Classification, recording, and cleft palate surgery at the Uppsala Cleft Palate Centre

Area of Science:

• Pediatric Surgery
• Craniofacial Anomalies
• Plastic Surgery

Background:

• Uppsala Cleft Palate Centre utilizes a detailed classification system for isolated cleft palate.
• A longitudinal registration system, established in 1967, tracks patient progress from primary surgery through 20 years of age.
• The system emphasizes therapeutic aspects, reducing radiation exposure by recording every three years.

Purpose of the Study:

• To describe the classification system, recording methods, and surgical techniques for isolated cleft palate in Uppsala.
• To detail the evolution of surgical timing and procedures for cleft palate repair.
• To present a refined approach to managing pediatric cleft palate.

Main Methods:

• Classification based on Kernahan and Stark, and American Cleft Palate Association systems, with hard palate divided into thirds.
• Longitudinal data collection at 5, 8, 11, 14, 17, and 20 years post-primary surgery.
• Surgical techniques evolved from one-stage to two-stage procedures, with adjusted timing for soft and hard palate closure.

Main Results:

• A detailed classification system allows for precise description of cleft morphology.
• The two-stage surgical technique, with soft palate closure at 6 months and hard palate at 2 years, is now standard for children born in 1975 and later.
• Reduced radiation exposure achieved through triennial follow-ups without compromising data reliability.

Conclusions:

• The described classification and longitudinal recording system provide a comprehensive approach to managing isolated cleft palate.
• The evolution of surgical techniques, particularly the two-stage approach with optimized timing, has improved treatment protocols.
• This methodology ensures detailed assessment and effective management of cleft palate in pediatric patients.