Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population

• Published in: The Cleft palate-craniofacial journal Vol. 60; no. 2; pp. 159 - 167
• Main Authors: Drilleaud, Adrien, Corre, Pierre, Perrin, Jean-Philippe, Loin, Justine, Durand, Thomas, Salagnac, Jean-Michel, Delaire, Jean, Mercier, Jacques-Marie, Bertin, Helios
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-02-2023; SAGE PUBLICATIONS, INC; American Cleft Palate-craniofacial Association
• Subjects: Adult; Birth defects; Cleft Lip - surgery; Cleft Palate - surgery; Cohort analysis; Cohort Studies; Drug Repositioning; Face; Human health and pathology; Humans; Incidence; Life Sciences; Maxilla - surgery; Patients; Reconstructive surgery; Retrospective Studies; cephalometry; osteotomy; nonsyndromic clefting; facial growth
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1177/10556656211056807

Objective
We aimed to evaluate the rate of patient requiring Surgical Repositioning of the Premaxilla in a population carrying BCL  ±  P, retrieve age and operative indication. Our secondary objective was to present further facial growth characteristics.
Settings
This was a retrospective, single-center cohort study conducted in Nantes University Hospital, Oral and Maxillofacial Surgery department, tertiary cleft center.
Patients
Patients with BCL  ±  P born between 1980 and 2019 treated at Nantes University Hospital were included.
Main outcome measure
Our primary outcome measure was the rate of patient requiring SRP.
Results
Over the whole period, 189 patients with BCL  ±  P were identified. Three patients (1,58%) underwent SRP. Patients who underwent SRP all had BCLP. SRP was performed during their primary dentition period. The indication for surgical repositioning was always premaxilla vertical overgrowth with an overbite over 10 mm. Facial growth features in the three patients were mostly comparable with a population carrying BCLP who had no premaxillary surgery.
Conclusion
Our results showed a low incidence of SRP. No SRP was necessary during early infancy (ie, before lip repair) or during adulthood. Surgical repositioning of the premaxilla is beneficial for patient with orthodontically uncorrectable vertical premaxillary excess, even more since facial development compared with other patients with BCLP appears comparable.