Follow-up Study on Primary Cleft Palate Repair Cases

Clinical Evaluation at Six Years of Age

Abstract

This investigation was carried out to evaluate the velopharyngeal closure and the facial growth after the primary push-back operation in which the raw palatal surface was postoperatively left.
Fifty-five 6-years-old children with the cleft palate (41 children with unilateral cleft lips a nd palates; 14 with isolated cleft palates) were operated at the age of about 2 years, in one of the following three types of operation methods:
1. Wardill's method: Nasal mucosa sep a rated from hard palate bone was approximated and sutured.
2. Section of Nasal Mucosa method: Nasal mucosa was divided transver s ely at the posterior border of the bony palate and pushed backward. The raw area was left on the nasal surface of soft palate.
3. Manchester's method: Nasal mucosa separate d from hard plate bone was cut at the hard palate and pushed backward. So, the raw area on the nasal side was left at hard palate. The patients were evaluated by the nasal emission rat i o, lateral cephalometric roentgenograms and study-models of the dental arch. The results were as follows:
1. In 17(94.4%)of 18 cases operated by Manchester's method there was no nasal escape.
2. The push-back ratio of soft palate according to the lateral cephalometric roentgenograms was the best in the cases operated by Manchester's method.
3. The maxillary depth on the palatal plane was within normal limits in all cases.
4. All of the cleft palate cases had the small angle of SNA and the narrowed and shortened dental arch.