Maxillary growth in patients with complete cleft lip and palate, operated on around 4-6 months of age.

Background: The controversy about timing of cleft palate repair has been focused on early closure for improved speech versus delayed repair for enhancing maxillary growth. Early palatal repair enhances phonological development decreasing the frequency of articulation disorders associated with velopharyngeal insufficiency (VPI). In contrast, it has been described that early surgery adversely affects maxillary growth.

Reconstruction of the premaxilla: an option for mutilated bilateral clefts.

The loss of the maxilla is a severe mutilation resulting from inadequate surgery of bilateral clefts of the lip and palate. It is usually associated with palatal fistulae, collapse of the maxillary segments, and limited facial growth.Functional rehabilitation can be achieved by reconstruction of the premaxilla with osteomucosal fibula grafts.