Identical twins with bilateral and unilateral clefts: a 20-year study

A pair of monozygotic male twins are presented. One subject, with unilateral left complete cleft lip and palate, underwent lip surgery at 3 months and palate closure at 2 years 2 months. The second twin, with bilateral complete cleft lip and palate, underwent these operations at the same times. His lip was closed in two stages because of the severely forward positioning of the premaxilla, which was surgically set back at 4 years 9 months. Additional surgical intervention involved correction of his nose tip at 8 years 9 months. The findings suggest that surgical intervention of repositioning of the premaxilla in the bilateral cleft twin may have been responsible for the underdeveloped middle third of his face and also for the much shorter anterior lower facial height. In spite of these, this twin presents acceptable final facial and dental results.