Comparison of growth status of

patients with unilateral cleft lip and

palate from two centres practicing two
different primary surgical protocol
• Cleft lip and palate is the most frequently occurring congenital anomaly.
• The primary surgery for cleft lip is done at 6 months of age.
• Followed by surgery of cleft palate at 11-12 months
• Modified von langenback method is followed commonly.
AIM
• The purpose of this research was to compare the growth status of patients with
unilateral cleft lip and palate from two centres (centre A and centre B)
practicing two different primary surgical protocols.

• Centre A follows a surgical procedure involving lip and anterior palate repair at
6 months and 2 flap technique.

• Centre B follows a surgical procedure involving lip without anterior palate

repair at 6 months and 2 flap technique.
MATERIAL AND METHODS:

• STUDY TYPE: cross sectional study

• STATISTICAL ANALYSIS:

• For continuous data, mean and 95% confidence interval will be used. For
dichotomous data, odds ratio with 95% confidence interval will be performed.

• Independent sample t- tests will be used to compare maxillary growth status.

• Chi squared tests will be used to assess nasolabial aesthetic score and Goslon
index scores.

• Silhouette assessment (facial profile- soft tissue) will be analysed using

independent sample t-test
SOURCE OF SAMPLING
• Sample size – 46 patients

• We have based the sample size calculation on data from previous investigation
comparing two different surgical protocols on unilateral complete cleft lip and
palate patients between the age group of 8-10 years.

• We used maxillary growth assessed using cephalometric radiograph (SNA) as

the primary outcome for sample size calculation.

• For a trial with a power of 90%, alpha of 0.05 and an effect size of 0.98, we
need sample of 23 patients in each group.
• Investigation routinely carried out
• 2D radiographs
Details of the study participants:

• INCLUSION CRITERIA:

• Patient age 8-10 years

• Patients with unilateral cleft lip and palate

• EXCLUSION CRITERIA:

• Patients with syndromes or any systemic medical conditions

• Patients with bilateral cleft lip and palate

OUTCOME ASSESSED :

• By ANB and SNA

• Silhouette assessment

• GOSLON INDEX

• Nasolabial aesthetic score-ASHER McDADE

• Speech data
REFERENCES
• 1.The Asher-McDade Aesthetic Index in Comparison With Two Scoring Systems in Nonsyndromic Complete
Unilateral Cleft Lip and Palate Patients D.G.M. Mosmuller, MD, C.L. Bijnen, MD,y G.J.C. Kramer, DDS, PhD,z
M.A. Disse, DDS,z C. Prahl, DDS, PhD,z D.J. Kuik, MSc,§ F.B. Niessen, MD, PhD, and J.P.W. Don Griot, MD,
PhD

• 2.Asher-McDade C, Roberts C, Shaw WC, et al. Development of a method for rating nasolabial appearance in
patients with clefts of the lip and the palate. Cleft Palate Craniofac J 1991;28:385–391

• 3. Cleft Palate Repair: A History of Techniques and Variations Priyanka Naidu, MBChB, MSc,* Caroline A. Yao,
MD, MSc, FACS,† David K. Chong, MBBS, FRACS,‡ and William P. Magee, III, MD, DDS, FACS

• Plast Reconstr Surg Glob Open. 2022 Mar; 10(3): e4019.

• 4. Unilateral Cleft Lip: Principles and Practice of Surgical Management Raymond Tse, MD1 1Division of Plastic
Surgery, Department of Surgery, University of Washington, Seattle, Washington Semin Plast Surg 2012;26:145–
155.

• 5. L Caouette Laberge. Unilateral cleft lip and palate: Simultaneous early repair of the nose, anterior palate and lip.
Can J Plast Surg 2007;15(1):13-18.