Mean tensor cephalometric analysis of a patient population with clefts of the palate and lip

This study was designed to elucidate the net "effect" of primary and secondary palatal clefts on the craniofacial skeleton as viewed in the lateral cephalogram. A tensor cephalometric analysis is reported for 144 patients with cleft lip, cleft palate, or both. The study involves 13 lateral landmarks located in the patients' cephalograms and in the Michigan normative means. The net deformity (total sample) is a reduction of size in all directions, but primarily in the horizontal dimension (ANS-PNS) at the palatal level. Lower face height is affected less than upper face height. The bilateral group shows a considerably greater amount of "net" deformity in the cranial base and reduction in mandibular body length. The effect of cleft of the secondary palate alone is horizontal. The effect of an additional primary cleft is aligned instead vertically in the maxilla and intensifies the reduction of cranial base depth. These findings concur with the literature that attributes these syndromes to different mechanisms with different modes of inheritance.