The effect of Delaire cheilorhinoplasty on midfacial growth in patients with unilateral cleft lip and palate

• Published in: European journal of orthodontics Vol. 31; no. 1; pp. 64 - 67
• Main Authors: Rullo, Rosario, Laino, Gregorio, Cataneo, Marisa, Mazzarella, Nicoletta, Festa, Vincenzo Maria, Gombos, Fernando
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2009; Oxford Publishing Limited (England)
• Subjects: Case-Control Studies; Cephalometry - methods; Child; Child, Preschool; Chin - pathology; Cleft Lip - physiopathology; Cleft Lip - surgery; Cleft Palate - physiopathology; Cleft Palate - surgery; Dentistry; Female; Humans; Lip - surgery; Male; Malocclusion, Angle Class I - pathology; Mandible - growth & development; Mandible - pathology; Maxilla - growth & development; Maxilla - pathology; Maxillofacial Development - physiology; Nasal Bone - pathology; Reconstructive Surgical Procedures - methods; Retrospective Studies; Rhinoplasty - methods; Rotation; Sella Turcica - pathology; Skull Base - pathology
• ISSN: 0141-5387; 1460-2210
• DOI: 10.1093/ejo/cjn068

The aim of this research was to evaluate the effect of the Delaire surgical technique on the midfacial morphology in a group of subjects with a congenital unilateral cleft of lip and palate (UCLP), prior to orthodontic treatment. Thirty-five UCLP (15 left and 20 right) patients (16 males and 19 females, mean age 7.03 ± 0.9 years; age range 8.7–5.0 years), treated for the correction of congenital malformation, were retrospectively selected. Analysis of midfacial growth was undertaken on lateral cephalograms, and the data were compared with reference values (Ricketts analysis). A Mann–Whitney ranked sum test was used to detect significant differences between the findings and reference values. P ≤ 0.05 was considered as significant. The results demonstrated a retropositioning of both the maxilla and mandible (SNA and SNB P < 0.01) and increased mandibular development (Go–Me distance). Vertically, there was a trend to a posterior rotation of the mandible (P < 0.01), resulting in a hyperdivergent profile. This trend was confirmed by the increase in SpA–SpP/Go–Me (P < 0.05). In agreement with previous studies, the effects of surgical closure of a cleft lip might be responsible for excessive maxillary retropositioning with a downward rotation.