Umbilical cord stem cells can help early repair of cleft palate

Bogota: Researchers have found that a technique using umbilical cord blood stem cells could be a promising new approach for repair of cleft palate in infants.

Performed as part of reconstructive surgery when the infant is a few months old, the stem cell procedure provides good results in growing new bone to close the upper jaw cleft and may avoid the need for later bone graft surgery, said Alejandro Garcia Botero, from Hospital De San Jose, in Colombia.

In the study, reported in The Journal of Craniofacial Surgery, the team used the stem cell procedure in an infant with cleft lip and palate, diagnosed by ultrasound before birth.

Immediately after delivery, a sample of the infant’s umbilical cord blood — a rich source of various types of stem cells — was collected to isolate stem cells.

For the first few months the infant underwent a nonsurgical “nasoalveolar shaping” procedure to align the soft tissues of the upper jaw.

At age five months, the stem cells were thawed for use as part of “boneless bone grafting” surgery (gingivoperiostioplasty).

The stem cells were placed in a pocket of soft tissue bridging the gap in the upper jaw. A small piece of absorbable biomaterial (Gelfoam) was used as scaffold to guide growth of new bone across the cleft palate. This procedure was performed at the same time as surgery to correct the cleft lip (cheiloplasty).

The surgery led to the formation of new bone to close the cleft palate, providing good position and support for normal eruption of the teeth.

Imaging scans at five years of age showed good thickness of the upper jaw bone in the area where the cleft had been.

According to the researchers, a major advantage of the stem cell procedure is avoiding the need for later bone grafting surgery — currently the standard technique for closing the cleft, which uses bone taken from elsewhere in the child’s body, typically the hip.

Bone grafting has potential complications and subjects the child to one or more additional surgeries.