Our Summary

This research paper focuses on the rates of a type of surgery called orthognathic surgery in patients with different types of cleft lip and palate. Cleft lip and palate is a condition where the child’s lip or mouth does not form properly during pregnancy, leading to a gap in the lip or palate. Midface hypoplasia, or underdevelopment of the middle part of the face, is a common problem that can occur after surgeries to fix this condition.

Orthognathic surgery is often used to correct this and other jaw and face problems. The authors of this paper wanted to understand how often this surgery is needed in patients with different types of cleft lip and palate, to help inform patients and their families about what to expect after the initial surgery. They also wanted to establish a standard measure to evaluate the outcome of different treatment methods.

They reviewed studies from 1987 to 2016 and found that this type of surgery was needed most often in patients with both a cleft lip and palate on both sides (38.1%), followed by those with a cleft lip and palate on one side (30.2%). It was less common in patients with only a cleft palate (4.4%) or a cleft lip (1.8%).

The authors hope that sharing this information will help families understand the likelihood of needing further surgery, and help doctors to evaluate the success of their treatment plans.

FAQs

  1. What is orthognathic surgery and why is it used in patients with cleft lip and palate?
  2. How often is orthognathic surgery needed in patients with different types of cleft lip and palate?
  3. How will the results of this study benefit patients with cleft lip and palate and their families?

Doctor’s Tip

One helpful tip a doctor might tell a patient about orthognathic surgery is to follow all pre-operative and post-operative instructions carefully to ensure the best possible outcome. This may include maintaining a healthy diet, avoiding smoking, and attending all follow-up appointments. Additionally, it is important to communicate openly with your healthcare team about any concerns or questions you may have throughout the process.

Suitable For

Patients who are typically recommended for orthognathic surgery include those with midface hypoplasia, jaw deformities, bite problems, and facial asymmetry. This can include patients with cleft lip and palate, as well as other conditions such as craniofacial syndromes, developmental abnormalities, and traumatic injuries. Orthognathic surgery is often recommended when other treatment options such as orthodontics and orthopedics have been unsuccessful in correcting the underlying issues.

Orthognathic surgery is a complex procedure that involves repositioning the upper jaw (maxilla), lower jaw (mandible), or both to improve facial aesthetics, function, and overall oral health. It is typically performed by a team of specialists including oral and maxillofacial surgeons, orthodontists, and other healthcare professionals.

Overall, patients who are experiencing significant functional or aesthetic issues related to their jaw and facial structure may be recommended for orthognathic surgery. It is important for patients to consult with their healthcare providers to determine if orthognathic surgery is the right treatment option for their specific needs.

Timeline

Timeline of what a patient experiences before and after orthognathic surgery:

Before surgery:

  1. Consultation with a maxillofacial surgeon to discuss treatment options and plan for surgery.
  2. Pre-surgical evaluations such as dental impressions, X-rays, and CT scans to assess the extent of the jaw and face abnormalities.
  3. Orthodontic treatment to align the teeth and prepare the jaw for surgery.
  4. Pre-surgical counseling to discuss the risks, benefits, and expected outcomes of the surgery.

After surgery:

  1. Hospitalization for a few days following the surgery to monitor for any complications and manage pain.
  2. Initial recovery period at home with a specialized diet and pain management medications.
  3. Follow-up appointments with the surgeon and orthodontist to monitor healing progress and adjust treatment as needed.
  4. Physical therapy to regain jaw function and improve speech and chewing ability.
  5. Long-term follow-up care to monitor the stability of the surgical results and address any issues that may arise.

Overall, the entire process of orthognathic surgery can take several months to complete, from the initial consultation to the final follow-up appointments. It is important for patients to follow their healthcare team’s recommendations and attend all scheduled appointments to ensure the best possible outcome from the surgery.

What to Ask Your Doctor

  1. What specific jaw or face problems can orthognathic surgery help correct in my case?
  2. What is the success rate of orthognathic surgery in patients with cleft lip and palate?
  3. What are the potential risks and complications associated with orthognathic surgery?
  4. How long is the recovery process after orthognathic surgery?
  5. Will I need to follow any specific post-operative care instructions or attend any follow-up appointments?
  6. Are there alternative treatment options to orthognathic surgery that I should consider?
  7. Will orthognathic surgery improve my overall facial appearance and function?
  8. How experienced are you in performing orthognathic surgery on patients with cleft lip and palate?
  9. What type of anesthesia will be used during the surgery?
  10. Are there any dietary or lifestyle changes I should make before or after the surgery to ensure optimal results?

Reference

Authors: Choi KJ, Wlodarczyk JR, Nagengast ES, Wolfswinkel E, Munabi NCO, Yao C, Magee WP 3rd. Journal: J Craniofac Surg. 2021 May 1;32(3):902-906. doi: 10.1097/SCS.0000000000007262. PMID: 33235169