**1. Introduction**

Deficiency of growth and development in the midfacial complex is a major drawback of primary CLP repair in the neonatal period of growth, well documented in the literature [1–3]. Causes are thought to be formation of scar tissue in the growth centers of the maxilla [4], mouth breathing due to obstruction of the nasal passage [5], deficiency of the alveolar process due to missing teeth [6], and a tense upper lip [7, 8]. Unrepaired bone defects on the other hand result in closer to normal maxillo-facial development [7, 8]. Because of midfacial deficiency, orthognathic surgery becomes often indispensable at the adult ages in CLP management. Treatment of CLP with orthognathic surgery involves maxillary advancement, distraction osteogenesis, and mandibular setback, combined with orthodontic treatment [9].
