Vertical changes in the positions of the cleft segments of patients with unilateral cleft lip and palate. Changes from birth to palatoplasty at the age of 10-14 months.

Patients And Method: Clinically discernible vertical deviations of the cleft segments in nasal direction were registered and visualized using model series of 16 patients with unilateral cleft lip and palate. All patients were treated according to the cleft concept of the University of Leipzig, with labioplasty being performed at the age of 4-6 months and palatoplasty at the age of 10-14 months. All patients had a modified Hotz plate inserted until the palate was closed. Casts of a collective of non-cleft infants served as controls. The vertical deviations of the segments from the reference plane, defined by us through the tuber points and the canine point of the non-cleft side, were registered metrically by three-dimensional (3D) measuring of maxillary casts, using a reflex microscope. The registered values were represented three-dimensionally, and the absolute growth was compared with the relative vertical changes.

Results: The results show that 3D representation with superimposition of the individual results offers the clinician clear, continuous monitoring of the treatment progress. In comparison with the control group, the cleft patients showed significantly greater vertical deviations in nasal direction in the region of the incisor and canine points at each observation timepoint. A significant reduction in vertical divergences was recorded only in the region of the cleft pole point of the larger segment during the study period. The results furthermore suggest that investigation of absolute changes in segment positions alone in comparison with relative growth changes may lead to misinterpretations.