From birth to maturity: a group of patients who have completed their protocol management. Part II. Isolated cleft palate.

Background: The optimal management of the cleft palate patient from birth to completion of treatment continues to present a formidable challenge to the plastic surgeon. The management by multidisciplinary teams is well established, but long-term outcome data of cases managed by protocol remain sparse. This study continues to present the results of the Australian Craniofacial Unit of patients with isolated cleft palate who completed protocol management at the unit under the care of the senior author (D.J.D.) during the 29-year period from 1974 to 2003.

Methods: A retrospective study of the outcomes in relation to facial growth, speech, hearing, and occlusion is presented of patients with an isolated cleft palate.

Results: Thirty-two cases were identified from the departmental database, involving 17 female patients and 15 male patients. Cephalometric analysis at skeletal maturity revealed a range of facial growth, and maxillary advancement surgery was deemed necessary in just two cases. Speech results were evaluated using speech therapy assessments during development and at maturity. At maturity, 18 of 32 patients were assessed as being within normal limits. The hearing was within -20 dB, with just two exceptions.

Conclusions: Overall, these is a range of outcomes, but the results confirm that facial growth does not appear to be adversely affected by use of the pushback technique to reconstruct the palate.