The frequency of Le Fort I osteotomy in cleft patients

Introduction: Maxillary hypoplasia is the most frequent seen skeletal malformation in repaired cleft patients, which can be translated into the number of Le Fort I osteotomies (LFI) performed. Aim of this research was to study the incidence of LFI in skeletal full-grown cleft patients treated according to protocol of the Erasmus University Medical Center, Rotterdam, the Netherlands. Possible correlated prognostic factors were assessed.

Methods: Retrospective cohort study of 508 cleft patients born between 01-01-1983 and 31-12-1992. 251 non-syndromic cleft patients fulfilled inclusion criteria.

Results: Overall, 28 of the 251 patients (11.2%) required LFI. The incidence of LFI increased with the severity of the cleft type. The number of previous surgical interventions is significantly higher in cases with an indication for Le Fort I osteotomy ( p < 0.001). The incidence of LFI is significantly higher in male cleft patients ( p < 0.05).

69 of the 251 included cleft patients required pharyngoplasty (27.5%). The LFI frequency of 19% in cleft patients with pharyngeal flap surgery is significantly higher compared to the percentage of 8% LFI in patients without pharyngeal flap surgery.

Conclusion: The frequency of LFI in repaired cleft patients is low compared to previous reports. Possibly, the two-staged palatal closure over several years leaves more room for maxillary growth. The significant difference between cleft lip patients and cleft lip and alveolus patients marks the importance to differentiate between these two cleft types. The significant higher incidence of LFI in patients who underwent pharyngeal flap surgery indicates a negative influence on maxillary outgrowth.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on The frequency of Le Fort I osteotomy in cleft patients
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