The effect of two-stage palatoplasty on facial development in unilateral cleft lip and palate.

Measurements on X-ray films were used for the assessment of facial development in 24 individuals with complete unilateral cleft lip and palate, ranging in age from 10 to 11 years and operated upon in two stages. The suture of the velum was performed simultaneously with cheiloplasty at the age of 7 months, the suture of the hard palate followed at the age of 6 years. They were compared with a series of 27 individuals with the same type of cleft who were subjected to one-stage closure of the palate at the age of 4 years. But for the more favourable occlusion of incisors after two-stage palatoplasty, which was due to the more intense orthodontic therapy, these two series showed no differences in facial growth and development. The delay of surgical repair of the hard palate by two years did not improve the growth and development of jaws. However, it is not possible to exclude favourable effects of a delay of the suture of hard palate into a substantially more mature age.