Management of unilateral cleft lip, alveolus and palate patients in Riga Cleft Lip and Palate Centre

Introduction. Children receive all their treatment by the Cleft team established
in Riga in 1964, the only one in Latvia. Importance of record collection and
evaluation of treatment results in patients with completed growth has been
recognised for many years.
The aim of this study was to evaluate the management and long-term treatment
results of patients with unilateral cleft lip, alveolus and palate UCLP.
Methods. All consecutive non-syndromic patients with UCLP, born between 2000
to 2006 and treated by our team were selected. There were 27 patients, 16 male
and 11 female. Routinely collected speech records, lateral cephalograms and
dental casts at 16 to 18 years of age were evaluated.
Results. All 27 patients had lip plastic and primary rhinoplasty at mean age 8.7
months. Two-stage palate closure was performed in 21 patients, starting with
soft palate at mean age 10.7 months, followed by hard palate closure at mean age
41.4 months. In 6 cases, one-stage cleft palate closure was performed at mean
age 47 months. Alveolar bone grafting we performed in 25 patients at mean age
of 96.5 months. Secondary lip revisions and rhinoplasties we did in 13 and 20
patients accordingly. Velopharyngeal flap surgery was done in 4 patients and
closure of residual palate fistula - in 10 patients.
Speech evaluation results in 23 patients demonstrated an accurate speech in 15
(65%), mild hypernasality in 4 (17%) and mild hypernasality with articulation
disorders in 4 (17%) patients.
Growth evaluation results in 19 patient indicated objective need for orthognathic
surgery in 5 (26%) patients.
Conclusions. In non-syndromic UCLP patients treated by our team speech
quality could be considered as good. Maxillary growth at 18 years of age was
comparable with other studies. There were a few patients with no records at 16-
18 years of age.