Tillman KK, Hakelius M, Höijer J, Ramklint M, Ekselius L, Nowinski D, Papadopoulos FC.
JAACAP. 2018 Nov;57(11):876-883
This large nationwide register study sought to investigate the risk of psychiatric disorders among children born with clefts. The results showed that there were increased risks for neurodevelopmental disorders and the risk increases were generally higher for girls than boys. Sibling analyses showed no increased risk of neurodevelopmental disorders among unaffected siblings. These results support the neurodevelopmental hypothesis stating that the events in earlyembryonic life that lead to the cleft malformation may also cause certain disturbances of brain development ultimately leading to psychiatric disorders.
Versnel SL, van den Elzen ME, Wolvius EB, Biesmeijer CS, Vaandrager JM, van der Meulen JC, Mathijssen IM.
J Plast Reconstr Aesthet Surg. 2011 Oct;64(10):1334-43
Twenty-nine adults with an oblique or paramedian cleft are presented and based on their outcome and surgical history, a guideline is provided with the aim to minimize the number of operations and to ameliorate the long-term outcomes. The most significant deformity that persisted is asymmetry of the midface, such as a different position of the orbits in height. This underdevelopment occurs in all three dimensions and is difficult to correct. More definite surgery at adolescence appears to be required to optimize symmetry.
van den Elzen ME, Versnel SL, Wolvius EB, van Veelen ML, Vaandrager JM, van der Meulen JC, Mathijssen IM.
J Plast Reconstr Aesthet Surg. 2011 Oct;64(10):1344-52.
Twenty adults with a symmetrical cleft of the midline are evaluated and based on their outcome and surgical history, a guideline is provided with the aim to minimize the number of operations and to ameliorate the long-term outcomes. The intrinsic growth restriction is mainly situated in the midface, but the severity of the growth restriction varies and is difficult to predict. Results of surgery of the nose at a young age are often disappointing because the result deteriorates with time due to the abnormal growth of the face. Midface advancement and nose correction are preferably done at adolescence for a final and more predictable result.