Craniofacial morphology in children with complete unilateral cleft lip and palate: a comparison of two surgical protocols.

The facial morphology of 2 groups of complete unilateral cleft lip and palate children (n = 75), ranging in age from 4 to 7 years old, were retrospectively studied cephalometrically before the beginning of the orthodontic treatment. Each group was submitted to a different surgical protocol. The control group was comprised of 53 children (33 males and 20 females) and was treated according to the surgical protocol of the Hospital for Rehabilitation of Craniofacial Anomalies (HRCA) from the University of São Paulo, in Bauru, Brazil. Lip repair was performed between 3 months and 27 months of age (mean age of 9 months) and palate repair between 12 months and 44 months of age (mean age of 19 months). The experimental group was comprised of 22 children (12 males and 10 females). They were treated with Malek's surgical protocol, modified at the HRCA, with lip and soft palate repair at 5.5 months of age on average and hard palate repair at 20 months of age on average. The cephalometric results did not show any difference, suggesting that both surgical protocols have the same influence on facial growth, at least during the age range studied. Therefore, palate repair in 2 surgical times with earlier closure of the soft palate (Malek's protocol) did not cause greater restriction to the midface growth.