Does the GOSLON yardstick predict the need for orthognathic surgery?

Abstract

The ability of the GOSLON yardstick, scored at nine years of age, to predict the need for orthognathic surgery in a cohort of complete unilateral cleft lip and palate (UCLP) patients treated in the Cleft Lip and Palate (CLP) unit, Princess Margaret Hospital (PMH) for Children, Perth, Western Australia, was assessed. Sixty-six consecutively treated UCLP patients with dental models at age nine and details on referral for orthognathic surgery were retrieved from medical and dental records. Cephalometric appraisal at 18-year-old patients was also conducted. Twenty four of 66 patients were referred for orthognathic surgery at growth completion (36%). Referral pattern stratified by GOSLON scores at age nine found that four of four patients (100%), with a GOSLON score of five, were referred for orthognathic surgery. Eleven of 14 patients (79%) with a GOSLON score of four, four of 16 patients (25%) with a GOSLON score of three and five of 32 patients (15%) with a GOSLON score of two were referred. No patient recorded a GOSLON score of one at age nine. Cephalometric appraisals conducted on 38 subjects at age 18 significantly discriminated the referral group from the non-referral group. Of the 17 patients referred for surgery, eight fulfilled the objective cephalometric criteria for orthognathic surgery, none of the patients who were not referred for orthognathic surgery fulfilled the objective criteria. The GOSLON yardstick was found to be a good predictor of the need for orthognathic surgery at growth completion in our unit.