Outcome of Patients with Complete Unilateral Cleft Lip and Palate: 20-Years Follow-up of Treatment Protocol

Background: The treatment plan for cleft lip and palate varies among centers, and requires long-term evaluation of its final outcome. Methods: A consecutive patients born in 1994 to 1996 were reviewed. Inclusion criteria were complete unilateral cleft lip and palate, receiving all treatment procedures in the team and continuous follow-ups until 20 years of age. Exclusion criteria were incomplete data, having microform cleft lip in contralateral side, presence of Simonart's band and other abnormalities. Results: A total of 72 patients were included. Average age at final evaluation was 21.3 years. 83.3% patients received one-stage rotation-advancement lip repair and 16.7% had two-stage with an initial adhesion cheiloplasty. All patients received palate repair using two-flap method at an average age of 12.3 months. Velopharyngeal insufficiency occurred and required surgical interventions in 19.4% at the preschool age, and 16.7% at the time of alveolar bone grafting. 56.9% of patients received secondary lip/nose revision in the growing age. Alveolar bone grafting was performed in 94.4% of the patients. Regular orthodontic treatment was administered to 34.7% of patients between 12 to 16 years of age. Orthodontic treatment and orthognathic surgery were applied in 37.5% of the patients after maturity. The average surgical procedures were 4.8 per patient to complete the treatment. Conclusion: This treatment protocol provided generally acceptable final outcome after the 20-year follow-up. Some results were less ideal and have yielded modifications of the planning and methods in the protocol. Conflicts of interest statement: No conflicting relationship exists for all authors Meeting presentation: Oral presentation in the 11th Congress of the Asian Pacific Craniofacial Association, December 2nd, 2016, Nara, Japan. Financial disclosure: None of the authors have any sources of financial or other support or any financial or professional relationships that may pose a competing interest. ACKNOWLEDGEMENT: We would like to thank Dr. M. Samuel Noordhoff for guiding and supervising this treatment protocol. The study was performed in the Chang Gung Craniofacial Research Center. We also thank Miss Hsiao-Hua Lee for coordinating the patient treatment. * Corresponding author: Lun-Jou Lo, M.D. Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital. 5 Fu-Shin Street, Kwei Shan, Taoyuan, Taiwan 333. Tel: 886-3-3281200, ext. 2430. Fax: 886-3-3271029. Email: lunjoulo@cgmh.org.tw ©2018American Society of Plastic Surgeons

https://ift.tt/2QnNwoT