Evaluation of Postoperative Outcomes Following Early and Late Palate Repair: A Preclinical Study

Fabiana Aellos; Ishita Verma; Melody Ly; Mackenzie Hoy; Tom Quach; Isabel Rosbander; Alejandro Sandoval; Eppo Wolvis; Hakan Turkkahraman; Jill A Helms

doi:10.1097/SCS.0000000000010827

Evaluation of Postoperative Outcomes Following Early and Late Palate Repair: A Preclinical Study

J Craniofac Surg. 2024 Nov 4. doi: 10.1097/SCS.0000000000010827. Online ahead of print.

Authors

Affiliations

¹ Department of Surgery, Stanford University School of Medicine, Stanford, CA.
² Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
³ School of Medicine, Ludwig-Maximilians-Universität, Munich, Germany.
⁴ Department of Oral and Maxillofacial Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
⁵ Department of Orthodontics and Orofacial Genetics, School of Dentistry, Indiana University, Indianapolis, IN.

PMID: 39499137
DOI: 10.1097/SCS.0000000000010827

Abstract

Objective: To quantitatively assess the impact of early versus late surgical intervention on midfacial growth using a mouse model.

Methods: A full-thickness mucoperiosteal flap surgery was performed on newborn (P17) mice and on neonatal (P30) mice. High-resolution micro-computed tomographic imaging coupled with histomorphometric analyses was used to assess craniomaxillofacial growth. Histology and immunohistochemical analyses were used to assess cellular and molecular responses postsurgery.

Results: Early surgical intervention at P17 resulted in significant midfacial growth arrest, with pronounced maxillary hypoplasia. Histomorphometric analyses revealed significant (P < 0.05) growth disruptions in the mid-palatal suture complex, including premature removal of the cartilaginous growth plate and its replacement by bone. In the suture itself, cell proliferation was significantly reduced (P < 0.05) compared with controls. The same surgical intervention performed in mice at P30 did not lead to significant midfacial growth arrest.

Conclusions: Early surgical intervention in a mouse model mirrors the adverse growth outcomes in children undergoing early cleft repair. Molecular and cellular observations accompanying this midfacial growth arrest may inform therapeutic strategies to mitigate midfacial growth disturbances in patients and highlight the need for refined surgical techniques to minimize adverse growth outcomes.