[Alveolar and hard palate repair by tibial periosteal graft in complete unilateral cleft lip and palate. Long-term follow-up of 51 cases].

PURPOSE OF THE STUDY: The purpose of this study was double: appreciate the osteogenic and growth capacities of the free tibial periosteal graft concerning the alveolar and hard palate repair in the complete unilateral cleft lip and palate, and evaluate long-term follow-up concerning maxillo-mandibular morphology and palatal air-tight.

MATERIAL AND METHOD: This retrospective study concerns 51 patients, of more than 13 years of age, treated for complete unilateral cleft lip and palate. The treatment included a Skoog type cheiloplasty, a tibial periosteal graft between 4 and 6 months (as described by M. Stricker) and a staphyloraphy between 8 and 18 months. Our documentation was: figures, pictures and precise description of the initial cleft, dental casts, teleradiographies, dental panorams performed at different stages of treatment, orthodontic, orthophonic and otologic follow-up. Growth was evaluated using casts during the first 6 years then by profil teleradiographies after puberty. Ossification was evaluated quantitatively by CT scan in 18 patients.

RESULTS

Results confirm an ossification of the periosteal graft in 72% of cases and the advantage of periosteal graft in palatal air-tight. 85% of cases show equilibrated squeletal growth with good occlusion, and 13.7% of cases needed deferral osteotomy.

CONCLUSION

We propose a method for long-term cleft results evaluation, with the use of periosteal graft.