Relationship between palate-vomer development and maxillary growth in submucous cleft palate patients

Objective : Experimental and clinical findings suggest that the vomer is involved in facial development and might contribute to the short and retrusive maxilla in cleft patients. The aim of this study was to investigate the relationship between vomer development and maxillary growth in unoperated submucous cleft palate (SMCP) patients. Design : Retrospective cohort study. Participants : Thirty unoperated SMCP patients were included. The criteria for clinical diagnosis were: bifid uvula, a translucent zone in the midline of the soft palate, and a touchable "V" notch on the posterior border of the bony palate. There were 19 female and 11 male patients, with an age range from 3 to 25 years. Interventions : All patients were imaged using spiral computed tomography (CT) while in centric occlusion before the surgeries. Main Outcome Measures : Three-dimensional (3D) reconstruction models were created, and dentoalveolar relationships were rated by three experienced doctors according to the GOSLON score principles. The patients then were divided into three groups: 1 - normal occlusion, 2 - edge-to-edge bite, and 3 - crossbite. The vomer-palate fusion rate was calculated on 3D CT images and represented the vomer development. Results : The sagittal extent of the palatal cleft and the malformation of vomer in SMCP were greatly varied. The vomer-palate fusion rate in the crossbite group (occlusal score = 3) was significantly lower than that in the normal occlusion group (P = .027). Conclusions : Our findings suggest that correlation exists between vomer development and sagittal maxillary growth in unoperated SMCP patients.