Fundamentals Cleft Orthognathic Surgery

Orthognathic surgery in the cleft lip and palate population is often necessary to optimize both facial function and aesthetics. Cleft patients commonly present with maxillary hypoplasia, which can be associated with difficulty eating, sleep apnea, as well as an unfavorable facial appearance contributing to psychosocial distress. In order to achieve optimum outcomes, various factors unique to the cleft patient must be considered and incorporated into the treatment plan. The status of any alveolar bone grafting that patients have undergone and the presence of any fistulae must be accounted for. It is critical to work closely with an orthodontist in both the preoperative and postoperative periods to ensure surgical success. Patients should be aware that orthognathic surgery has the potential to alter their speech, worsening velopharyngeal insufficiency in some cases, and be prepared to follow-up with a speech therapist and the rest of the cleft team.