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Cleft Lip and Palate Correction: The Utah Protocol.

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This study presents a new protocol for cleft lip and palate repair, including alveolar bone grafting (ABG). The modified approach shows satisfactory graft outcomes and minimal complications, suggesting improved results over traditional methods.

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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.