Craniofacial growth in bilateral cleft lip and palate: ages six years to adulthood.

The purpose of the study was to localize the characteristic craniofacial abnormalities in young children with complete bilateral cleft lip and palate, to average their growth changes, and to compare all these to observations from a normative sample. A longitudinal sample of 30 males with complete bilateral cleft lip and palate was obtained from the files of the Craniofacial Center at The Hospital for Sick Children, Toronto. An age-matched noncleft control sample was selected from the Burlington Orthodontic Research Center. All individuals had lateral cephalometric radiographs at approximately 6 years, 12 years, and as adults. These were analyzed by cephalometrics and by tensor biometrics. The results of the two methods of analysis were in agreement and tended to complement each other. In the cleft sample, there was little clefting effect on the midline structures of the cranial base; the premaxilla was initially protruded but became normal in the adult; the nasal bone was longer and more protruded; the posterior maxillary segments were hypoplastic and the bony pharynx narrower; there was over-eruption of the posterior teeth; and the mandibular gonial area was smaller.