Unoperated adult cleft lip and palate: changes in form and function after operation

This report describes the occlusion and craniofacial morphology--together with changes in tongue activity during swallowing before and after surgical correction--in a 26-year-old female patient with unilateral cleft lip and palate. Cross-bites were not observed before or after repair. Lateral cephalometric findings revealed a convex profile with a normal anterior cranial base length, a flat mandibular plane, and a short lower-anterior face height. Preoperative cineradiographic appraisal showed atypical tongue activity during swallowing. The dorsum of the tongue remained high to seal the cleft. The bolus was kept on the floor of the mouth and passed along the lateral margins of the tongue. The swallow duration, as determined by EMG of the tongue, was extremely long when compared with infant-operated cleft lip and palate patients and to noncleft subjects. Postoperatively, tongue function was similar to that in both cleft patients in whom closure was performed in infancy and to noncleft controls.