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New method to fix cleft palate shows promise in Mayo Clinic lab study

laps of the roof of the mouth are sewn together over the cleft. The actual missing bone is not repaired. Some of the potential downsides of this repair method, according to Dr. Moore, can include leaving exposed areas of hard palate bone, producing scars that sometimes interfere with the child's later midfacial growth. This growth impairment can lead not only to a poor cosmetic appearance, but also can lead to poor contact between lower and upper teeth when the child's mouth is closed. The lack of actual bony repair of the cleft, in addition to the tension placed on the mucosal flaps on the roof of the mouth during traditional cleft palate repair surgery, also increases risk of the wound splitting open or the creation of an abnormal passage between the mouth and nose. The current repair method also may shorten and scar the soft palate, which can impair speech.

The study of this method of cleft palate repair was conducted on 10 adult hounds, due to similarities to the human mouth. Two hounds served as study controls and had a surgically created cleft palate, but no subsequent repair. In the other eight hounds, the distraction osteogenesis device was used to close the cleft palate. In seven of the eight hounds that were treated, the researchers observed some degree of bony closure of the cleft; in five of them the cleft was closed completely with no side effects.

The Mayo Clinic researchers are currently working on perfecting the technique through study of the hounds with incomplete closure. The researchers also felt that the distraction osteogenesis device used in this study was too bulky, so they are now testing another more agile apparatus, says Dr. Moore.

"We continue to work on improving this procedure in the laboratory," says Dr. Tibesar. "We are not ready to perform this yet on human patients, but we are hopeful that day will come soon."

Uldis Bite, M.D., Mayo Clinic plastic surgeon, co-director of Mayo's Cleft Palate/Cran
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Contact: Lisa Lucier
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
22-Jan-2005


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