Study on three-dimensional effects of Hotz plate-based two-stage palatoplasty on mid-facial development

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The purpose of this study was to investigate the effects of two-stage palatoplasty combined with Hotz' plate on sagittal mid-facial development in complete unilateral cleft lip and palate (UCLP) individuals.Materials and Methods:The subjects selected for this study were 72 Japanese individuals (age: 9-19 years) divided into Group A (two-stage palatoplasty) consisting of 24 UCLP subjects (12 females and 12 males), Group B (one-stage palatoplasty) consisting of 24 UCLP subjects (12 females and 12 males), Group C (control group) consisting of 24 non cleft subject (12 females and 12 males) who had Class I skeletal relation. The investigation of soft tissue morphology was carried out using a three-dimensional surface scanner (VIVID 700, Minolta. co) and an analyzing soft ware. The 9 corresponding facial measurement points were obtained by intersection of the following planes; 3 vertical planes parallel to mid-sagittal planes through entocanthion, pupulare and ectocanthion, 3 horizontal planes parallel to Frankfort plane through ear rod, alare and mid-point ear rod and alare, respectively. Mid-facial sagittal growth was determined by evaluating the difference of z-coordinates values of 9 corresponding facial measurement points between both sides for each cleft group and between right and left sides for control group. Both side in the cleft group and in the control group were evaluated by student's t-test. The differences among the three groups were statistically compared by ANOVA.Results:The chi-square test using scores gained by each group, revealed significant difference among three groups. Mid-facial sagittal growth was similar on cleft side and non-cleft side or right and left side in two-stage group and control group. Mid facial sagittal growth on non-cleft side was bigger than cleft side in one-stage group.Conclusion:Cleft patients, who undertook two-stage palatoplasty showed a better sagittal mid-facial development than the one with one-stage palatal closure.