Huang CS. Two-stage palate repair with delayed hard palate closure is related to favorable maxillary growth in unilateral cleft lip and palate. Plast Reconstr Surg. 2010;125(5):1503–10.PubMedCrossRef
41.
Currie K, Sawchuk D, Saltaji H, Oh H, Flores-Mir C, Lagravere M. Posterior cranial base natural growth and development: A systematic review. Angle Orthod. 2017;87(6):897–910.PubMedPubMedCentralCrossRef
42.
Karsten A, Larson M, Larson O. Dental occlusion after Veau-Wardill-Kilner versus minimal incision technique repair of isolated clefts of the hard and soft palate. Cleft Palate Craniofac J. 2003;40(5):504–10.PubMedCrossRef
43.
Lu Y, Shi B, Wang Z, Zhan X. STUDY ON WOUND HEALING AFTER Sommerlad TECHNIQUE REPAIR OF ISOLATED CLEFT PALATE. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014;28(7):869–72.PubMed
44.
Shibasaki Y, Ross RB. Facial growth in children with isolated cleft palate. Cleft Palate J. 1969;6:290–302.PubMed
45.
46.
Silva Filho OG, Calvano F, Assunção AG, Cavassan AO. Craniofacial morphology in children with complete unilateral cleft lip and palate: a comparison of two surgical protocols. Angle Orthod. 2001;71(4):274–84.PubMed
47.
Johnston CD, Leonard AG, Burden DJ, McSherry PF. A comparison of craniofacial form in Northern Irish children with unilateral cleft lip and palate treated with different primary surgical techniques. The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. 2004;41(1):42–6.PubMedCrossRef
48.
Bishara SE, Enemark H, Tharp RF. Cephalometric comparisons of the results of the Wardill-Kilner and Von Langenbeck palatoplasties. Cleft Palate J. 1976;13:319–29.PubMed
49.
da Silva Filho OG, Rosa LA, Lauris Rde C. Influence of isolated cleft palate and palatoplasty on the face. J Appl Oral Sci. 2007;15(3):199–208.PubMedCrossRef
50.
Corthouts P, Boels F, Van de Casteele E, Nadjmi N. Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review. Plastic and Aesthetic Research. 2020;7:46.CrossRef
51.
Bichara LM, Araújo RC, Flores-Mir C, Normando D. Impact of primary palatoplasty on the maxillomandibular sagittal relationship in patients with unilateral cleft lip and palate: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2015;44(1):50–6.PubMedCrossRef
52.
Ebin LE, Zam NM, Othman SA. Cephalometric analysis of Malay children with and without unilateral cleft lip and palate. Aust Orthod J. 2010;26(2):165–70.PubMed
53.
Farronato G, Kairyte L, Giannini L, Galbiati G, Maspero C. How various surgical protocols of the unilateral cleft lip and palate influence the facial growth and possible orthodontic problems? Which is the best timing of lip, palate and alveolus repair? literature review. Stomatologija. 2014;16(2):53–60.PubMed
Metadata
Title
A comparison of maxillofacial growth in Chinese children with isolated cleft palate treated with two different palatoplasty techniques without relaxing incisions: a preliminary study
Authors
Sadam Ahmed Elayah
Jiayi Yin
Waseem Saleh Al-Gumaei
Hamza Younis
Karim Ahmed Sakran
Ziwei Tang
Mubarak Ahmed Mashrah
Grace Paka Lubamba
Min Wu
Yang Li
Bing Shi
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Incision
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03588-6

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