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Long-term follow-up of UCLP at the Reine Fabiola Children's Hospital.
B-ENT. 2006; 2 Suppl 4:44-50.B

Abstract

BACKGROUND

The purpose of this retrospective of prospectively acquired data was to evaluate and to compare global evolution in children with complete unilateral cleft lip and palate treated at the Brussels cleft centre following two different surgical treatment protocols.

METHODS

A series of forty-four patients operated for non-syndromic complete unilateral cleft lip and palate were included in this study at the age of approximately ten years. Twenty-six children (17 males, 9 females) were treated according to the Malek surgical treatment protocol: the soft palate was closed at a mean age of 3 months, followed by simultaneous repair of the lip and hard palate at a mean age of 6 months. Eighteen children (15 males, 3 females) underwent one-stage "all-in-one" closure of the lip, hard and soft palate at a mean age of 3 months. Craniofacial morphology was evaluated by means of digital lateral cephalometric analysis. Cephalometric data were compared to a control, non-cleft group (n = 40) matched according to age. Data concerning otological status and speech were collected in the same series of children.

RESULTS

Statistical analysis showed that the inclination of the maxillary (MxPVSN) plane to the anterior cranial base was significantly increased (p <0.001) in both cleft groups compared to the non-cleft group and significantly increased (p = 0.002) in the Malek cleft group compared to the "all-in-one" cleft group. Otological status was not improved by an early complete closure but by close follow-up and the repeated placement of ventilating tubes. Speech was found to be satisfactory in the majority of children of both groups at six years after speech therapy. Only 15% needed further surgery with pharyngeal flaps.

CONCLUSIONS

There were no significant differences in anteroposterior midfacial morphology between the Malek and "all-in-one" protocols at ten years of age. One-stage "all-in-one" closure resulted in less downward inclination of the maxillary plane to the anterior cranial base compared to the Malek protocol at ten years of age. Early complete closure of the cleft resulted in no significant change in otological status or the occurrence of nasality. However, early complete closure of the cleft allowed for earlier intelligibility of speech compared to the staged later closure.

Authors+Show Affiliations

Department of plastic surgery, Free University Brussels, Belgium. albert.demey@chu-brugmann.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17366847

Citation

De Mey, A, et al. "Long-term Follow-up of UCLP at the Reine Fabiola Children's Hospital." B-ENT, vol. 2 Suppl 4, 2006, pp. 44-50.
De Mey A, Swennen G, Malevez C, et al. Long-term follow-up of UCLP at the Reine Fabiola Children's Hospital. B-ENT. 2006;2 Suppl 4:44-50.
De Mey, A., Swennen, G., Malevez, C., George, M., & Mansbach, A. L. (2006). Long-term follow-up of UCLP at the Reine Fabiola Children's Hospital. B-ENT, 2 Suppl 4, 44-50.
De Mey A, et al. Long-term Follow-up of UCLP at the Reine Fabiola Children's Hospital. B-ENT. 2006;2 Suppl 4:44-50. PubMed PMID: 17366847.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of UCLP at the Reine Fabiola Children's Hospital. AU - De Mey,A, AU - Swennen,G, AU - Malevez,C, AU - George,M, AU - Mansbach,A L, PY - 2007/3/21/pubmed PY - 2007/4/4/medline PY - 2007/3/21/entrez SP - 44 EP - 50 JF - B-ENT JO - B-ENT VL - 2 Suppl 4 N2 - BACKGROUND: The purpose of this retrospective of prospectively acquired data was to evaluate and to compare global evolution in children with complete unilateral cleft lip and palate treated at the Brussels cleft centre following two different surgical treatment protocols. METHODS: A series of forty-four patients operated for non-syndromic complete unilateral cleft lip and palate were included in this study at the age of approximately ten years. Twenty-six children (17 males, 9 females) were treated according to the Malek surgical treatment protocol: the soft palate was closed at a mean age of 3 months, followed by simultaneous repair of the lip and hard palate at a mean age of 6 months. Eighteen children (15 males, 3 females) underwent one-stage "all-in-one" closure of the lip, hard and soft palate at a mean age of 3 months. Craniofacial morphology was evaluated by means of digital lateral cephalometric analysis. Cephalometric data were compared to a control, non-cleft group (n = 40) matched according to age. Data concerning otological status and speech were collected in the same series of children. RESULTS: Statistical analysis showed that the inclination of the maxillary (MxPVSN) plane to the anterior cranial base was significantly increased (p <0.001) in both cleft groups compared to the non-cleft group and significantly increased (p = 0.002) in the Malek cleft group compared to the "all-in-one" cleft group. Otological status was not improved by an early complete closure but by close follow-up and the repeated placement of ventilating tubes. Speech was found to be satisfactory in the majority of children of both groups at six years after speech therapy. Only 15% needed further surgery with pharyngeal flaps. CONCLUSIONS: There were no significant differences in anteroposterior midfacial morphology between the Malek and "all-in-one" protocols at ten years of age. One-stage "all-in-one" closure resulted in less downward inclination of the maxillary plane to the anterior cranial base compared to the Malek protocol at ten years of age. Early complete closure of the cleft resulted in no significant change in otological status or the occurrence of nasality. However, early complete closure of the cleft allowed for earlier intelligibility of speech compared to the staged later closure. SN - 1781-782X UR - https://www.unboundmedicine.com/medline/citation/17366847/Long_term_follow_up_of_UCLP_at_the_Reine_Fabiola_Children's_Hospital_ L2 - https://medlineplus.gov/cleftlipandpalate.html DB - PRIME DP - Unbound Medicine ER -