The purpose of this study was to determine the anatomical differences among selected individuals with a cleft palate repaired using “The Buccal Flap Approach” during primary palatoplasty compared to aged-matched participants without cleft palate.
Design
Observational, prospective.
Setting
Two regional hospitals.
Participants
A total of 30 adult males consisting of 15 adults born with cleft palate who received the Double Opposing Z-Plasty plus Buccal Flaps (DOZP + BF) repair at the time of primary palatoplasty and no history of secondary speech surgery or orthognathic surgery and 15 adults without a history of cleft palate.
Interventions
All participants underwent MRI to visualize anatomy.
Main Outcome Measures
Ten velopharyngeal and craniofacial anatomical measures.
Results
No statistically significant differences between groups were observed for velar thickness, velar length, pharyngeal depth, NSBa angle, SNB angle, or levator veli palatini length. Individuals with the DOZP + BF presented with a greater effective velar length (p < .001), greater effective VP ratio (p < .001), smaller SNA angle (p < .001), and smaller maximal velar stretch (p < .001) compared to the control participants.
Conclusions
This study suggests that adult males who received the DOZP + BF repair at the time of primary palatoplasty and no history of secondary speech surgery or orthognathic surgery present with a longer effective velar length and larger effective VP ratio in comparison to the non-cleft group. Future research is needed to compare patients with and without favorable outcomes from multiple surgical types to fully understand how surgical techniques alter the anatomy.
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