Facial growth after pharyngeal flap surgery in cleft palate patients: a five-year longitudinal study

To assess the influence of a pharyngeal flap on facial morphology in patients with cleft lip and palate, we studied prospectively 20 consecutive patients with cleft lip and palate aged 4 to 9 years who needed a pharyngeal flap. We also studied a control group of 20 subjects matched with regard to age, sex, diagnosis, and method of primary treatment. Facial growth was followed for five years, beginning one year before operation. Before operation there was no significant difference between the operated group and the reference group as far as skeletal facial dimensions and angular measurements were concerned. The longitudinal comparison within each group showed that there was a change in mandibular growth direction backwards and downwards in the operated group. The changes in facial growth after pharyngeal flap operation were similar to those reported in patients with enlarged adenoids. Four years after operation, the change in the direction of mandibular growth did not result in any specific facial form that could be identified clinically.