Timing of cleft palate closure should be based on the ratio of the area of the cleft to that of the palatal segments and not on the age alone

Abstract

1. When the ratio of posterior cleft space to the total palatal surface area medial to the alveolar ridges is no more than 10%, it is the best time to surgically close the palatal cleft space. Therefore, one need not wait until 5-9 years of age to close the cleft space in order to maximize palatal growth. 2. Presurgical orthopedics does not stimulate palatal growth beyond its normal growth potential. 3. There is more than one physiological surgical procedure to achieve good palatal growth. 4. Extensive velar flaps with or without palatal pushback surgery is detrimental to palatal growth. © 2006 Springer-Verlag Berlin Heidelberg.