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Corthouts et al. Plast Aesthet Res 2020;7:46 Plastic and
DOI: 10.20517/2347-9264.2020.97 Aesthetic Research

Systematic Review Open Access

Effects of various surgical protocols on maxillofacial
growth in patients with unilateral cleft lip and palate:

a systematic review

Pasquier Corthouts , Fien Boels , Elke Van de Casteele 1,2,3 , Nasser Nadjmi 1,2,3,4
1,#
1,#
1 Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp 2610, Belgium.
2 Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem 2650, Belgium.
3 All for Research VZW, Antwerp 2018, Belgium.
4 Department of Cranio-Maxillofacial Surgery, ZMACK, AZ MONICA Antwerp, Antwerp 2018, Belgium.
# Co first authors.

Correspondence to: Prof. Nasser Nadjmi, Department of Cranio-Maxillofacial Surgery, University of Antwerp, AZ MONICA
Antwerp, Harmoniestraat 68, Antwerp 2018, Belgium. E-mail: nasser@nadjmi.com

How to cite this article: Corthouts P, Boels F, Van de Casteele E, Nadjmi N. Effects of various surgical protocols on maxillofacial
growth in patients with unilateral cleft lip and palate: a systematic review. Plast Aesthet Res 2020;7:46.
http://dx.doi.org/10.20517/2347-9264.2020.97

Received: 28 Apr 2020 First Decision: 6 May 2020 Revised: 8 Jun 2020 Accepted: 24 Jun 2020 Published: 21 Aug 2020
Academic Editor: Carroll Ann Trotman Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: The purpose of this study was to ascertain the effect of surgical procedures and their timing on maxillofacial
growth in unilateral cleft lip and palate (UCLP) patients through a systematic literature review.

Methods: In December 2019, a search was conducted in PubMed and Web of Science on the basis of the keywords:
“UCLP”, “maxillofacial growth” and “facial growth”, complemented by a hand search.

Results: Eleven articles were included. An important finding was the wide range of treatment protocols. Eight
studies performed a multistage procedure, whereas three studies applied a simultaneous repair of cleft lip, palate,
and alveolus in a single surgical session. The findings in these articles were based on cephalometric measures.
Comparative tables were constructed regarding method of study and time and technique of closure.

Conclusion: The results of the articles were conflicting, and it was clear that more research on this subject is
necessary. Overall, most studies agreed on the important factor of palatoplasty in maxillofacial growth. The most
common finding was a retrusive maxillary growth in comparison to a noncleft control group. This was illustrated
by a negative effect on A-point - nasion - B-point. A lot of discussion remains on the effect of lip closure. However,

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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