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
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.
Presurgical orthopedics does not stimulate palatal growth beyond its normal growth potential.
There is more than one physiological surgical procedure to achieve good palatal growth.
Extensive velar flaps with or without palatal pushback surgery is detrimental to palatal growth.
KeywordsSoft Palate Cleft Palate Alveolar Ridge Cleave Palate Palatal Surgery
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- 1.Millard DR. Cleft craft: the evolution of its surgery, Part I: the unilateral deformity. Boston: Little Brown; 1976.Google Scholar
- 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
- 5.Veau V. Le Sequalette due bec-de-lievre. Ann Anat Pathol 1934; 11:873.Google Scholar
- 6.Brophy TW. Cleft lip and palate. Philadelphia: Blakiston’s; 1923. p. 131–132.Google Scholar
- 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.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.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.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
- 17.Berkowitz S. Cleft lip and palate and craniofacial anomalies perspectives in management. San Diego: Singular Press; 1996b.Google Scholar
- 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.Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Cleft palate speech. 3rd edn. St. Louis: Mosby; 2000. p. 123–147.Google Scholar