Cleft Lip and Palate Correction: The Utah Protocol

Area of Science:

• Craniofacial Surgery
• Pediatric Plastic Surgery
• Oral and Maxillofacial Surgery

Background:

• Cleft lip and palate repair timing and techniques are debated in craniofacial surgery.
• Alveolar bone grafting (ABG) is a critical component of comprehensive cleft care.
• Institutions continuously refine protocols for optimal patient outcomes.

Purpose of the Study:

• To present a modified institutional protocol for cleft lip and palate repair.
• To evaluate the outcomes of early hard palate closure with concurrent alveolar bone grafting (ABG).
• To assess graft success and potential complications in treated patients.

Main Methods:

• Retrospective evaluation of 17 patients (20 clefts) treated between 2016-2023.
• Protocol includes lip repair at 3 months, soft palate repair at 1 year, and hard palate closure with ABG at 2 years.
• Analysis of demographic data, clinical records, and graft success metrics.

Main Results:

• Mean graft height and thickness scores were 2.3 and 2.2, respectively.
• Minimal malocclusion and no significant velopharyngeal insufficiency observed.
• Three clefts required potential regrafting due to borderline thickness scores.

Conclusions:

• The modified protocol with early hard palate closure and ABG demonstrates satisfactory graft outcomes.
• The approach appears safe and efficient, potentially offering advantages over conventional methods.
• Long-term follow-up is necessary to fully validate the efficacy of this protocol.