Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment Eva Hoffmannova a, * , S arka Bejdov a a , Jiri Borský b ,J an Dupej a, c , Veronika Cag a nov a a , Jana Velemínsk a a a Department of Anthropology and Human Genetics, Faculty of Science, Charles University in Prague, Vinicna 7, 128 43, Prague 2, Czech Republic b Department of Otorhinolaryngology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Úvalu 84,150 00, Prague 5, Czech Republic c Department of Software and Computer Science Education, Faculty of Mathematics and Physics, Charles University in Prague, Malostranskenam. 25, 118 00, Prague 1, Czech Republic article info Article history: Received 20 July 2016 Received in revised form 27 August 2016 Accepted 29 August 2016 Available online 31 August 2016 Keywords: Unilateral cleft lip and palate Early neonatal cheiloplasty 3-D geometric morphometry Traditional morphometry Palatal growth abstract Background: A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3) the development of these dimensions compared with published data on noncleft controls and on cUCLP patients operated using later operation protocol (LOP; 6 months of age). Methods: Sixty-six virtual dental models of 33 longitudinally evaluated cUCLP patients were analysed using metric analysis, a dense correspondence model, and multivariate statistics. We compared the palatal surfaces before neonatal cheiloplasty (mean age, 4 days) and before palatoplasty (mean age, 10 months). Results: The palatal form variability of 10-month-old children was considerably reduced during the observed period thanks to their undisturbed growth, that is, the palate underwent the same growth changes following neonatal cheiloplasty. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. The maxilla of cUCLP patients after neonatal cheiloplasty had a growth tendency similar to noncleft controls (unlike LOP). Conclusions: Both methodological approaches showed that early neonatal cheiloplasty in cUCLP patients did not prevent forward growth of the upper jaw segments and did not reduce either the length or width of the maxilla during the first 10 months of life. © 2016 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Orofacial clefts are among the most common craniofacial de- formities [1e3] and are associated with serious orthodontic anomalies [4]. The incidence in the Czech Republic is approximately 1:530 of living newborns. Their background is multifactorial, in other words, orofacial clefts are caused by a combination of genetic and environmental factors [5]. They are the result of hypoplasia of facial prominences and palatal shelves and growth restriction of the mandible [6]. This malformation emerges from approximately the fourth to the eighth week of prenatal development. The range of the affliction varies, being localised to the lip, upper jaw, and palate, separately or in different combinations [1]. Complete uni- lateral cleft lip and palate (cUCLP), the subject of our study, is the most common type of orofacial cleft [7,8]. Treatment of cleft patients should begin as soon as possible [9] and includes surgical repair of the cleft lip, cleft palate, affected nose, along with orthodontic therapy [7]. The surgical treatment goals are mainly to restore the form and function of structures affected by clefting [10] and thus improve facial appearance and, ultimately, influence the psychological impact on the child and * Corresponding author. E-mail address: eva.hoffmannova87@gmail.com (E. Hoffmannova). Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: http://www.ijporlonline.com/ http://dx.doi.org/10.1016/j.ijporl.2016.08.028 0165-5876/© 2016 Elsevier Ireland Ltd. All rights reserved. International Journal of Pediatric Otorhinolaryngology 90 (2016) 71e76