Advertisement

Timing of Cleft Palate Closure Should Be Based on the Ratio of the Area of the Cleft to That of the Palatal Segments and Not on the Age Alone

  • Samuel Berkowitz

17.5 Conclusions

  1. 1.

    When the ratio of posterior cleft space to the total palatal surface area medial to the alveolar ridges is no more than 10%, it is the best time to surgically close the palatal cleft space. Therefore, one need not wait until 5–9 years of age to close the cleft space in order to maximize palatal growth.

     
  2. 2.

    Presurgical orthopedics does not stimulate palatal growth beyond its normal growth potential.

     
  3. 3.

    There is more than one physiological surgical procedure to achieve good palatal growth.

     
  4. 4.

    Extensive velar flaps with or without palatal pushback surgery is detrimental to palatal growth.

     

Keywords

Soft Palate Cleft Palate Alveolar Ridge Cleave Palate Palatal Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Millard DR. Cleft craft: the evolution of its surgery, Part I: the unilateral deformity. Boston: Little Brown; 1976.Google Scholar
  2. 2.
    Kaplan EN. Cleft palate repair at three months. Ann Plast Surg 1981; 7:179–190.PubMedGoogle Scholar
  3. 3.
    Slaughter WB, Brodie AG. Facial clefts and their surgical management in view of recent research. Plast Reconstr Surg 1949; 4:311–332.Google Scholar
  4. 4.
    Maisels DO. The timing of various operations required for complete alveolar clefts and their influence on facial growth. B J Plast Surg 1966; 20:230–243.CrossRefGoogle Scholar
  5. 5.
    Veau V. Le Sequalette due bec-de-lievre. Ann Anat Pathol 1934; 11:873.Google Scholar
  6. 6.
    Brophy TW. Cleft lip and palate. Philadelphia: Blakiston’s; 1923. p. 131–132.Google Scholar
  7. 7.
    Koberg W., Koblin I. Speech development and maxillary growth in relation to technique and timing of palatoplasty J: Maxillofac Surg. 1973; 1:44.CrossRefGoogle Scholar
  8. 8.
    Hotz M, Gnoinski W. Comprehensive care of cleft lip and cleft palate children at Zurich University: a preliminary report. Am J Orthod 1976; 70:481–504.PubMedCrossRefGoogle Scholar
  9. 9.
    Hotz MM. 22 years of experience in cleft palate management and its consequences for treatment planning. In: Kherer B, Slongo T, Graf B, et al. (eds.) Long-term treatment in cleft lip and palate with coordinated approach. Bern: Hans Huber; 1979. p. 208–211.Google Scholar
  10. 10.
    Schweckendiek W. Two stage closure of cleft palate. Rationale for its use. In: Kherer B, Slongo T, Graf B, et al. (eds.) Long-term treatment in cleft lip and palate with coordinated approach. Bern: Hans Huber; 1979a. p. 254.Google Scholar
  11. 11.
    Schweckendiek W: Speech development after two stage closure of cleft palate. In: Kherer B, Slongo T, Graf B, et al. (eds.) Long-term treatment in cleft lip and palate with coordinated approach. Bern: Hans Huber; 1979b. p. 307.Google Scholar
  12. 12.
    Weil J. Orthopaedic growth guidance and stimulation for patients with cleft lip and palate. Scand J Plast Reconstr Surg 1987; 21:57–64.Google Scholar
  13. 13.
    Friede H. Growth sites and growth mechanisms at risk in cleft lip and palate. Acta Odontol Scand 1998; 56:346–351.PubMedCrossRefGoogle Scholar
  14. 14.
    Kremenak CR, Huffman WC, Olin WM. Maxillary growth inhibition by mucoperiosteal denudation of palatal shelf bone in noncleft beagles. Cleft Palate J 1970; 7:817–825.PubMedGoogle Scholar
  15. 15.
    Berkowitz S. State of the art in cleft palate, orofacial growth. Am J Orthodont 1978; 74:5, 564–576.CrossRefGoogle Scholar
  16. 16.
    Prahl C, Kuijpers-Jagtman AM, Van’t Hof MA, Prahl-Andersen B. A randomized prospective clinical trial into the effect of infant orthopaedics on maxillary arch dimensions in unilateral cleft lip and palate. Eur J Oral Sci 2001; 109:297–305.PubMedCrossRefGoogle Scholar
  17. 17.
    Berkowitz S. Cleft lip and palate and craniofacial anomalies perspectives in management. San Diego: Singular Press; 1996b.Google Scholar
  18. 18.
    Berkowitz S. Timing cleft palate closure-age should not be the sole determinant. J Craniofac Genet Devel Biol 1985; (Suppl.) 1:69–83.Google Scholar
  19. 19.
    Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Cleft palate speech. 3rd edn. St. Louis: Mosby; 2000. p. 123–147.Google Scholar
  20. 20.
    Bzoch KR. Clinical studies of the efficacy of speech appliances compares to pharyngeal flap surgery. Cleft Palate J 1964; 35:275–286.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Samuel Berkowitz

There are no affiliations available

Personalised recommendations