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KMID : 1033720120130010004
Archives of Craniofacial Surgery
2012 Volume.13 No. 1 p.4 ~ p.10
Bony Stability and Soft Tissue Changes after Orthognathic Surgery on Patients with Cleft
Shin Hea-Kyeong

Hsieh Yuh-Jia
Liao Yu-Fang
Lo Lun-Jou
Jo Myung-Soo
Abstract
Purpose: The objective of this retrospective study was to assess the skeletal stability after orthognathic surgery for patients with cleft lip and palate. The soft tissue changes in relation to the skeletal movement were also evaluated.

Methods: Thirty one patients with cleft received orthognathic surgery by one surgeon at the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Osseous and soft tissue landmarks were localized on lateral cephalograms taken at preoperative (T0), postoperative (T1), and after completion of orthodontic treatment (T2) stages. Surgical movement (T0-T1) and relapse (T1-T2) were measured and compared.

Results: Mean anteroposterior horizontal advancement of maxilla at point A was 5.5 mm, and the mean horizontal relapse was 0.5 mm (9.1%). The degree of horizontal relapse was found to be correlated to the extent of maxillary advancement. Mean vertical lengthening of maxilla at point A was 3.2 mm, and the mean vertical relapse was 0.6 mm (18.8%). All cases had maxillary clockwise rotation with a mean of 4.4 degrees. The ratio for horizontal advancement of nasal tip/anterior nasal spine was 0.54/1, and the ratio of A¡¯ point/A point was 0.68/1 and 0.69/1 for the upper vermilion/upper incisor tip.

Conclusion: Satisfactory skeletal stability with an acceptable relapse rate was obtained from this study. High soft tissue to skeletal tissue ratios were obtained. Two-jaw surgery, clockwise rotation, rigid fixation, and alar cinch suture appeared to be the contributing factors for favorable results.
KEYWORD
Orthognathic surgery, Cleft lip and palate, LeFort I osteotomy
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