Accuracy of virtual surgical planning-assisted management for maxillary hypoplasia in adult patients with cleft lip and palate

Purpose: Management of maxillary hypoplasia in patients with cleft lip and palate (CLP) remains a significant clinical challenge. The objective of this retrospective study is to evaluate the accuracy of virtual surgical planning (VSP) with different maxillary advancement techniques. Methods: Ninety adult patients with cleft-related maxillary hypoplasia between April 2010 and April 2016 were enrolled in our study. Various surgical techniques including conventional orthognathic surgery, total maxillary distraction osteogenesis, and anterior maxillary segmental distraction were used according to the characteristics of patients. All the cases were aided with VSP and three-dimensional (3D)-printed surgical splints. The virtual surgical plan was compared with the postoperative surgical results by analyzing the positions of several landmarks and planes relative to reference planes. Results: Both the profile and occlusion were improved significantly in all the cases. VSP was successfully transferred to actual surgery with the help of 3D-printed surgical splints in different surgical techniques. Conclusion: Management of cleft-related maxillary hypoplasia requires both comprehensive surgical planning and accurate execution. VSP serves as a viable alternative to conventional model surgery with high accuracy in patients with adult CLP. (c) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.