Rate of Orthognathic Surgery Indication in Patients with Complete Bilateral Transforaminal Cleft Treated with the Spina Protocol: A Retrospective Study

Abstract

Introduction

Cleft lip and palate (CLP) is the most common congenital facial deformity, which requires a multidisciplinary and interdisciplinary approach for its management. There is no consensus about the ideal surgical approach of patients with CLP, and the search for the best aesthetic and functional result motivates comparisons between different surgical techniques. An important variable that must be analyzed is the impact of the surgical technique on maxillary growth. The aim of this study is to evaluate the rate of orthognathic surgery indication in patients treated with the Spina protocol.

Methods

This retrospective study was conducted at an academic tertiary care center in Curitiba, PR, Brazil. A total of 3930 medical records were reviewed from the institution's database, resulting in 231 patients with complete bilateral CLP. Among these, 197 were operated on using the Spina protocol and were included in the study.

Results

The literature shows variable rates of orthognathic surgery in patients with complete bilateral transforaminal CLP. In our service, it was observed a 39.59% rate on patients treated according to the Spina protocol. This could be a result of many factors, including the surgical technique, since a significant advantage of the Spina protocol is to enable better maxillary growth, because there is less surgical trauma and fewer displacements in the region.

Conclusions

The application of the Spina protocol in patients with complete bilateral transforaminal CLP resulted in lower rates of maxillary growth alteration and future need for orthognathic surgery.

Keywords

cleft lip - cleft palate - craniofacial abnormalities - oral and maxillofacial - orthognathic surgery - surgeons

Author's Contributions

MAG: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

KG: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

BMA: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, Resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

MCCO: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

LS: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

VCS: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, oftware, supervision, validation, visualization.

DTLP: data analysis and/or interpretation, statistical analysis, final approval of manuscript, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of operations and/or experiments, writing - original draft preparation, writing - review & editing, software, supervision, validation, visualization.

Publication History

Received: 22 September 2024

Accepted: 24 March 2025

Article published online:
23 June 2025

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