Detailed Cleft Measurements: A Comparison between Isolated Cleft Palates and Cleft Palates Associated with Cleft Lips

Abstract

Objective To determine whether there are differences in the anatomical cleft measurements between patients with isolated cleft palate (CP) with or without Pierre Robin sequence (PR) and those with cleft lip and palate (CLP). Design Prospective case series. Setting Tertiary care university-based medical center. Patients From 1993 to 2012, CP and CLP patients were prospectively enrolled in a database. Main Outcome Measures Several anatomical cleft parameters were recorded with precise measurements at the time of palatoplasty under general anesthesia. Results One hundred twenty-five patients were included in our study: 50 patients in the CP without PR group, 87 patients in the CP with or without PR (CPPR) group, and 38 patients in the CLP group. Patients in the CLP group had increased values for the following parameters compared to patients with CP and patients with CPPR: nasopharyngeal depth ( P = .02 and P = .01, respectively); cleft width at posterior hard palate border ( P < .001 and P < .001); width of the dental arch ( P < .001 and P < .001); and total cleft length ( P < 01 and P < .001). For cleft width at the soft palate level, there was a significant difference between the CP and CLP groups ( P = .005). We found no statistically significant differences between the groups (CLP versus CP and CPPR, respectively) for the length of the soft palate ( P = .74, P = .21) or for the length of the hard palate ( P = .19, P = .08). Conclusion There are significant differences in cleft and palate measurements between CLP and CP patients that may be useful to predict the occurrence of velopharyngeal insufficiency or other complications.