Maxillary hypoplasia in patients with cleft lip and palate deformity--the alternative surgical approach

Modified maxillary osteotomies at Le Fort I, II and III levels, employing transection of the hard palate, have been performed on a group of 42 consecutive patients with maxillary hypoplasia secondary to a cleft lip and palate deformity. The surgical technique has been described, and a pilot study has been made of the results over a period of up to 5 years in order to assess the postoperative stability. The skeletal relapse in the horizontal plane was 13% during the first year, with minimal subsequent relapse. The vertical skeletal relapse over a 4 year period was 20%, and these results compare very favourably with other published reports. The authors conclude that these results are due to a combination of factors, including the modified technique, the postsurgical craniomaxillary fixation and a prolonged period of orthodontic retention.