The need for maxillary osteotomy after primary cleft surgery: A systematic review framing a retrospective study.

OBJECTIVE

This study assessed the rate of maxillary osteotomies after cleft palate surgery following a standardized two-stage palatoplasty protocol. In order to improve our treatment strategy, the results were compared with the data extracted from the literature by means of a systematic review.

DESIGN

Retrospective cohort study.

PATIENTS: Non-syndromic cleft lip, alveolus, and palate patients with complete records who underwent primary cleft palate surgery.

INTERVENTION: The incidence of midface hypoplasia after primary cleft surgery that required surgical intervention was retrospectively evaluated.

RESULTS

Of the final 51 patients included in our retrospective analysis, two required a maxillary repositioning osteotomy. The frequency was lower than reported in the literature. In the literature, there was no difference between patients treated according to a one-stage protocol (21%) and patients treated according to a two-stage protocol (20.8%), but a higher incidence of pharyngeal surgery was noted in the two-stage closure group. Only the cleft type, timing of hard palate closure, and orthodontic treatment proved to influence the need for maxillary osteotomy.

CONCLUSION

Our protocol shows promising results and needs more validation.