The influence of pharyngeal flap on facial growth. Long-term results in the patients with isolated cleft palate.

The facial growth of 22 children from 6 to 17 years of age with repaired isolated cleft palate was studied. Eleven patients had had posterior pharyngeal flap surgery at about 7 years of age and were examined one year before, and three and 10 years after, flap surgery. The other eleven patients served as matched references. The convexity of the facial profile decreased significantly in both groups. There were differences in growth between the two groups in the variables that concerned mandibular position and anterior facial height. The results indicated that the reference individuals had achieved more anterior growth rotation during the development of the face. There was no improvement in mandibular retrognathism in the flap group until the patients were 10 years of age, but the mandible then resumed the normal anterior rotation and had caught up with the reference group after puberty, to result in a facial form with no significant difference from that in adolescents with cleft palate and without pharyngeal flaps. We suggest that the influence of a pharyngeal flap on facial growth has no long term clinical importance in patients with an isolated cleft palate, but the impact of the temporary change in facial growth after pharyngoplasty should be taken into consideration when orthodontic treatment is planned.