Title:
Long-term follow-up of UCLP at the Reine Fabiola Children’s Hospital
Authors:
A. De Mey*, G. Swennen*, C. Malevez**, M. George*** and A. L. Mansbach***
Institutions:
*Department of plastic surgery, Free University Brussels, **Department of maxillofacial surgery, Free University Brussels, ***Department of ENT surgery, Free University Brussels
Keywords:
Long-term follow-up; all-in-one; unilateral cleft lip palate; craniofacial morphology; hearing; speech and velopharyngeal function
Pages:
44 - 50
Abstract:
Long-term follow-up of UCLP at the Reine Fabiola Children’s Hospital. Background: The purpose of this retrospective of prospectively acquired data was to evaluate and to compare global evo- lution 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 includ- ed 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 simultane- ous 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 eval- uated 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 maxil- lary 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.
Issue:
Suppl. 4, 2006


Download:
Long-term follow-up of UCLP at the Reine Fabiola Children’s Hospital