Orthognathic surgery for the adult patient with cleft lip and palate

A review of the surgical management of adult patients with cleft lip and palate is presented together with the anatomical relationship to surgical procedures. There is still a much higher tendency to relapse after maxillary osteotomy in cleft patients compared to non-cleft patients. However relapse can be reduced by prolonged cranio-maxillary fixation or by direct skeleton fixation with bone plates. Techniques which mobilise the badly scarred palate and avoid dragging it forward with the osteotomy also reduces relapse.