Variations in craniofacial morphology with severity of isolated cleft palate

Cephalometric X-ray studies were carried out in 90 adult males with isolated cleft palate operated upon by the same method. The results were evaluated according to the extent of the clefts (complete, incomplete, or soft palate alone). But for a few exceptions the neurocranium and the cranial base showed no substantial deviations. Similarly, as in cleft lip and palate, a shortening of maxillary depth and a deficient mandibular growth were recorded, with no reduction of the vertical growth of the upper face, retroclination of the dentoalveolar maxillary component or increase of the interocular distance noted. No posterior displacement of the maxilla was found. The two observed deviations resulted in the retrusion of the upper and lower jaws, the flattening of the skeletal profile, impaired maxillomandibular relations and limitation of anterior growth rotation. Soft palate clefts were associated with less retrusion of the maxilla, while the growth deficiency of the mandible was even more marked. The least shortening of the mandible occurred in complete clefts. In general, incomplete clefts were associated with the most marked changes. The flattening of the skeletal profile in complete and incomplete clefts was masked by an increased thickness of the upper lip. Soft palate clefts were associated frequently with a shorter and hard palate. Our results were in agreement with experimental knowledge of the role played by the mandible in the development of isolated cleft palate.