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| |  Cleft Palate Repair Better When Child Is Older NEW YORK -- May 13, 2008 -- Research presented by Damir Matic, MD, MSc, FRCSC, a scientist with Lawson Health Research Institute, London, Ontario, and Professor, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, also in London, Ontario, suggested that it is best to wait until a child is older to close the gum tissue of the cleft palate. Surgical timing has been a controversial topic with various cleft centres around the world opting for early closure at about 3 to 6 months of age. However, Dr. Matic, using research compiled over the past 20 years, has shown that the best time to close the cleft at the alveolus (gum) in patients with either 1- or 2-sided clefts is at 8 or 9 years of age prior to canine tooth eruption. "We close the lip at 3 months of age, we close the palate at 1 year old, but we don't touch the gum until they are 8 or 9, a time that corresponds to when the adult teeth start to appear," Dr. Matic said. The study represents a significant breakthrough in cleft research involving an unprecedented sample size of 136 children. Dr. Matic and his team looked at a large group of children who had the cleft repair performed early and then compared them to another large group of children who had the repair performed when they were older. "Cleft is the most common facial anomaly and the second most common congenital anomaly among children," Dr. Matic added. "Our research is clinically based in terms of looking at how we can make our repairs better in light of our current knowledge and past discoveries. Based on our data, the downside of early closure is much worse than any potential benefits, and repairing the cleft prior to this time [7-9 years] will damage facial growth." Parts 1 and 2 of the study looked at bone production and facial growth in unilateral clefts and were presented in 2006 and 2007 to the American Cleft-Palate-Craniofacial Association (ACPA). Dr. Matic's research won best paper in the Junior Investigator Competition out of hundreds of submissions from around the world. Part 3 of the study, presented at the April 2008 ACPA meeting in Philadelphia, Pennsylvania, looked at how the repair affects bone production and facial growth in patients with bilateral clefts. At this meeting, Dr. Matic was involved in a panel discussion/debate regarding his research where he recommended the later closure. The overall majority of the participants voted with Dr. Matic, leading to a change in recommendation in the way cleft palates will be treated in hospitals around the world. SOURCE: University of Western Ontario
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