The incidence of cleft lip/palate is approximately 1/750, making it one of the most common congenital malformations. The primary goal in surgically repairing the palatal cleft is to construct a velopharyngeal port capable of supporting normal non-nasal speech without impairing growth of the face or Dental arches. Adults with unrepaired cleft lip and palate rarely have the recessed midface that too often characterizes the profile of adults whose cleft lip and palate have been repaired in infancy. Factors associated with the surgery are likely the major cause of midface growth disturbance. The University of Florida, in collaboration with the University of Sao Paulo, Bauru, Brazil, is proposing a longitudinal study to determine whether children between 6 and 10 years of age, born with complete unilateral cleft lip and palate, have different facial and/or Dental arch relationships as a function of the surgical techniques used in repairing their lip and/or palate, and/or as a function of their age when they received palatal surgery. This study proposes to enroll the entire patient pool of 475 patients who currently are subjects in an ongoing NIDCR sponsored study in which speech and velopharyngeal outcome measures are being assessed relative to the surgical techniques subjects underwent. Subjects were randomly assigned for lip surgery (Spina vs. Millard technique), palatal surgery (von Langenbeck vs. Furlow procedure), and age of palatal repair (9-12 months vs. 15-18 months). The proposed study will provide data defining the maxillary growth and Dental arch relationships in this very large group of patients, from which conclusions should be possible regarding the relative importance of the Millard or Spina lip repair and the von Langenbeck palatoplasty or the double opposing z-plasty palate repair on facial and Dental arch growth. A secondary part of the study will be a long-term follow-up of velopharyngeal function for speech.
