PURPOSE: The congenital cleft palate model in the caprine species has been previously described by Weinzweig. In utero surgical repair of cleft palate in this model has been successfully demonstrated with resultant scarless palatal healing and unimpaired midfacial growth. The present work evaluated midfacial growth following cleft palate repair in the newborn.

METHODS AND MATERIALS: Time-dated pregnant goats were gavaged twice daily with anabasine, an extract of Nicotiana glauca, during gestational days 32-41 (term, 145 days). At 6 weeks of age, two sets of twins (4 goats) underwent cleft palate repair using a modified von Langenbeck technique. All goats were sacrificed at 6 months of age, and underwent dry skull analysis following debridement and beetle colony preparation.

RESULTS: Multiple parameters on dry skulls were measured to identify pertinent indices of craniofacial growth such as bony cleft width (1), maxillary width (2), and maxillary length (3). Data were collected from four groups: unclefted control, clefted unrepaired, clefted repaired in utero, and clefted repaired at 6 weeks of age. There was evidence of anterior bony cleft narrowing in the groups repaired in utero and at 6 weeks of age by 48% and 32%, respectively. The posterior bony cleft width was also reduced by 60% and 27%, respectively. Maxillary width was decreased in the transverse dimension at the level of the third molar following newborn repair. Maxillary length also demonstrated significant shortening by 11.4% compared to the unclefted control group, and 9.4% compared to the group repaired in utero.

CONCLUSIONS: Significant midfacial growth impairment was demonstrated in animals that underwent cleft palate repair at six weeks of age compared to those repaired in utero. We attribute this to the palatal scarring secondary to surgical manipulation at this point in time.