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Craniofacial growth after iatrogenic cleft palate repair in a fetal ovine model.

Controversy exists over the impact of scar formation on craniofacial growth after cleft palate repair. The fetal ovine model presents an opportunity to study a group of animals with little or no scar using cephalometric studies of cranio-facial growth after iatrogenic cleft palate repair. Grossly evident scar is formed in the palates of lambs repaired at 118 days or later in gestation, while those animals operated at 70 and 77 days' gestation exhibited no scar grossly and minimal scar histologically in the submucosa with normal nasal and oral mucosal surfaces. For this study, 15 lambs were studied: four were unoperated, three were operated at 70 days, one at 77 days, and seven had clefts produced and repaired at 118 to 133 days' gestation. The animals were euthanized at 1 month of age and the heads removed and frozen until analyzed. Computerized tomography of the heads was used to create voxel (volume pixel) data sets, and volume rendering and measurement software (Voxblast) was used to create a three-dimensional reconstruction of the skull. Palate measurements were obtained by selecting points on the upper deciduous premolars. A plane was set through the palate and upper deciduous premolars using standard points on the skull to maintain consistent visualization and point selection. The measurements were normalized to skull size measured by the distance between points on the right and left zygomatic bones. Using one-way analysis of variance, followed by a protected t test, no significant differences were found between the means of any measurement in the three treatment groups. Fetal palate repair, with or without scarring, resulted in normal craniofacial growth in the 1-month-old lamb.