Craniofacial morphology in unilateral cleft lip and palate prior to palatoplasty.

Roentgencephalometric studies were carried out in 30 boys with unilateral cleft lip and palate approximately five years of age, none of whom had had a palatoplasty. A comparison with 27 normal individuals matched in age showed that most basic deviations of the craniofacial configuration recorded in adults developed at an early age, often prior to palatoplasty, i.e., reduced height of the upper face, maxillary dentoalveolar retroinclination, displacement of the upper jaw backwards, widening of some components of the maxillary complex, and a shortening of the mandibular body and ramus associated with changes in the mandibular shape. Only the length of the upper jaw was not reduced. The shortening of this dimension occurred postoperatively at a more mature age. The described basic deviations exerted untoward effects on further facial parameters (proportions, retrusion of the jaws, limitation of anterior growth rotation, maxillomandibular and other interrelations, and malocclusion). The height of the upper lip showed a similar shortening as in adults, but lip thickness was not reduced. There was good prominence of the upper lip.