WorldWideScience

Sample records for cleft patient principles

  1. Skeletal facial balance and harmony in the cleft patient: Principles and techniques in orthognathic surgery

    Directory of Open Access Journals (Sweden)

    Salyer Kenneth

    2009-10-01

    Full Text Available The management of the palatal cleft, dental arch, and subsequent maxillary form is a challenge for the craniomaxillofacial surgeon. The purpose of this paper is to present the experience of a senior surgeon (KES who has treated over 2000 patients with cleft lip and palate. This paper focuses on the experience of a recent series of 103 consecutive orthognathic cases treated by one surgeon with a surgical-orthodontic, speech-oriented approach. It will concentrate on not only correcting the occlusion, as others have described, but also on how a surgeon who was trying to achieve optimal aesthetic balance, harmony, and beauty, approached this problem.

  2. Presurgical nasoalveolar moulding treatment in cleft lip and palate patients

    Directory of Open Access Journals (Sweden)

    Grayson Barry

    2009-10-01

    Full Text Available Presurgical infant orthopedics has been employed since 1950 as an adjunctive neonatal therapy for the correction of cleft lip and palate. Most of these therapies did not address deformity of the nasal cartilage in unilateral and bilateral cleft lip and palate as well as the deficiency of the columella tissue in infants with bilateral cleft. The nasolaveolar molding (NAM technique a new approach to presurgical infant orthopedics developed by Grayson reduces the severity of the initial cleft alveolar and nasal deformity. This enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This paper will discuss the appliance design, clinical management and biomechanical principles of nasolaveolar molding therapy. Long term studies on NAM therapy indicate better lip and nasal form, reduced oronasal fistula and labial deformities, 60 % reduction in the need for secondary alveolar bone grafting. No effect on growth of midface in sagittal and vertical plane has been recorded up to the age of 18 yrs. With proper training and clinical skills NAM has demonstrated tremendous benefit to the cleft patients as well as to the surgeon performing the repair.

  3. An Otorhinological study of patients with cleft lip and palate

    OpenAIRE

    Bariar, L. M.; Ahmad, Imran; Sharma, S. C.

    2001-01-01

    32 patients of cleft palate with or without cleft lip were subjected to otorhinological study from January 1998 to September 2000, with special attention to the rhinological anomalies, ear pathology, any deafness, discharge or any other findings relevant to the middle ear. Hearing loss and ear changes were not seen in any patient with cleft lip alone, hence these patients were not included in this study. These changes were confined to the patients with cleft palate only, with or without cleft...

  4. Comparison of periodontal status among patients with cleft lip, cleft palate, and cleft lip along with a cleft in palate and alveolus

    OpenAIRE

    Boloor Vinita; Thomas Biju

    2010-01-01

    Background and Objectives : A healthy periodontium is an important prerequisite for unhindered dentition and long-term oral health. In cleft subjects, especially in those with cleft lip, alveolus and palate (CLAP), maintenance of oral hygiene is a difficult task for the patients because of the patent oro-nasal communication. Crowding of teeth in cleft patients is a common finding, especially in those with CLAP and those with cleft palate (CP). In the case of multiple tooth-malpositions , tran...

  5. Cleft sidedness and congenitally missing teeth in patients with cleft lip and palate patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Jamilian

    2016-05-01

    Full Text Available Abstract Background The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender. Methods The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial tests were used for assessment of the data. Results and conclusions One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients (P < 0.001. This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area.

  6. Comparison of periodontal status among patients with cleft lip, cleft palate, and cleft lip along with a cleft in palate and alveolus

    Directory of Open Access Journals (Sweden)

    Boloor Vinita

    2010-01-01

    Full Text Available Background and Objectives : A healthy periodontium is an important prerequisite for unhindered dentition and long-term oral health. In cleft subjects, especially in those with cleft lip, alveolus and palate (CLAP, maintenance of oral hygiene is a difficult task for the patients because of the patent oro-nasal communication. Crowding of teeth in cleft patients is a common finding, especially in those with CLAP and those with cleft palate (CP. In the case of multiple tooth-malpositions , transverse deficiency, arch length deficiency and primary cross-bite; periodontal trauma increases and is detrimental to periodontal health . According to literature, a critical periodontal situation was found in patients with CLAP. Hence a study was conducted to analyze the periodontal status of patients with cleft lip (CL; those with cleft palate; and those with cleft lip, alveolus and palate. Materials and Methods: The present study consisted of 60 cleft subjects divided into 3 groups: those with cleft lip; those with cleft palate; and those with cleft lip, alveolus and palate. Subjects with permanent dentition were selected, and the clinical examination included determination of oral hygiene status using Oral Hygiene Index - Simplified (OHI-S index and periodontal status using community periodontal index (CPI. Results: Statistically significant increase in the periodontal disease in the CLAP group as compared with the other 2 groups, and the oral hygiene was seen to be generally poor with the CLAP group. Interpretation and Conclusion: Individuals with clefts are more prone to periodontal disease due to the presence of cleft, which causes retention of food in the defect sites and inability to maintain good oral hygiene; but the severity of periodontal disease is more if the defect is large and involving the lip, alveolus and palate.

  7. Influence of lip closure on alveolar cleft width in patients with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Schmelzle Rainer

    2011-01-01

    Full Text Available Abstract Background The influence of surgery on growth and stability after treatment in patients with cleft lip and palate are topics still under discussion. The aim of the present study was to investigate the influence of early lip closure on the width of the alveolar cleft using dental casts. Methods A total of 44 clefts were investigated using plaster casts, 30 unilateral and 7 bilateral clefts. All infants received a passive molding plate a few days after birth. The age at the time of closure of the lip was 2.1 month in average (range 1-6 months. Plaster casts were obtained at the following stages: shortly after birth, prior to lip closure, prior to soft palate closure. We determined the width of the alveolar cleft before lip closure and prior to soft palate closure measuring the alveolar cleft width from the most lateral point of the premaxilla/anterior segment to the most medial point of the smaller segment. Results After lip closure 15 clefts presented with a width of 0 mm, meaning that the mucosa of the segments was almost touching one another. 19 clefts showed a width of up to 2 mm and 10 clefts were still over 2 mm wide. This means a reduction of 0% in 5 clefts, of 1-50% in 6 clefts, of 51-99% in 19 clefts, and of 100% in 14 clefts. Conclusions Early lip closure reduces alveolar cleft width. In most cases our aim of a remaining cleft width of 2 mm or less can be achieved. These are promising conditions for primary alveolar bone grafting to restore the dental bony arch.

  8. Hearing outcomes in patients with cleft lip/palate.

    Science.gov (United States)

    Skuladottir, Hildur; Sivertsen, Ase; Assmus, Jorg; Remme, Asa Rommetveit; Dahlen, Marianne; Vindenes, Hallvard

    2015-03-01

    Objective : Children with cleft lip and palate or cleft palate only have a high incidence of conductive hearing loss from otitis media with effusion. Studies demonstrating longitudinal results are lacking. This study was undertaken to investigate long-term longitudinal hearing outcomes of children with cleft lip and/or cleft palate and cleft palate only. Design : Retrospective chart review. Setting : Clinical charts of patients born with cleft lip and palate or cleft palate only in 1985 to 1994 who were referred to the cleft team in Bergen, Norway. Study findings include 15 years of follow-up. Participants : The study population consisted of 317 children of whom 159 had nonsyndromic cleft lip and palate and 158 had nonsyndromic cleft palate. Main Outcome Measures : Pure tone average calculated from pure tone audiometry at ages 4, 6, and 15 years. Results : The median pure tone average significantly improved with increasing age. For the cleft lip and palate group, the median pure tone average at ages 4, 6, and 15 years was 16 dB hearing level (HL), 13 dB HL, and 9 dB HL, respectively (P ≤ .001). In the cleft palate group the median pure tone average at ages 4, 6, and 15 years was 15 dB HL, 12 dB HL, and 9 dB HL, respectively (P ≤ .001). There was no significant difference in the hearing levels between the two groups. Patients who had surgical closure of the palate at age 18 months had a significantly better pure tone average outcome at age 15 compared with patients who had surgery at 12 months. Conclusions : Hearing improves significantly from childhood to adolescence in patients with cleft lip and palate and cleft palate only.

  9. Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian

    2012-01-01

    Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients......Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients...

  10. Prevalence of congenital heart diseases in oral cleft patients.

    Science.gov (United States)

    Barbosa, M M; Rocha, C M G; Katina, T; Caldas, M; Codorniz, A; Medeiros, C

    2003-01-01

    To establish the prevalence of congenital heart diseases (CHDs) in cleft patients, the type of cleft and the presence of a syndrome were coded in 220 patients. A Doppler echocardiogram with color-flow mapping (DE) was obtained in all patients. Mean age was 112.0 +/- 101.2 months (range, 1-576 months), and 56.8% (125) were males. Cleft lip and palate occurred in 144 patients (65.5%), cleft lip in 40 (18.2%), and cleft palate in 36 (16.4%). Cleft palates were more frequent among females. Twenty-four CHDs were diagnosed in 21 of 220 patients (9.5%): 7 mitral valve prolapses, 6 atrial septal defects, 4 patent ductus arteriosus, 3 ventricular septal defects, 2 cases of tetralogy of Fallot, 1 pulmonary stenosis, and 1 bicuspid aortic valve. The presence of CHD did not correlate with the type of cleft. Syndromes occurred in 28 patients (12.7%), and this association was higher among patients with a cleft palate.

  11. Effects of lip repair on maxillofacial morphology in patients with unilateral cleft lip with or without cleft palate.

    Science.gov (United States)

    Shao, Qinghua; Chen, Zhengxi; Yang, Yang; Chen, Zhenqi

    2014-11-01

    Objective : To evaluate the effects of lip repair on maxillofacial development of patients with unilateral cleft lip with or without cleft palate. Design : Retrospective. Patients : A total of 75 patients were recruited, including 38 surgical patients with complete unilateral cleft lip and alveolus and 37 patients with complete unilateral cleft lip and palate who had lip but not palate repair. As controls, 38 patients with no cleft were selected. All subjects were divided according to two growth stages: before the pubertal peak (GS1) and after the pubertal peak (GS2). Interventions : Lateral cephalograms of all subjects were obtained. Main Outcome Measures : Cephalograms were analyzed and compared in the study and control groups. Results : The patients with unilateral cleft lip and palate in both GS1 and GS2 demonstrated an almost normal maxillary and mandibular growth with retroclined maxillary incisors. The patients with unilateral cleft lip and palate showed a shorter length of maxilla, a more clockwise-rotated mandible, and retroclined maxillary incisors. Conclusions : There was an almost normal maxillary and mandibular growth but retroclined maxillary incisors in patients with cleft lip with or without cleft palate who had received lip repair only, indicating that lip repair may not have a negative impact on the maxillofacial development and influences only the inclination of the maxillary incisors. The shorter anterior-posterior maxillary length and larger gonial angle in patients with unilateral cleft lip and palate compared with those in patients with unilateral cleft lip and alveolus suggest that these variations in maxillary and mandibular growth may be a consequence of the cleft itself.

  12. Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting.

    Science.gov (United States)

    Jabbari, Fatima; Reiser, Erika; Thor, Andreas; Hakelius, Malin; Nowinski, Daniel

    2016-01-01

    Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning.

  13. Nasalance measures in German-speaking cleft patients.

    Science.gov (United States)

    Swennen, Gwen R J; Grimaldi, Hannes; Upheber, Juliane; Kramer, Franz-Josef; Dempf, Rupert

    2004-01-01

    The purpose of this study was to evaluate nasalance measures in German-speaking patients with different types of repaired cleft lip and palate and to find out if significant nasalance gender differences exist in the different cleft groups. A total of 125 German-speaking cleft patients (74 male and 51 female) were included in this study: 18 patients with isolated unilateral cleft lip (UCL; mean age: 13.00 +/- 2.03 years), 66 patients with complete unilateral cleft lip and palate (UCLP; mean age: 14.80 +/- 3.45 years), 25 patients with isolated cleft palate (CP; mean age: 14.60 +/- 3.48 years), and 16 patients with complete bilateral cleft lip and palate (BCLP; mean age: 14.30 +/- 3.61 years). Nasalance data were collected and computed using the NasalView hardware/software system (Fa. Tiger Electronics, Seattle, WA). Speech stimuli according to a modified Heidelberg Rhinophonia Assessment Form (sustained vowels "a," "e," "i," "o," and "u"; oral and nasal sentences; and three oral-nasal reading passages) were used to obtain nasalance scores. Nasalance distance and ratio were also calculated for the oral and nasal sentences and for one of the oral-nasal reading passages. Unpaired t tests showed no significant gender nasalance differences in each cleft group. Analysis of variance showed no significant differences in mean nasalance distance and ratio. For the nasal sentence, a significant difference (P = 0.032) in mean nasalance scores was found between the UCL and UCLP groups.

  14. Assessment of nostril symmetry after primary cleft rhinoplasty in patients with complete unilateral cleft lip and palate

    NARCIS (Netherlands)

    Reddy, S.G.; Devarakonda, V.; Reddy, R.R.

    2013-01-01

    The aim of this study was to assess the nostril symmetry following primary cleft rhinoplasty done with either a dorsal onlay or columellar strut graft in patients with non-syndromic complete unilateral cleft lip and palate. In this retrospective study 30 consecutive patients treated with autogenous

  15. SURGICAL METHODS OF CLEFT LIP, CLEFT PALATE AND COMBINED CLEFT LIP WITH CLEFT PALATE - OUR EXPERIENCE

    OpenAIRE

    Polisetti Ravi; Durga Prasad; Soumya; Krishna Sasanka

    2015-01-01

    INTRODUCTION Cleft lip and cleft palate is the most common congenital malformation of the face and its pattern varies with geography world wide. This study was done in 67 patients presenting to Department of ENT, Santhiram Medical College, Nandyal with cleft deformities to assess the surgical outcome of cleft lip, cleft palate and combined cleft lip cleft palate cases.

  16. A study of nasal cavity volume in patients with cleft lip and palate by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Kenichi [Showa Univ., Tokyo (Japan). School of Medicine

    1996-02-01

    Nasal cavity volume was studied in 11 patients with cleft lip and palate by magnetic resonance imaging. The areas of horizontal sections of the nasal cavity on the cleft and non-cleft sides were measured with the help of a personal computer and image analyzing software. Nasal cavity volume was determined by integrated volume calculation. The volume of each side was measured before and after cleft lip repair. Before cleft lip repair nasal cavity volume on the non-cleft side was larger than on the cleft side. However there was no significant difference in the volume of the cleft and non-cleft sides after cleft lip repair. (author)

  17. Fixed prosthetic treatment in patients with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Bajevska Jagoda

    2017-01-01

    Full Text Available Introduction. The prosthetic treatment of patients with cleft palate includes various treatment options such as fixed partial dentures, removable partial prosthesis, etc. The type of prosthetic appliance is determined by the oral health of each individual and the circumstances. We presented three adult patients with the cleft lip and palate subjected to prosthetic treatment. Case report. From the possible prosthetic solutions according to the conditions in the oral cavity and the circumstances, fixed partial dentures veneered with composite or ceramic were chosen. A proper relationship between the teeth was reached with the fixed partial dentures, and function established, the phonetics improved and satisfying aesthetics effect accomplished improving the profile appearance of the patient’s face. Plastic surgery of the nose was performed after that. Conclusion. Multidisclipinary treatment is necessary for favourable long-term outcome in cleft lip and palate patients.

  18. Assessing Angle's malocclusion among cleft lip and/or palate patients in Jammu

    Science.gov (United States)

    Gupta, Akshay; Gupta, Anur; Bhardwaj, Amit; Vikram, S.; Gomathi, Ajeetha; Singh, Karanprakash

    2016-01-01

    Objective: The study was conducted to examine the patients with abnormalities of cleft lip and/or palate and its association with different types of malocclusion. Materials and Methods: This descriptive study was done among 168 patients with abnormalities of cleft lip and/or palate. Angle's classification of malocclusion was applied for assessment of occlusion as Class I, Class II, and Class III. The types of oral clefts classification such as cleft lip unilateral and cleft lip bilateral, cleft palate (CP), unilateral cleft lip with palate (UCLP) and bilateral cleft lip with palate (BCLP) was considered. Chi-square test was applied to analyze the data at P Class III malocclusion. Conclusion: Cleft lip was the most commonly observed deformity and high frequency of Class II and III malocclusion was evident. Therefore, patients with such abnormalities should be screened timely. PMID:27195223

  19. Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Knudsen, Johan;

    Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients......Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients...

  20. Examine your orofacial cleft patients for Gorlin-Goltz syndrome.

    Science.gov (United States)

    Lambrecht, J T; Kreusch, T

    1997-07-01

    The Gorlin-Goltz syndrome is characterized by four primary symptoms: multiple nevoid basal cell epitheliomas that usually undergo malignant transformation; jaw keratocysts that show constant growth; skeletal anomalies; and intracranial calcifications. A myriad of additional findings may also be noted. Among the most frequent are: palmar and plantar pits, a characteristic flattened facies and broad nasal root, frontal and parietal bossing, mandibular prognathia, hypertelorism, strabismus, dystrophia of the canthi, and clefts of the lip, alveolus, and/or palate. In this study, we review the literature and our 25 cases of Gorlin-Goltz syndrome patients, questioning their incidence of cleft formations (8.5%) as compared to the general population (0.1%). It is our contention that all patients who present with an orofacial cleft warrant deeper investigation as to the presence of additional signs indicative of Gorlin-Goltz syndrome. The nevi turn malignant with time, and thus, early diagnosis, follow-up, and treatment are imperative.

  1. Surgical management of cleft lip in pedo-patients.

    Science.gov (United States)

    Taware, C P; Kulkarni, S R

    1991-01-01

    The Present article describes in short etiology of cleft lip and cleft palate. With this in-born defect, patient develops crucial problems with feeding, phonation, overall growth and development of affected and allied soft and hard tissue structures. This in turn results in deformity and asymmetry which is going to affect functional requirements as well as aesthetic outlook. Hence it really becomes mandatory to correct this defect surgically as early as possible, at stipulated timings so as to avoid present and future anticipated problems.

  2. An illusionary prosthetic design for a unilateral cleft palate patient

    Directory of Open Access Journals (Sweden)

    Andaç Barkın Bavbek

    2014-01-01

    Full Text Available The prosthetic rehabilitation is an important part of the cleft lip and palate therapy assisting orthodontic and orthognathic treatments. Prosthesis does not only help to improve function and aesthetics but also needs to facilitate a better oral health. The aim of this report is to introduce the prosthetic approach of a 21-year-old female unilateral cleft palate patient that considered reinforcing the mobile canine adjacent to the cleft, easing the elimination of dental plaque from the remaining fistula and reaching an accurate occlusion. Facial aesthetics was established by the illusionary effect of a removable crown complex which is joined onto a fixed partial denture with a precision attachment system.

  3. Oblique lip-alveolar banding in patients with cleft lip and palate.

    Science.gov (United States)

    Naidoo, S; Bütow, K-W

    2015-04-01

    We report an oblique lip-alveolar band, a rare banding of soft tissue that involves the lip and alveolus, which we have found in five patients with cleft lip and palate (0.2%), compared with an incidence of the Simonartz lip-lip band of 5.7%). To our knowledge this has not been reported previously. In two patients the bands affected the cleft lip and alveolus bilaterally, with or without the palatal cleft, and in three the bands were unilateral cleft lip and alveolus with or without the palatal cleft.

  4. A Review of Hearing Loss in Cleft Palate Patients

    Directory of Open Access Journals (Sweden)

    Bilal Gani

    2012-01-01

    Full Text Available Background. Cleft palate is associated with recurrent otitis media with effusion and hearing loss. This study analysed the way these patients’ hearing is managed in Alder Hey Children’s Hospital. Method. A retrospective audit was carried out on cleft palate patients in Alder Hey Children’s Hospital. Audiology assessment and treatment options were reviewed. Comparisons were made between the use of ventilation tubes (VTs and hearing aids (HAs. The types of cleft, types of hearing loss, and the management output of the audiology regions were also reviewed. Results. The audiology assessments of 254 patients were examined. The incidence of VT insertion in this group of patients was 18.9%. The hearing aid incidence rate was 10.1%. The VT-related complication rate was 25.5% and the HA related complication rate was 9.1%. Conclusion. The data demonstrates that both treatments are viable, and a new protocol which combines the short term benefit of VT insertion with the lower complication rate of HA is required.

  5. 3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

    Energy Technology Data Exchange (ETDEWEB)

    Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki [Showa Univ., Tokyo (Japan). School of Medicine

    2001-04-01

    Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

  6. Application of high resolution SNP arrays in patients with congenital oral clefts in south China

    Indian Academy of Sciences (India)

    TING-YING LEI; HONG-TAO WANG; FAN LI; YING-QIU CUI; FANG FU; RU LI; CAN LIAO

    2016-12-01

    Chromosome microarray analysis (CMA) has proven to be a powerful tool in postnatal patients with intellectual disabilities. However, the diagnostic capability of CMA in patients with congenital oral clefts remain mysterious. Here, we present ourclinical experience in implementing whole-genome high-resolution SNP arrays to investigate 33 patients with syndromic and nonsyndromic oral clefts in whom standard karyotyping analyses showed normal karyotypes. We aim to identify the genomic aetiology and candidate genes in patients with congenital oral clefts. CMA revealed copy number variants (CNVs) in every patient, which ranged from 2 to 9 per sample. The size of detected CNVs varied from 100 to 3.2 Mb. In 33 patients, we identified six clinically significant CNVs. The incidence of clinically significant CNVs was 18.2% (6/33). Three of these six CNVs were detected in patients with nonsyndromic clefts, including one who presented with isolated cleft lip with cleft palate (CLP) and two with cleft palate only (CPO). The remaining three CNVs were detected in patients with syndromic clefts. However, no CNV was detected in patients with cleft lip only (CLO). The six clinically significant CNVs were as follows: 8p23.1 microduplication (198 kb); 10q22.2-q22.3 microdeletion (1766 kb); 18q12.3 microduplication (638 kb); 20p12.1 microdeletion (184 kb); 6q26 microdeletion (389 kb); and 22q11.21-q11.23 microdeletion (3163 kb). In addition, two novel candidate genes for oral clefts, KAT6B and MACROD2, were putatively identified. We also found a CNV of unknown clinical significance witha detection rate of 3.0% (1/33). Our results further support the notion that CNVs significantly contributed to the genetic aetiology of oral clefts and emphasize the efficacy of whole-genome high-resolution SNP arrays to detect novel candidate genes in patients with syndromic and nonsyndromic clefts.

  7. Orthodontic treatment results following grafting autologous mandibular bone to the alveolar cleft in patients with a complete unilateral cleft.

    NARCIS (Netherlands)

    Ruiter, A. de; Bilt, A. van der; Meijer, G.J.; Koole, R.

    2010-01-01

    OBJECTIVE: To analyze orthodontic treatment results following mandibular symphysis bone grafting and postoperative orthodontic treatment. DESIGN: Randomized selection of 75 patients out of 308 with unilateral cleft of lip, alveolus, and palate, operated upon according to protocol between 1990 and 20

  8. Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... health conditions > Cleft lip and cleft palate Cleft lip and cleft palate E-mail to a friend Please fill ... repair cleft lip and palate. What are cleft lip and cleft palate? Cleft lip is a birth defect in ...

  9. A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Küseler, Annelise

    2012-01-01

    A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla......A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla...

  10. Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients

    NARCIS (Netherlands)

    Booij, A; Raghoebar, GM; Jansma, J; Kalk, WWI; Vissink, A

    2005-01-01

    Objective: The aim of this study was to evaluate the objective and subjective morbidity of symphyseal chin bone harvesting used for reconstruction of alveolar defects in young cleft patients. Design: All patients who had undergone chin bone harvesting for alveolar cleft reconstruction in the period

  11. The Role of the Velopharyngeal Sphincter in the Speech of Patients with Cleft Palate or Cleft Lip and Palate Using Perceptual Methods

    OpenAIRE

    Tatjana Georgievska-Jancheska; Juliana Gjorgova; Mirjana Popovska

    2016-01-01

    BACKGROUND: The velopharyngeal sphincter (VPS) plays the main role in speech formation. The cleft palate, due to the damage of the soft palate, leads to dysfunction of the velopharyngeal sphincter thus causing speech disorder. AIM: To establish a link between the nasal air escape and the perceptual symptoms in the speech of patients with cleft palate or cleft lip and palate using auditory-visual perceptual procedures for determining the influence the velopharyngeal dysfunction has on spee...

  12. Nasopharyngeal Development in Patients with Cleft Lip and Palate: A Retrospective Case-Control Study

    Directory of Open Access Journals (Sweden)

    Kai Wermker

    2012-01-01

    Full Text Available Introduction. The aim of this paper was to evaluate cephalometrically the nasopharyngeal development of patients with complete unilateral cleft lip and palate. Influencing factors were evaluated and cleft to noncleft subjects were compared to each other. Material and Methods. The lateral cephalograms of 66 patients with complete cleft lip and palate were measured and compared retrospectively to the cephalograms of 123 healthy probands. Measurements were derived from a standardized analysis of 56 landmarks. Results. We observed significant differences between cleft and control group: the cleft patients showed amaxillary retroposition and a reduced maxillary length; the inclination of the maxilla was significantly more posterior and cranial; the anterior nasopharyngeal height was reduced; the nasopharyngeal growth followed a vertical tendency with reduced sagittal dimensions concerning hard and soft tissue. The velum length was reduced. In the cleft group, an accumulation of mandibular retrognathia and an anterior position of the hyoid were observed. Skeletal configuration and type of growth were predominantly vertical. Conclusions. Our data provides a fundamental radiological analysis of the nasopharyngeal development in cleft patients. It confirms the lateral cephalogram as a basic diagnostic device in the analysis of nasopharyngeal and skeletal growth in cleft patients.

  13. Comparison of oral hygiene and periodontal status in patients with clefts of palate and patients with unilateral cleft lip, palate and alveolus

    Directory of Open Access Journals (Sweden)

    Mutthineni Ramesh

    2010-01-01

    Full Text Available Aim: This study was conducted to analyze and compare the oral hygiene and periodontal status in patients with clefts of palate (CP and patients with unilateral cleft lip, palate and alveolus (UCLPA. Materials and Methods: The study group consisted of 120 cleft patients. Subjects were divided into two groups of 60 each. Group I - patients with UCLPA and Group II - patients with CP. For comparison, all the four quadrants were defined, Q1-right upper quadrant, Q2-left upper quadrant, Q3-left lower quadrant and Q4-right lower quadrant, in both groups and the following parameters were recorded: Plaque Index (PI, Silness and Loe, Sulcus Bleeding Index (SBI, Muhlemann and Son, Probing Pocket Depth (PPD, Clinical Attachment Level (CAL, Mobility Index (Miller and Radiographic Amount of Bone Loss. Results: The periodontal destruction was seen to be higher in UCLPA patients compared with CP patients. The poor oral hygiene status, as indicated by higher values of PI, and the periodontal status, evaluated by SBI, PPD, CAL, mobility and Radiographic Amount of Bone Loss, were higher in patients with UCLPA than in patients with CP. Conclusion: In this study, patients with cleft lip, palate and alveolus had poor oral hygiene and periodontal status compared with patients with cleft palate.

  14. Long-term outcome of secondary alveolar bone grafting in cleft lip and palate patients

    DEFF Research Database (Denmark)

    Meyer, Steffen; Pedersen, Kirsten Mølsted

    2013-01-01

    The objective was to assess the long-term outcome of secondary alveolar bone grafting (SABG) in cleft lip and palate patients and to examine relationships between preoperative and postoperative factors and overall long-term bone graft success. The records of 97 patients with cleft lip and palate......, who had secondary alveolar bone grafting of 123 alveolar clefts, were examined. Interalveolar bone height was assessed radiographically a minimum of 10 years after grafting using a 4-point scale (I-IV), where types I and II were considered a success. After an average follow-up of 16 years after SABG...... to the cleft. No significant differences were found with regard to the other parameters investigated. The timing of secondary alveolar bone grafting is critical with regard to the age of the patient and the stage of eruption of the tooth distal to the cleft....

  15. Cone-Beam Computed Tomography Assessment of Lower Facial Asymmetry in Unilateral Cleft Lip and Palate and Non-Cleft Patients with Class III Skeletal Relationship.

    Directory of Open Access Journals (Sweden)

    Yifan Lin

    Full Text Available To evaluate, using cone-beam computed tomography (CBCT, both the condylar-fossa relationships and the mandibular and condylar asymmetries between unilateral cleft lip and palate (UCLP patients and non-cleft patients with class III skeletal relationship, and to investigate the factors of asymmetry contributing to chin deviation.The UCLP and non-cleft groups consisted of 30 and 40 subjects, respectively, in mixed dentition with class III skeletal relationships. Condylar-fossa relationships and the dimensional and positional asymmetries of the condyles and mandibles were examined using CBCT. Intra-group differences were compared between two sides in both groups using a paired t-test. Furthermore, correlations between each measurement and chin deviation were assessed.It was observed that 90% of UCLP and 67.5% of non-cleft subjects had both condyles centered, and no significant asymmetry was found. The axial angle and the condylar center distances to the midsagittal plane were significantly greater on the cleft side than on the non-cleft side (P=0.001 and P=0.028, respectively and were positively correlated with chin deviation in the UCLP group. Except for a larger gonial angle on the cleft side, the two groups presented with consistent asymmetries showing shorter mandibular bodies and total mandibular lengths on the cleft (deviated side. The average chin deviation was 1.63 mm to the cleft side, and the average absolute chin deviation was significantly greater in the UCLP group than in the non-cleft group (P=0.037.Compared with non-cleft subjects with similar class III skeletal relationships, the subjects with UCLP showed more severe lower facial asymmetry. The subjects with UCLP presented with more asymmetrical positions and rotations of the condyles on axial slices, which were positively correlated with chin deviation.

  16. Prosthetic Modalities Used to Treat Cleft Palate Patients in a University Clinic: A 10-Year Review

    OpenAIRE

    Kranjčić, Josip; Žabarović, Domagoj; Čelebić, Asja; Mehulić, Ketij; Komar, Daniel; Vojvodić, Denis

    2013-01-01

    Cleft palate patients are not usually seen in general dental clinics, but this congenital anomaly is one of the most frequent of cases. General dental practitioners are usually unwilling or/and not sufficiently trained to treat such patients for whom rehabilitation and interdisciplinary cooperation is often needed. The aim of this study was to determine the incidence of prosthetic modalities most frequently used by licensed prosthodontists for prosthetic rehabilitation of cleft palate patient...

  17. Genetics and Management of the Patient with Orofacial Cleft

    Directory of Open Access Journals (Sweden)

    Luciano Abreu Brito

    2012-01-01

    Full Text Available Cleft lip or palate (CL/P is a common facial defect present in 1 : 700 live births and results in substantial burden to patients. There are more than 500 CL/P syndromes described, the causes of which may be single-gene mutations, chromosomopathies, and exposure to teratogens. Part of the most prevalent syndromic CL/P has known etiology. Nonsyndromic CL/P, on the other hand, is a complex disorder, whose etiology is still poorly understood. Recent genome-wide association studies have contributed to the elucidation of the genetic causes, by raising reproducible susceptibility genetic variants; their etiopathogenic roles, however, are difficult to predict, as in the case of the chromosomal region 8q24, the most corroborated locus predisposing to nonsyndromic CL/P. Knowing the genetic causes of CL/P will directly impact the genetic counseling, by estimating precise recurrence risks, and the patient management, since the patient, followup may be partially influenced by their genetic background. This paper focuses on the genetic causes of important syndromic CL/P forms (van der Woude syndrome, 22q11 deletion syndrome, and Robin sequence-associated syndromes and depicts the recent findings in nonsyndromic CL/P research, addressing issues in the conduct of the geneticist.

  18. DENTAL CAST STUDY OF ADULT PATIENTS WITH UNTREATED UNILATERAL CLEFT-LIP OR CLEFT-LIP AND PALATE IN INDONESIA COMPARED WITH SURGICALLY TREATED PATIENTS IN THE NETHERLANDS

    NARCIS (Netherlands)

    SPAUWEN, PHM; HARDJOWASITO, W; BOERSMA, J; LATIEF, BS

    1993-01-01

    To determine differences in maxillary and dentoalveolar relationships between untreated and treated patients having unilateral clefts of the lip and alveolus (UCLA) or lip and palate (UCLP), dental cast assessments were done on 70 untreated adult Indonesian patients (UCLA-I, UCLP-I) and 67 Dutch pat

  19. Dual embryonic origin of maxillary lateral incisors: clinical implications in patients with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Daniela Gamba Garib

    2015-10-01

    Full Text Available Introduction:Cleft lip and palate are craniofacial anomalies highly prevalent in the overall population. In oral clefts involving the alveolar ridge, variations of number, shape, size and position are observed in maxillary lateral incisors. The objective of this manuscript is to elucidate the embryonic origin of maxillary lateral incisors in order to understand the etiology of these variations.Contextualization: The hypothesis that orofacial clefts would split maxillary lateral incisor buds has been previously reported. However, recent studies showed that maxillary lateral incisors have dual embryonic origin, being partially formed by both the medial nasal process and the maxillary process. In other words, the mesial half of the lateral incisor seems to come from the medial nasal process while the distal half of the lateral incisor originates from the maxillary process. In cleft patients, these processes do not fuse, which results in different numerical and positional patterns for lateral incisors relating to the alveolar cleft. In addition to these considerations, this study proposes a nomenclature for maxillary lateral incisors in patients with cleft lip and palate, based on embryology and lateral incisors position in relation to the alveolar cleft.Conclusion:Embryological knowledge on the dual origin of maxillary lateral incisors and the use of a proper nomenclature for their numerical and positional variations renders appropriate communication among professionals and treatment planning easier, in addition to standardizing research analysis.

  20. Three-dimensional quantitative evaluation of facial morphology in adults with unilateral cleft lip and palate, and patients without clefts.

    Science.gov (United States)

    Othman, Siti Adibah; Ahmad, Roshahida; Asi, Salina Mohd; Ismail, Nor Hidayah; Rahman, Zainal Ariff Abdul

    2014-03-01

    The aims of this study were to assess the quantitative values of measurements using proportion indices in the craniofacial region in patients with repaired, non-syndromic, complete unilateral cleft lip and palate (UCLP), and compare them with a control group who did not have clefts using the non-invasive systems of 3-dimensional technology. Three-dimensional measurements of the facial surfaces of 15 Malay patients who had UCLP repaired and 100 Malay control patients aged 18-25 years were analysed. The 3-dimensional images of the respondents' faces were captured using the VECTRA-3D Stereophotogrammetry System. Eleven craniofacial proportions were assessed using a combination of 18 linear measurements obtained from 21 anthropometric soft tissue landmarks. These measurements were used to produce proportion indices to find the differences in the morphological features between the groups, and assessed using the independent sample t test and z scores. There were significant differences between the groups in 7 out of 11 craniofacial proportion indices (p=0.001-0.044). Z scores of 2 indices were disproportionate. They were nasal index (which was severely supernormal) and upper lip index (which was moderately supernormal). Patients with UCLP had higher mean z scores, indicating that patients with UCLP tended to have larger faces than the control group. There were clinically important differences mainly in the nasolabial area, where the nose and the upper lip were wider, larger, or flatter in patients with UCLP.

  1. Alveolar distraction osteogenesis applications in cleft lip and palate patients: a literature review

    Directory of Open Access Journals (Sweden)

    Öznur Mülayim

    2016-05-01

    Full Text Available Distraction osteogenesis technique has been successfully applied in the craniofacial area for long time, and it is being applied increasingly more in cleft lip and palate patients also. Especially in large cleft palate cases, bone grafting or surgical procedures such as distraction osteogenesis can be applied in order to ensure a smooth alveolar arc. In this literature review, alveolar (segmental distraction osteogenesis applications in patients with cleft lip and palate, indications of the technique, advantages and disadvantages, application methods and types of appliances used for this purpose have been evaluated. As conclusion, especially with the application of alveolar (segmental distraction osteogenesis, successful outcome can be achieved in cleft lip and palate patients with velopharyngeal insufficiency, maxillary hypoplasia and maxillary crowding, and this technique may be an alternative to conventional osteotomies and extraoral distractions.

  2. Repair of bilateral clefts of lip, alveolus and palate. Part 1: A refined method for the lip-adhesion in bilateral cleft lip and palate patients.

    Science.gov (United States)

    Bitter, K

    2001-02-01

    The protruding premaxilla represents the most severe problem in the surgical closure of a bilateral cleft lip, alveolus and palate (BCLP). In principle there are two methods to overcome this obstacle: (1) preliminary lip adhesion and (2) presurgical repositioning with intraoral devices. According to the various degrees of premaxillary protrusion, sometimes adhesion alone is sufficient, if the surgical technique is unlikely to break down. In this paper a refined adhesion method is presented, withstanding traction to the wound margins and concomitantly enables lip and nose repairs in a single second operation. For patients with severe premaxillary protrusion, presurgical use of a Latham appliance achieves conditions for safe lip adhesion as above. Both treatment methods are outlined.

  3. Bony defect of palate and vomer in submucous cleft palate patients.

    Science.gov (United States)

    Ren, S; Ma, L; Zhou, X; Sun, Z

    2015-01-01

    The aim of this study was to visualize bony defects of the palate and vomer in submucous cleft palate patients (SMCP) by three-dimensional (3D) computed tomography (CT) reconstruction and to classify the range of bony defects. Forty-eight consecutive non-operated SMCP patients were included. Diagnosis was based on the presence of at least one of three classical signs of SMCP: bifid uvula, a translucent zone in the midline of the soft palate, and a palpable 'V' notch on the posterior border of the bony palate. Patients were imaged using spiral CT. 3D reconstruction models were created of the palate and vomer. The sagittal extent of the bony cleft in SMCP was classified into four types: type I, no V-shaped hard palate cleft (8.3%); type II, cleft involving the partial palate (43.8%); type III, cleft involving the complete palate and extending to the incisive foramen (43.8%); type IV, cleft involving the complete palate and the alveolar bone (4.2%). The extent of the vomer defect was classified into three types: type A, vomer completely fused with the palate (8.3%); type B, vomer partially fused with the palate (43.8%); type C, vomer not fused with the palate up to the incisive foramen (47.9%). Significant variability in hard palate defects in SMCP is the rule rather than the exception. The association of velopharyngeal insufficiency with anatomical malformations may be complex.

  4. A new primary cleft lip repair technique tailored for Asian patients that combines three surgical concepts: Comparison with rotation--advancement and straight-line methods.

    Science.gov (United States)

    Funayama, Emi; Yamamoto, Yuhei; Furukawa, Hiroshi; Murao, Naoki; Shichinohe, Ryuji; Hayashi, Toshihiko; Oyama, Akihiko

    2016-01-01

    Various techniques have been described for unilateral cleft lip repair. These may be broadly classified into three types of procedure/concept: the straight-line method (SL; Rose-Thompson effect); rotation-advancement (RA; upper-lip Z-plasty); and the triangular flap method (TA; lower-lip Z-plasty). Based on these procedures, cleft lip repair has evolved in recent decades. The cleft lip repair method in our institution has also undergone several changes. However, we have found that further modifications are needed for Asian patients who have wider philtral dimples and columns than Caucasians, while following the principles of the original techniques mentioned above. Here, we have incorporated the advantages of each procedure and propose a refined hybrid operating technique, seeking a more appropriate procedure for Asian patients. To evaluate our new technique, a comparison study was performed to evaluate RA, SL, and our technique. We have used our new technique to treat 137 consecutive cleft lip cases of all types and degrees of severity, with or without a cleft palate, since 2009. In the time since we adopted the hybrid technique, we have observed improved esthetics of the repaired lip. Our technique demonstrated higher glance impression average scores than RA/SL.

  5. Speech and language in the patient with cleft palate.

    Science.gov (United States)

    Mildinhall, Sue

    2012-01-01

    This chapter describes the normal development of speech and speech problems that may arise for the child born with cleft lip and/or palate. It describes current trends and the importance of multidisciplinary working in this complex field. The contribution of the speech and language therapist to the management of this population is considered.

  6. Nasoalveolar molding in cleft care--experience in 40 patients from a single centre in Germany.

    Directory of Open Access Journals (Sweden)

    Andrea Rau

    Full Text Available Nasoalveolar molding (NAM has gained wide acceptance and evidence in cleft therapy. However, standardized treatment protocols and experiences recorded from European centres are lacking. The results of 40 infants with cleft lip and palate treated with presurgical NAM according to the Grayson technique were analyzed. Standardized parameters of cleft width and nasal symmetry were measured in pre- and posttreatment plaster casts and in digitalized 3-dimensional STL models. Statistical analyses were performed by using Student's t-test in a per-protocol manner. 27 out of 40 infants completed NAM and were analyzed. In 13 patients NAM was either temporarily interrupted or terminated prematurely due to skin irritations or lack of parental support. These cases were excluded from statistical analysis, resulting in a drop-out rate of 32.5%. Intersegmental alveolar distance (ISAD, intersegmental lip distance (ISLD, nostril height (NH, nostril width (NW and columella deviation angle (CDA were significantly changed in unilateral cleft lip and palate (UCLP (n = 8. In unilateral cleft lip (UCL (n = 9, only ISLD, NH and CDA were significantly changed. ISAD of the right and left side, ISLD of the right and left side, premaxilla deviation angle, nostril height and columella length were changed significantly in bilateral cleft lip and palate (BCLP cases (n = 10. NAM is a suitable presurgical treatment modality. A positive effect has been seen in UCLP and BCLP infants, as compared with their birth status.

  7. Comparative study of nasoalveolar molding methods: nasal elevator plus DynaCleft® versus NAM-Grayson in patients with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Monasterio, Luis; Ford, Alison; Gutiérrez, Carolina; Tastets, María Eugenia; García, Jacqueline

    2013-09-01

    Objective : To compare nasoalveolar molding (NAM) effect employing a nasal elevator plus DynaCleft® and NAM-Grayson system in patients with complete unilateral cleft lip and palate. Method : Prospective study in two groups. Group A included 20 consecutive patients treated with DynaCleft® and a nasal elevator before lip surgery. Group B included 20 patients treated with NAM-Grayson system. Maxillary casts and standard view photographs were done before and after treatment. Columella deviation angle, soft tissue distance of the cleft, intercommisural distance, and nostril height and width were traced and measured on the printed photos; a ratio was obtained and compared before and after treatment. Cleft width, anterior width, and anteroposterior distances were measured on the maxillary cast. Results : Group A began treatment at an average age of 14.3 days and group B at an average age of 16.9 days; no complications were observed. For group A, the initial average alveolar cleft within the cast was 10.7 mm, and after treatment it was 6.6 mm. For group B, pretreatment width was 11.2 mm, and after treatment it was 5.9 mm. No differences were found on the anterior and posterior width, and A-P distance of both groups. The initial mean columellar angle in group A was 38.1°, and after treatment it was 61.5°; for group B the initial mean columellar angle was 33.6°, and after treatment it was 59.5°. Results of Mann-Whitney U and Student's t tests showed no differences (P > .05). Width and height dimensions of the nostril showed minor differences. Conclusions : Both methods significantly reduced the cleft width and improved the nasal asymmetry. Our findings show that both methods produced similar results.

  8. Value of acoustic perceptual method for analysis of compensatory articulation errors in postoperative patients with cleft palate

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To establish an acoustic perceptual method analyzing the compensatory articulation errors in children with operated cleft palate via the formants of Chinese pure vowels. Methods The first three formants which represent vocal transmission character in Chinese pure vowels of 84 subjects with operated cleft palate, were measured by Computerized Speech Signal Processing System (CSSPS). The Chinese vowel graph of postoperative patients with cleft palate was stated by the first formant frequencies (F1) ...

  9. Pre: Surgical orthopedic pre-maxillary alignment in bilateral cleft lip and palate patient

    OpenAIRE

    Vijaya Prasad Kamavaram Ellore; Naveen Kumar Ramagoni; Mahantesha Taranatha; Asha Nara; Gururaj Gunjalli; Ashwin Devasya Bhat

    2012-01-01

    Pre-surgical orthopedic appliances are mainly used to retract and align the protruded and deviated pre-maxilla and to facilitate initial lip repair. This article presents a case report of a five year old male child patient with bilateral cleft lip and palate in whom a special custom made pre-surgical orthopedic appliance was delivered. Use of a special custom made presurgical orthopedic appliance for repositioning pre-maxilla in bilateral cleft lip and palate patient is discussed in this arti...

  10. Simultaneous premaxillary repositioning and cheiloplasty in adult patients with unrepaired bilateral cleft lip and palate.

    Science.gov (United States)

    Lee, Ui-Lyong; Cho, Jun-Bum; Choung, Pill-Hoon

    2013-03-01

    Primary cheiloplasty in adult patients with unrepaired complete bilateral cleft lip and palate is quite challenging due to severe premaxillary anterior projection. To get the best repair results, the author carried out repositioning of the premaxilla and repair of the lip deformity in a single stage. Positive results for the primary lip repair and appropriate repositioning of the premaxilla were achieved. No avascular necrosis of the premaxilla was observed. Repositioning of the premaxilla and repair of the lip deformity in a single operation appears to be a reliable method for treating adult patients with previously unrepaired or poorly repaired bilateral cleft lip and palate.

  11. Pre: Surgical orthopedic pre-maxillary alignment in bilateral cleft lip and palate patient

    Directory of Open Access Journals (Sweden)

    Vijaya Prasad Kamavaram Ellore

    2012-01-01

    Full Text Available Pre-surgical orthopedic appliances are mainly used to retract and align the protruded and deviated pre-maxilla and to facilitate initial lip repair. This article presents a case report of a five year old male child patient with bilateral cleft lip and palate in whom a special custom made pre-surgical orthopedic appliance was delivered. Use of a special custom made presurgical orthopedic appliance for repositioning pre-maxilla in bilateral cleft lip and palate patient is discussed in this article.

  12. Determination of genomic variants of the complex aetiology cleft lip and (or) palate in Lithuanian patient group

    OpenAIRE

    Ambrozaitytė, Laima

    2011-01-01

    The incidence of cleft lip and (or) palate (CL/P) varies from 0.4 to 2.0 in 1000 live births across populations. More and more CL/P candidate loci are being confirmed using novel genome-wide methods of molecular genetics and tools of statistical analysis. The aim of this study was to identify the alleles of the candidate genes for cleft lip with or without cleft palate and isolated cleft palate in the Lithuanian patient group, applying the molecular genotyping of the genomic markers in 42 CL...

  13. The Role of the Velopharyngeal Sphincter in the Speech of Patients with Cleft Palate or Cleft Lip and Palate Using Perceptual Methods

    Science.gov (United States)

    Georgievska-Jancheska, Tatjana; Gjorgova, Juliana; Popovska, Mirjana

    2016-01-01

    BACKGROUND: The velopharyngeal sphincter (VPS) plays the main role in speech formation. The cleft palate, due to the damage of the soft palate, leads to dysfunction of the velopharyngeal sphincter thus causing speech disorder. AIM: To establish a link between the nasal air escape and the perceptual symptoms in the speech of patients with cleft palate or cleft lip and palate using auditory-visual perceptual procedures for determining the influence the velopharyngeal dysfunction has on speech. MATERIAL AND METHODS: Twenty patients with speech disorders, out of which 10 have cleft palate or cleft lip and palate (experimental group), participated in the perceptual assessment by means of Czermak mirror fogging test for assessing the nasal air escape and Pittsburgh Weighted Speech Scale (PWSS) for assessing the probable nature of the velopharyngeal sphincter. RESULTS: The respondents with a considerable nasal air escape have a higher velopharyngeal inability, that is, probably incompetent nature of the velopharyngeal sphincter. There is a strong correlation between the nasal air escape and the probable nature of the velopharyngeal sphincter (the coefficient of linear correlation r = 0.9756). The calculated p-value is p = 0.000002. CONCLUSION: The perceptual speech symptoms and the nasal air escape provide unique insight into the state and role the velopharyngeal sphincter has in speech. PMID:28028412

  14. Is there an optimal resting velopharyngeal gap in operated cleft palate patients?

    Directory of Open Access Journals (Sweden)

    Rajesh Yellinedi

    2013-01-01

    Full Text Available Context: Videofluoroscopy in operated cleft palate patients. Aims: To determine the existence of an optimal resting velopharyngeal (VP gap in operated cleft palate patients Settings and Design: A retrospective analysis of lateral view videofluoroscopy of operated cleft palate patients. Materials and Methods: A total of 117 cases of operated cleft palate underwent videofluoroscopy between 2006 and 2011. The lateral view of videofluoroscopy was utilised in the study. A retrospective analysis of the lateral view of videofluoroscopy of these 117 patients was performed to analyse the resting VP gap and its relationship to VP closure. Statistical analysis used: None. Results: Of the 117 cases, 35 had a resting gap of less than 6 mm, 34 had a resting gap between 6 and 10 mm and 48 patients had a resting gap of more than 10 mm. Conclusions: The conclusive finding was that almost all the patients with a resting gap of 10 mm (group A did not achieve VP closure on phonation, thus having full-blown VPI. Therefore, it can be concluded that the ideal resting VP gap is approximately 6 mm so as to get the maximal chance of VP closure and thus prevent VPI.

  15. ANATOMICAL VARIATIONS FINDINGS ON CONE BEAM-COMPUTED TOMOGRAPHY IN CLEFT LIP AND PALATE PATIENTS

    Directory of Open Access Journals (Sweden)

    Yllka DECOLLI

    2015-09-01

    Full Text Available Introduction: Cone beam computed tomography (CBCT is frequently used in surgery treatment planning in patients with cleft lip and palate (CLP. The aim of this study was to investigate the presence of different anatomical variations of patients with cleft lip and palate using CBCT images. Materials and method: CBCTs taken from consecutive patients (n =25; mean age 10.7±4 years, range 6.5–23 years with a non-syndromic cleft lip and palate (CLP, between June 2014-2015, were systematically evaluated. Sinuses, nasopharynx, oropharynx, hypopharynx, temporo-mandibular joint (TMJ, maxilla and mandible were checked for incidental findings. Results: On 90.1 % of the CBCTs, incidental findings were found. The most prevalent ones were airway/sinus findings (78.1%, followed by dental problems, e.g. missing teeth (54%, nasal septum deviation (93%, middle ear and mastoid opacification, suggestive for otitis media (8% and (chronic mastoiditis (7%, abnormal TMJ anatomy (4.3%. Conclusions: Incidental findings are common on CBCTs in cleft lip and palate patients. Compared with the literature, CLP patients have more dental, nasal and ear problems. The CBCT scan should be reviewed by all specialists in the CLP team, stress being laid on their specific background knowledge concerning symptoms and treatment of these patients.

  16. Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review

    Directory of Open Access Journals (Sweden)

    P Priyanka Niranjane

    2014-01-01

    Full Text Available Rehabilitation of cleft lip and palate (CLP patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.

  17. Assessment of middle ear function in patients with cleft palate treated under "Smile Train Project"

    Directory of Open Access Journals (Sweden)

    Prachi Gautam

    2011-01-01

    Full Text Available Objective: To evaluate the middle ear function in patients of cleft palate treated under "Smile Train Project". Materials and Methods: Sixty patients (120 ears; 32 male and 28 female of cleft palate with or without cleft lip were evaluated in pediatrics and ENT OPD in preoperative period. A general medical check up was performed in pediatrics OPD to evaluate the associated craniofacial anomalies. Middle ear function was evaluated in ENT OPD. Otoscopy was done in all patients. Cases under five years of age were evaluated for middle ear function by tympanometry and cases with more than five years of age were evaluated by tympanometry for middle ear function and pure tone audiometry to establish the type of hearing loss. The results are presented as number of ears. Results: A total of 50% of the patients in the study group were in zero- to two-year age group. Otoscopy findings in 120 ears showed that 66.66% of the patients had dull tympanic membrane suggesting a diagnosis of otitis media with effusion. Tympanometry was done in 110 ears, of which, 72.72% of ears had type B tympanogram suggesting otitis media with effusion. Pure tone audiometry in more than five years age group showed that 81.25% ears had conductive hearing loss. Conclusion: This study suggests the need of preoperative ENT check up and audiological assessment in patients of cleft palate undergoing palatal surgery under "Smile Train Project". The association of otitis media with effusion in patients with cleft palate appears strong and a high degree of suspicion for the disease should be kept in them. The anatomical defect and possible causative pathophysiology also supports the inference. Otitis media with effusion causing hearing loss in these patients causes speech delay and unfavorable outcome despite aggressive speech therapy in postoperative period. A co-ordinate team approach of concerned specialists involved in managing these patients would definitely improve their outcome.

  18. Orthognathic Surgery for Achieving Facial Balance and Harmony in Cleft Patients

    Institute of Scientific and Technical Information of China (English)

    Kenneth E Salyer; XU Hai-song

    2015-01-01

    Cleft surgery requires an expert team performing ongoing treatment in order to achieve optimal outcomes. The senior author's (KES) experiences of more than 2 000 patients with cleft lip and palate treated by a surgical-orthodontic protocol were introduced. The paper here will concentrate on not only correcting the occlusion as others have described, but also on what one surgeon can do to achieve optimal aesthetic balance, harmony and beauty. The results of orthognathic surgery in respect to function, stability, cosmesis, and complications are also audited.

  19. Sociodemographic profile of orofacial cleft patients in India: A hospital-based study

    Directory of Open Access Journals (Sweden)

    Nagappan Nagappan

    2015-01-01

    Full Text Available Aim: Long-term health of the stomatognathic system as well as esthetic aspects is the therapeutic goals in patients with orofacial clefts (OFCs. The aim of this study was to assess the sociodemographic profile of patients with OFCs in India. Materials and Methods: The study group consisted of 108 cleft patients. Subjects were divided into three groups. Group 1: Patients with cleft lip (CL, Group 2: Subjects with cleft palate and Group 3: Subjects with CL alveolus and palate (CLAP. A pretested interviewer administered questionnaire was used. Socioeconomic status (SES was assessed using Pareek's scale for the rural population and Kuppuswamy's scale for the urban population. Results: Among the 108 study subjects, 69 (63.9% were males, and 39 (36.1% were females. 64 (59.2% study subjects were residing in rural areas, and 44 (40.8% were residing in urban areas. 29 (26.80% from rural areas and 21 (19.50% from the urban areas had a family income below Rs. 5001-10000. In rural areas, 47 (73.40% study subjects belonged to the middle class and 17 (26.60% study subjects belonged to the lower middle class. In urban areas, 20 (45.50% study subjects belonged to the middle class and 24 (54.50% study subjects belonged to the lower class. Conclusion: Most of the study subjects in rural areas belonged to middle SES, whereas in urban areas belonged to lower SES.

  20. EFFECT OF HOTZ PLATE APPLIANE TO MAXILLARY ARCH DEVELOPMENT PATIENTS WITH CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Edy Machmud

    2015-06-01

    Full Text Available The purpose of this study was to analyze the effect of hotz plate appliance to maxillary arch development of complete unilateral cleft lip and palate patient. The subjects were divided into two groups. The first group consisted of 6 patients, aged under two years with hotz appliance, recruited from Hasan Sadikin Hospital Bandung, and the second group, as control group, consisted of 6 patients, aged under two years, without hotz appliance, recruited from Haji Hosiptal Makassar. It was showed that in group with hotz plate appliance, no difference found on the size of anterior maxillary arch and minor maxillary arch. On the other hand, in the control group, minor maxillary arch was longer than major maxillary arch. It was concluded that hotz plate appliances affected that palatal development of patient with complete unilateral cleft lip and palate.

  1. Use of buccal myomucosal flap for palatal lengthening in cleft palate patient: Experience of 20 cases

    Directory of Open Access Journals (Sweden)

    Don Varghese

    2015-01-01

    Full Text Available Background: The purpose of this review was to assess the effectiveness of the buccal myomucosal flap in secondary repairs of cleft palate in 20 patients. Patients and Methods: Totally, 20 patients, who underwent secondary palatoplasty between 5 years and 8 years in which a buccal myomucosal flap was used, were reviewed retrospectively. All patients had undergone at least one previous attempted repair at other institutions. Indications for the secondary repair included velopharyngeal incompetence and/or oronasal fistula. Patients were evaluated preoperatively for oronasal fistula status, velopharyngeal competence, nasal resonance, speech quality, and nasal escape. Results: The buccal myomucosal flap was used in all 20 patients, and there was marked increase in the quality of speech as well as nasal regurgitation decreased. In patients with levator dysfunction due to poor primary surgery and glottal speech the results were inconclusive Conclusion: Palate re-repair combined with a buccal myomucosal flap, occasionally in conjunction with other techniques, is an effective method for correcting failed cleft palate repairs. Minimum donor site morbidity and complication makes the buccal flap a useful armamentarium of a cleft surgeon.

  2. Effectiveness of the Facemask and an Intraoral Appliance in Patients with Cleft Lip and Palate: A Systematic Review

    OpenAIRE

    Mendoza Gutiérrez, Kelia; Residente IV Especialización en Odontología Pediátrica Universidad el Bosque, Bogotá, Colombia;; González Carrera, Maria Clara; Directora grupo UMIMC, Universidad el Bosque, Coordinadora Postgrados, Facultad de Odontología, Profesor Titular, Docente Programa de Especialización Odontología Pediátrica, Universidad el Bosque, Bogotá, Colombia. Odontóloga FISULAB.; Mora Diaz, Ingrid Isabel; OD Universidad El Bosque, Especialización en periodoncia y medicina oral. Universidad El Bosque.

    2014-01-01

    Background: Several studies describe the orthopedic treatment of patients with cleft lip and palate, diagnosed with class III malocclusion; however, there is no standardization in the orthopedic treatment planning in these patients. Objective: To determine the effectiveness of treatment with facemask and a fixed intra-oral appliance for patients with cleft lip and palate and Class III malocclusion. Methods: A literature search conducted in several databases and print journals produced 199 art...

  3. Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever

    Directory of Open Access Journals (Sweden)

    Ana Cláudia De Franco Suzuki

    2014-10-01

    Full Text Available Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.

  4. 3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate.

    Science.gov (United States)

    Rusková, Hana; Bejdová, Sárka; Peterka, Miroslav; Krajíček, Václav; Velemínská, Jana

    2014-07-01

    Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly.

  5. Frontonasal and fibrous dysplasia in a patient with unilateral cleft lip and palate.

    Science.gov (United States)

    Weathers, William M; Wolfswinkel, Erik M; Albright, Steven B; Hollier, Larry H; Buchanan, Edward P

    2013-07-01

    Frontonasal dysplasia is a rare entity. It has characteristic physical deformities: hypertelorism, broad nasal root, median facial cleft of the upper lip or palate, clefting of the nasal alae, poorly formed nasal tip, cranium bifidum occultum, and a widow's peak hairline. Fibrous dysplasia is a benign bone tumor in which normal bone is replaced by fibrous, poorly formed osseus tissues. We present a patient with frontonasal dysplasia who desired correction of her hypertelorism. Incidentally, fibrous dysplasia was found in her left orbit complicating surgical correction. In addition, the patient has velopharyngeal insufficiency and a class III malocclusion. The interplay of all these craniofacial defects makes the sequencing and timing of surgery important in this unique patient.

  6. The nance obturator, a new fixed obturator for patients with cleft palate and fistula.

    Science.gov (United States)

    Borzabadi-Farahani, Ali; Groper, John N; Tanner, Aaron M; Urata, Mark M; Panossian, Andre; Yen, Stephen L-K

    2012-07-01

    In patients with fistulas that impair function (e.g., feeding, resonance, intelligibility), obturators are used to improve feeding and reduce nasal air emission by occluding the abnormal opening between the oral and nasal cavities. This report describes a novel method for occluding an anterior palatal fistula in patients with cleft palates. The new design for a fixed obturator is based on the Nance appliance, which was originally used as a space maintainer, but has been redesigned for closing an anterior palatal fistula in a patient with cleft lip and palate. The Nance obturator may be used when the surgical closure of the fistula is not feasible and a removable device is not successful. As it is a fixed device, it does not require remaking with maxillary growth. The new design may also function as a fixed space maintainer to preserve molar anchorage and maxillary transverse width.

  7. Risk of leukemia in first degree relatives of patients with nonsyndromic cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Eduardo GONÇALVES

    2014-01-01

    Full Text Available The aim of this study was to determine the frequency of leukemia in parents of patients with nonsyndromic cleft lip and/or cleft palate (NSCL/P. This case-control study evaluated first-degree family members of 358 patients with NSCL/P and 1,432 subjects without craniofacial alterations or syndromes. Statistical analysis was carried out using Fisher’s test. From the 358 subjects with NSCL/P, 3 first-degree parents had history of leukemia, while 2 out of 1,432 subjects from the unaffected group had a family history of leukemia. The frequency of positive family history of leukemia was not significantly increased in first-degree relatives of patients with NSCL/P.

  8. Distraction osteogenesis and orthognathic surgery for a patient with unilateral cleft lip and palate.

    Science.gov (United States)

    Kim, Ji Hyun; Lee, Il Hong; Lee, Sang Min; Yang, Byoung Eun; Park, In Young

    2015-03-01

    Maxillary deficiency is a common feature in patients with repaired cleft lip and palate. Orthognathic surgery has been the conventional approach for the management of cleft-related maxillary hypoplasia. However, for patients with a severe maxillary deficiency, orthognathic surgery alone has many disadvantages, such as high relapse rates of 25% to 40%, instability, limited amount of advancement, and a highly invasive surgical technique. As an alternative treatment method, distraction osteogenesis has been used successfully in the distraction of the mandible, the maxilla, the entire midface, and the orbits as well as the cranial bones, with stable outcomes. The type of distraction device, either external or internal, can be chosen based on the surgical goals set for the patient. In this study, we report on the use of a rigid external distraction device for maxillary advancement in a 22-year-old woman with a repaired unilateral cleft lip and palate and severe maxillary hypoplasia. After the distraction osteogenesis, 2-jaw surgery was performed to correct the maxillary yaw deviation and the mandibular prognathism.

  9. Transmigration of mandibular second premolar in a patient with cleft lip and palate: case report

    Directory of Open Access Journals (Sweden)

    Daniel Berretta Moreira Alves

    2008-10-01

    Full Text Available Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP, Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

  10. Telemedicine as a means of effective speech evaluation for patients with cleft palate.

    Science.gov (United States)

    Whitehead, Elizabeth; Dorfman, Valerie; Tremper, Glendora; Kramer, Amanda; Sigler, Alicia; Gosman, Amanda

    2012-04-01

    Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not been studied previously. We looked at determining whether a speech evaluation performed by a speech-language pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting between Tijuana, Mexico and San Diego, CA. Spanish-speaking SLPs developed an informal protocol to evaluate several speech characteristics. Patients were simultaneously evaluated by 2 SLPs, one in-person in Tijuana and the other over telemedicine videoconference from San Diego, CA. In addition, we obtained data regarding the parents experience with telemedicine through a satisfaction survey. Results showed no statistically significant differences between the 2 methods of speech evaluation, particularly in oral muscle tone, resonance, lingual lateralization, oral pressure, and dentition. The satisfaction survey showed family satisfaction with the speech evaluation performed using telemedicine. Thus, telemedicine represents an effective medium for conducting speech assessment in patients with cleft lip/palate, allowing for increased access to care for underserved populations.

  11. Eustachian tube dysfunction and its sequelae in patients with cleft palate.

    Science.gov (United States)

    Goldman, J L; Martinez, S A; Ganzel, T M

    1993-11-01

    The incidence of middle ear disorders in patients with cleft palate deformities was determined in a retrospective review of 110 children with palate or palate and lip involvement. Ages ranged from 2 months to 18 years and included patients with associated abnormalities such as Pierre Robin syndrome and Treacher Collins syndrome. Clinical manifestations of eustachian tube dysfunction were found in 79% in the form of effusions, retraction pockets, adhesions, and ossicular erosion. Only two patients had confirmed cholesteatoma formation. Despite the low incidence of acquired cholesteatoma in these patients, the frequent occurrence of other disorders that affect hearing warrants early and aggressive otologic management to prevent long-term sequelae.

  12. Do patients with isolated Pierre Robin Sequence have worse outcomes after cleft palate repair: A systematic review.

    Science.gov (United States)

    Wan, Teng; Chen, Yang; Wang, Guomin

    2015-08-01

    Cleft palate repair for Pierre Robin Sequence (PRS) patients has always been a challenge for surgeons and anesthetists. The aim of this systematic review is to investigate the outcome of cleft palate repair for PRS patients compared with cleft palate-only patients. All papers published before October 2014 were searched in the databases PubMed and MEDLINE. Search terms included "Pierre Robin Sequence," "cleft palate repair," and "speech result." Additional studies were identified by hand searching the reference lists of the papers retrieved from electronic search. Two independent reviewers assessed the eligibility of studies for inclusion, extracted the data, and assessed the quality of the studies. Six studies met the inclusion criteria. All but one study had multiple deficiencies in study designs. Four studies assessed the fistula rate of both groups, and all studies assessed some aspect of the speech results. Conflicting results and a lack of high-quality and long-term outcomes of reviewed studies provided no conclusive scientific evidence about whether the outcome of cleft palate repair for PRS patients was better or worse than cleft palate-only patients. Further well-designed, well-controlled, and long-term studies are needed.

  13. Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Rong-Rong [Tokyo Medical and Dental Univ. (Japan). School of Dentistry

    1994-12-01

    This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex. (author) 61 refs.

  14. An unusual type of sucking habit in a patient with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Satyaprasad Savitha

    2009-01-01

    Full Text Available Digit sucking, a form of non-nutritive sucking, is a habit of concern to specialist in various fields such as psychiatrist, psychologist, pediatricians, pediatric dentists, orthodontist, speech pathologist and plastic surgeon. The habits have harmful unbalanced pressures to be born by the immature highly malleable alveolar ridges. Sucking behaviors have long been recognized to affect occlusion and dental arch characteristics. As early as 1870s, Campbell and Chandler recognized that prolonged finger or thumb sucking habits had deleterious effects on certain occlusal traits including anterior open bite, increased over jet and class II canine and molar relationships. However, little is known about digit sucking habit and its effect in a cleft lip and palate child as there is no literature till now reported on the digit sucking in a cleft lip patient.

  15. The status of oral hygiene in cleft lip, palate patients after surgical correction

    Directory of Open Access Journals (Sweden)

    Pandey S

    2005-01-01

    Full Text Available The cleft lip and palate patients usually present a number of problems viz. altered oral anatomy leading to changes in oral physiology diminishing the self-cleansing ability of individual. The handicapped children are unable to maintain their oral hygiene properly. The present study was formulated with the aim that does normalization of oral anatomy have its effect on improvement of oral hygiene? An assessment of oral hygiene index-simplified was performed between preoperative and postoperative values in the same patient at KGMU and KGDU. A total of 50 cases were recorded in two groups of 25 each: (i < 6 years old and (ii > 6 years. The observations are statistically analyzed by paired ′t′ test to get the significance of results. Results: The data analyzed showed the significant decrease in oral hygiene indices observed in both groups. A relative significance in oral hygiene status following surgery was observed. Both groups expressed greater significance when compared pre and postoperatively which is indicative of considerable improvement of oral hygiene after surgical correction. The study concludes that oral hygiene improves more in older cleft lip-palate cases following reconstruction of palatal vault, premaxilla and anterior lip seal by secondary bone grafting method when compared with oral hygiene indices results in primary periosteoplasty cases. The surgical correction of cleft lip palate enhances self-cleaning ability and better compliance to maintain oral hygiene in children as the age advances.

  16. Effects of rapid maxillary expansion in cleft patients resulting from the use of two different expanders

    Science.gov (United States)

    Figueiredo, Daniel Santos Fonseca; Cardinal, Lucas; Bartolomeo, Flávia Uchôa Costa; Palomo, Juan Martin; Horta, Martinho Campolina Rebello; Andrade, Ildeu; Oliveira, Dauro Douglas

    2016-01-01

    ABSTRACT Objective: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p 0.05). Conclusions: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one. PMID:27683832

  17. Comprehensive Orthodontic Treatment of Adult Patient with Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Noemí Leiva Villagra

    2014-01-01

    Full Text Available The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient. Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy. Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.

  18. External frame distraction osteogenesis of the midface in the cleft patient

    Directory of Open Access Journals (Sweden)

    Hussain Syed

    2009-10-01

    Full Text Available Distraction osteogenesis has established itself as an accepted form of treatment in the management of midface deficiency in cleft patients. However, it is well known that some amount of relapse is inevitable in patients who undergo this procedure. Like most surgical techniques, it has its specific indications, limitations, and complications. The problems are amplified in some patients because of severe fibrosis resulting from previous palate and lip operations. This article reviews treatment planning, pre- and postoperative orthodontic management, operative technique, and mechanics of distraction. It also discusses long-term changes following distraction and protocols to optimize the results and minimize complications.

  19. Comprehensive orthodontic treatment of adult patient with cleft lip and palate.

    Science.gov (United States)

    Leiva Villagra, Noemí; Muñoz Domon, Miguel; Véliz Méndez, Sebastian

    2014-01-01

    The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient. Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.

  20. Aesthetic outcome of cleft lip and palate treatment. Perceptions of patients, families, and health professionals compared to the general public.

    Science.gov (United States)

    Gkantidis, Nikolaos; Papamanou, Despina A; Christou, Panagiotis; Topouzelis, Nikolaos

    2013-10-01

    The aesthetic outcome of cleft treatment is of great importance due to its complex management and the psychosocial consequences of this defect. The aim of the study was to assess the aesthetic evaluations of patients following cleft surgery by various groups and investigate potential associations of the assessments with life quality parameters. Head photos of 12 adult patients with treated unilateral cleft lip and palate were evaluated by laypeople and professionals. A questionnaire was distributed and answered by the patients and their parents. Intra-panel agreement was high (α > 0.8) for laypeople and professionals. Between-groups agreement was high for both laypeople and professionals, but not when patients and/or parents were tested. Professionals, parents, and patients were more satisfied with patients' appearance than laypeople, although in general all groups were not highly satisfied. Low satisfaction with aesthetics correlated with increased self-reported influence of the cleft in the patients' social activity and professional life (0.56 cleft on the patient's social activity and professional life and underline the need for the highest quality of surgical outcome for this group of patients.

  1. Movement of an upper central incisor across the midline in a patient with cleft of primary palate.

    Science.gov (United States)

    Manosudprasit, Montian; Wangsrimongkol, Tasanee; Pisek, Poonsak; Chittiwatanapong, Nisa

    2013-09-01

    Orthodontic treatment for a 10-years-old girl, with repaired bilateral cleft lip and left incomplete unilateral alveolar cleft, was performed by moving her right maxillary central incisor across the midline to replace her congenital missing central incisor and then moving the right lateral incisor toward the midline to act as a new central incisor. A malformed supernumerary tooth, positioned between the right central and lateral incisor, was extracted during incisor movement. Significant lip profile improvement was accomplished by maxillary and mandibular anterior teeth retraction into three-premolar extraction spaces. Not only natural functional occlusion, deviated midpalatal suture along the central incisor, and no obvious root resorption were obtained but also narrowing the alveolar bone cleft which was beneficial for bone continuity supporting dental structures, satisfactory results were possible for the patient with primary palate cleft.

  2. Three-dimensional nasal changes following maxillary advancement in cleft patients.

    Science.gov (United States)

    Stewart, A; McCance, A M; James, D R; Moss, J P

    1996-06-01

    Three-dimensional laser surface scanning of the face was performed before and after Le Fort I maxillary advancement in 24 patients with replaced clefts of the lip and palate. The surgery resulted in advancement of the upper lip and para-alar tissues and an increase in the relative prominence of the nose within the face. These changes were produced at the expense of an increase in nasal width and a reduction in nasal tip protrusion. The changes in nasal morphology showed significant variation among patients.

  3. Hypertelorism and micro-orbit simultaneous correction in a patient with paramedian bilateral facial clefts.

    Science.gov (United States)

    Prada, José Rolando; Mendoza, María Bibiana

    2014-09-01

    The aim of this paper is to report a case of a patient with paramedian bilateral facial clefts and hypertelorism associated with a severe encephalocele and micro-orbit. The patient required a facial bipartition to correct a transsphenoidal encephalocele, and a modified medialization surgery of the orbits to simultaneously expand the micro-orbit and correct the hypertelorism. These procedures achieved hypertelorbitism correction, orbital expansion which allowed symmetrical facial growth, and a functional orbit that permitted the use of an ocular prosthesis. We present this unique case to highlight the predictable results of a procedure that combines 2 surgical reproducible techniques of craniofacial surgery.

  4. Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate.

    Science.gov (United States)

    Hasanzadeh, Nadia; Majidi, Mohammad Reza; Kianifar, Hamidreza; Eslami, Neda

    2014-01-01

    The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

  5. Treatment Approach for Maxillary Hypoplasia in Cleft Patients: Class III Elastics with Skeletal Anchorage (Report of Two Cases)

    Science.gov (United States)

    Jahanbin, Arezoo; Kazemian, Mozhgan; Saeedi-Pouya, Iman; Eslami, Neda; Shafaee, Hooman

    2016-01-01

    Introduction: Treatment of cleft lip and palate patients requires a multidisciplinary plan. These patients usually have a hypoplastic maxilla due to the prior surgical scars. Orthognathic surgery to advance the maxilla in these patients is not very efficient; therefore, orthopedic interventions during an appropriate age seems to be essential. Case Report: In this article, two cleft lip and palate patients have been treated with Class III elastics anchored to the maxillary posterior and mandibular anterior miniplates in order to induce maxillary advancement. Conclusion: Both cases showed a significant improvement in their profiles with minimal dentoalveolar compensations. A counterclockwise rotation of the mandible occurred. PMID:27602343

  6. Prosthodontic Rehabilitation Alternative of Patients with Cleft Lip and Palate (CLP: Two Cases Report

    Directory of Open Access Journals (Sweden)

    Emrah Ayna

    2009-01-01

    Full Text Available Although patients with cleft lip and palate (CLP are not seen regularly in general dental practice, this is a frequent congenital anomaly; approximately one in every 800 live births results in a CLP. The cause of CLP is unknown, but possible causes are malnutrition and irradiation during pregnancy, psychological stress, teratogenic agents, infectious agents (viruses, and inheritance. Most clefts are likely caused by multiple genetic and nongenetic factors. Prosthetic reconstruction of the anterior maxilla is important for these patients. This paper describes the prosthetic rehabilitation of two patients with CLP, 19-year-old and 21-year-old women, both with surgically treated CLP. In both, an examination revealed a residual palatal defect of 2×3 mm and missing maxillary lateral incisors. The 19-year-old was treated with a fiber-reinforced composite resin-bonded fixed partial denture. The 21-year-old was treated with a removable partial denture with an extracoronal attachment system. The prosthetic rehabilitation of the two patients with CLP was evaluated clinically. In both, well-planned prosthetic, periodontal, and surgical therapy resulted in satisfactory function and esthetics, alleviating their deformities. With education and appropriate recall, the patients should be able to maintain their oral health.

  7. Assessment of nasalance and nasality in patients with a repaired cleft palate.

    Science.gov (United States)

    Sinko, Klaus; Gruber, Maike; Jagsch, Reinhold; Roesner, Imme; Baumann, Arnulf; Wutzl, Arno; Denk-Linnert, Doris-Maria

    2017-03-15

    In patients with a repaired cleft palate, nasality is typically diagnosed by speech language pathologists. In addition, there are various instruments to objectively diagnose nasalance. To explore the potential of nasalance measurements after cleft palate repair by NasalView(®), we correlated perceptual nasality and instrumentally measured nasalance of eight speech items and determined the relationship between sensitivity and specificity of the nasalance measures by receiver-operating characteristics (ROC) analyses and AUC (area under the curve) computation for each single test item and specific item groups. We recruited patients with a primarily repaired cleft palate receiving speech therapy during follow-up. During a single day visit, perceptive and instrumental assessments were obtained in 36 patients and analyzed. The individual perceptual nasality was assigned to one of four categories; the corresponding instrumental nasalance measures for the eight specific speech items were expressed on a metric scale (1-100). With reference to the perceptual diagnoses, we observed 3 nasal and one oral test item with high sensitivity. However, the specificity of the nasality indicating measures was rather low. The four best speech items with the highest sensitivity provided scores ranging from 96.43 to 100%, while the averaged sensitivity of all eight items was below 90%. We conclude that perceptive evaluation of nasality remains state of the art. For clinical follow-up, instrumental nasalance assessment can objectively document subtle changes by analysis of four speech items only. Further studies are warranted to determine the applicability of instrumental nasalance measures in the clinical routine, using discriminative items only.

  8. Effects of lip revision surgery on long-term orosensory function in patients with cleft lip/palate.

    Science.gov (United States)

    Essick, Greg; Phillips, Ceib; Chung, Yunro; Trotman, Carroll-Ann

    2013-09-01

    OBJECTIVE : To determine whether secondary lip revision surgery impacts sensitivity of the upper lip. DESIGN : A three-group, parallel, prospective, nonrandomized clinical trial. SETTING : University of North Carolina School of Dentistry. PATIENTS, PARTICIPANTS : Three groups: (1) patients with repaired cleft lip/palate who were scheduled for lip revision (revision; N = 20); (2) patients with repaired cleft lip/palate who did not receive a lip revision (non-revision; N = 13); and (3) non-cleft control subjects (non-cleft; N = 22). Interventions : Lip revision surgery. MAIN OUTCOME MEASURES : Measures of (1) two-point perception threshold (two-point), (2) warmth detection threshold (warm), and (3) cool detection threshold (cool) were obtained from two sites on the upper lip vermilion. The revision participants were tested approximately 1 week before surgery and then approximately 3 and 12 months after surgery. The non-revision and non-cleft participants were tested at similar times. RESULTS : There were no significant differences among the three groups at baseline for two-point, warm, or cool. The main effects of group, age, sex, and time were not statistically significant for the two-point or warm (p > .05). The mean differences between the 3- and 12-month follow-up visits and baseline for two-point and warm were small for all three groups. For cool, group was statistically significant (p = .04), the difference in the non-revision group between follow-up and baseline was 31% to 34% higher than in the non-cleft group (p = .01). CONCLUSIONS : Although at postsurgery revision participants exhibited threshold values comparable to presurgical values, the sensory differences observed among subgroups of participants with cleft lip are complex.

  9. Case series of undetected intranasal impression material in patients with clefts.

    Science.gov (United States)

    Jones, Simon D; Drake, David J

    2013-04-01

    We report the cases of two female patients in their twenties who had had corrective surgery for bilateral cleft lip and palate as babies. They had both had residual palatal fistulas and had had further treatment that required repeated dental impressions. Several years later both had complained of persistent nasal discomfort and discharge, and routine clinical examination and investigations had failed to identify the cause. Full examination of the whole nasal cavity under general anaesthesia, in both cases, showed the presence of displaced dental impression material in the nasal floor. Removal resulted in complete resolution of symptoms.

  10. [Nasal breath recovery and rhinoplasty in cleft lip and palate patient with unilateral choanal atresia].

    Science.gov (United States)

    Chkadua, T Z; Ivanova, M D; Daminov, R O; Brusova, L A; Savvateeva, D M

    2016-01-01

    The paper presents the analysis of clinical case of endoscopic nasal breath restoration and elimination of the secondary cleft lip nasal deformity in 27 years old patient with unilateral choanal atresia and secondary nasal deformity after rhinocheiloplasty. Preoperative examination revealed the absence of nasal breathing on collateral side due to complete bone choanal atresia. Surgical treatment included endoscopic choanal repair, elimination of the secondary nasal deformity, septoplasty, conchotomy and lateroposition of the inferior conchae. The treatment resulted in nasal breath restoration and elimination of nasal deformity. Long-term follow-up at 1 and 12 months post-operatively proved stable positive aesthetic and functional results.

  11. Speech understandability of repaired cleft palate patients pre and post caregiver training

    Directory of Open Access Journals (Sweden)

    Jobe Andrea L

    2007-01-01

    Full Text Available Background: Treating speech and language problems in repaired cleft palate patients in India is still an uphill task due to lack of facilities. This study attempted to use parents as team members for the speech management of cleft palate patients in Andhra Pradesh, India. Objectives: To investigate whether a positive change in speech understandability for individuals with cleft palate will result from a parent-administered intervention program. Materials and Methods: Twenty-eight parents had enrolled for the speech camp held in September 2004. The parent-training program at the speech camp ensured that parents were given adequate awareness. Out of the 28, 18 (64.28% reported for one follow-up, referred to in this article as Group I. Ten (35.72% out of the 28 came for two consecutive follow-ups, referred to in this article as Group II. Results: Pre and post training understandability scores obtained in the known context (reciting a familiar poem in the native language, counting 1 to 10 and unknown context (peer group names, family information, describing their journey from home to hospital for Group I and Group II were evaluated. Results revealed that a higher percentage of cases showed significant improvement in understandability in the unknown context after treatment. Unknown context can be considered a measure to assess speech understandability after training. Further, it shows that parent training without practice at home may not show the desired results. Conclusion: This study reveals that parents can effect a positive change in the speech understandability of their children following training, provided the exercises are carried out regularly at home and the parents report for the follow-up assessments and guidance.

  12. A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.

    Science.gov (United States)

    van der Zeeuw, Frederique; Murabit, Amera; Volcano, Johnny; Torensma, Bart; Patel, Brijesh; Hay, Norman; Thorburn, Guy; Morris, Paul; Sommerlad, Brian; Gnarra, Maria; van der Horst, Chantal; Kangesu, Loshan

    2015-09-01

    There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair.

  13. [Quantitative diagnosis of hypernasality in cleft lip and palate patients by computerized nasal quality assessment].

    Science.gov (United States)

    Bressmann, T; Sader, R; Awan, S; Busch, R; Zeilhofer, H F; Horch, H H

    1999-05-01

    In patients with cleft lip and palate (CLP), the assessment of velopharyngeal morphology and function and the quantitative analysis of perceptual consequences of velopharyngeal insufficiency are of major importance regarding the effective planning of velopharyngoplasties for speech improvement. The NasalView, a new instrument for the objective assessment of rhinophonia, is presented. The NasalView measures nasalance, the relative sound pressure level of the nasal signal in speech, expressed as a percentage. In order to evaluate the effectiveness of the computerised measurement of nasalance, 156 patients with surgically treated CLP were examined. The NasalView differentiated with high sensitivity and specificity between patients with normal nasal resonance and patients with varying degrees of hypernasality. To illustrate the importance of the NasalView for making the decision for a velopharyngoplasty, a single case is presented.

  14. Effect of an intraoral retrusion plate on maxillary arch dimensions in complete bilateral cleft lip and palate patients

    NARCIS (Netherlands)

    Oosterkamp, B.C.; van Oort, R.P.; Dijkstra, P.U.; Stellingsma, K.; Bierman, M.W.; de Bont, L.G.

    2005-01-01

    Objective: The aim of this study was to analyze maxillary arch dimensions in patients with complete bilateral cleft lip and palate treated with an intraoral retrusion plate prior to lip closure. Patients: The effects of the intraoral retrusion plate were evaluated on serially obtained maxillary cast

  15. Orthodontic Space Closure Versus Prosthetic Replacement of Missing Upper Lateral Incisors in Patients With Bilateral Cleft Lip and Palate

    NARCIS (Netherlands)

    Oosterkamp, Barbara C. M.; Dijkstra, Pieter U.; Remmelink, Hendrik J.; van Oort, Robert P.; Sandham, John

    2010-01-01

    Objective To compare dental aesthetics and function of orthodontic space closure versus prosthetic replacement of upper lateral incisors in patients with bilateral cleft lip and palate The predominant mode of prosthetic replacement was resin-bonded bridges Patients and Methods The retrospective stud

  16. [Orthomorphic facial treatment of patients with sequelae of bilateral lip-palate cleft by the "mask-lifting" procedure].

    Science.gov (United States)

    Krastinova-Lolov, D; Roddi, R

    1990-12-01

    The clinical study of the major cranio-facial malformations such as Apert syndrome, Treacher-Collins syndrome, Blepharophimosis and Bilateral Cleft Palate patients, lead us to note a similarity of the orbito-palpebral region. A characteristic obliquity and narrowness of the orbits associated with an antimongoloid eyelids disposal was noted after X-rays, CT-scan and clinical evaluation. Authors suggest a facial orthomorphic restoration of bilateral cleft palate patients by the "mask-lifting" procedure associated to the conventional maxillo-facial surgery.

  17. Value of acoustic perceptual method for analysis of compensatory articulation errors in postoperative patients with cleft palate

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To establish an acoustic perceptual method analyzing the compensatory articulation errors in children with operated cleft palate via the formants of Chinese pure vowels. Methods The first three formants which represent vocal transmission character in Chinese pure vowels of 84 subjects with operated cleft palate, were measured by Computerized Speech Signal Processing System (CSSPS). The Chinese vowel graph of postoperative patients with cleft palate was stated by the first formant frequencies (F1) and the second formant frequencies (F2) of the Chinese pure vowels between the two groups. Results Values of F1 and F2 of vowels except [a] in the poor articulation group (Group A) were significantly different from those in the good articulation group (Group B) (P<0.05 or P<0.01). As compared with that in Group B, the vowel graph demonstrated the decreased perceptual distances in Group A. These findings indicated that there might still be the backward movements of tongue, perverted mandibular movements and disharmonious lip movements in addition to the velopharyngeal insufficiency (VPI) in Group A. Conclusion The speech articulation of children with repaired cleft palate should be gained by correcting the aberrant compensatory articulation errors in the condition of velopharyngeal competence. Computerized Speech Signal Processing System (CSSPS), which is regarded as the content of objective quantitative measurement, is a precise, simple, reliable and atroumatic technique for children with cleft palate to analyze pathological compensatory articulation errors.

  18. The effect of Delaire cheilorhinoplasty on midfacial growth in patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Rullo, Rosario; Laino, Gregorio; Cataneo, Marisa; Mazzarella, Nicoletta; Festa, Vincenzo Maria; Gombos, Fernando

    2009-02-01

    The aim of this research was to evaluate the effect of the Delaire surgical technique on the midfacial morphology in a group of subjects with a congenital unilateral cleft of lip and palate (UCLP), prior to orthodontic treatment. Thirty-five UCLP (15 left and 20 right) patients (16 males and 19 females, mean age 7.03+/-0.9 years; age range 8.7-5.0 years), treated for the correction of congenital malformation, were retrospectively selected. Analysis of midfacial growth was undertaken on lateral cephalograms, and the data were compared with reference values (Ricketts analysis). A Mann-Whitney ranked sum test was used to detect significant differences between the findings and reference values. P cleft lip might be responsible for excessive maxillary retropositioning with a downward rotation.

  19. Neonatal Mandibular Distraction Osteogenesis Reduces Cleft Palate Width and Lengthens Soft Palate, Influencing Palatoplasty in Patients With Pierre Robin Sequence.

    Science.gov (United States)

    Collares, Marcus V M; Duarte, Daniele W; Sobral, Davi S; Portinho, Ciro P; Faller, Gustavo J; Fraga, Mariana M

    2016-07-01

    The aim of this study was to evaluate the influence of neonatal mandibular distraction osteogenesis (MDO) on cleft dimensions and on early palatoplasty outcomes in patients with Pierre Robin Sequence (PRS). In a prospective cohort study that enrolled 24 nonsyndromic patients with PRS, 12 submitted to the MDO group and 12 patients not treated (non-MDO group), the authors compared patients for cleft palate dimensions through 7 morphometric measurements at the moment of palatoplasty and for early palatoplasty outcomes. At palatoplasty, the MDO group presented a significant shorter distance between the posterior nasal spines (PNS-PNS, P < 0.001) and between uvular bases (UB-UB, P < 0.001), representing a reduction in cleft palate width. They also had significant soft palate lengthening represented by a larger distance between UB and retromolar space (UB-RM, P < 0.001) and UB and PNS (UB-PNS, P = 0.014). Their UB moved away from the posterior wall of the nasopharynx (UB-NPH, P < 0.001). The MDO group had a length of operative time significantly shorter (P < 0.001) and no early palatoplasty complications compared with the non-MDO group. In conclusion, MDO acted as an orthopedic procedure that reduced cleft palate width and elongated the soft palate in patients with PRS. These modifications enabled a reduction of around 11% in the length of operative time of palatoplasty (P < 0.001).

  20. Comparison of dermatoglyphic traits and dental anomalies associated with cleft lip or cleft lip and palate patients with normal healthy children

    Directory of Open Access Journals (Sweden)

    Neha Maheshwari

    2013-01-01

    Full Text Available Background: Dermatoglyphics are considered as a window of congenital abnormalities and is known to be one of the best available diagnostic tools in genetic disorders. Objective: The present study was conducted to observe and compare the differences in the dermatoglyphic patterns between cleft lip/palate (CL/P and normal healthy children and evaluate their associated dental findings. Setting: This is a cross-sectional prevalence study in which dermatoglyphic patterns and dental anomalies of 90 (CL/P and normal healthy children aged 0-15 years were recorded under standard conditions of seating and lighting. Materials and Methods: Dermatoglyphic traits were recorded using ink stamp pad method. Dental findings were recorded through clinical and radiographic examination. Results: The most frequently seen dermatoglyphic trait in the study and control group was loops followed by whorls and arches. A highly significant (P < 0.001 difference between loops in the study and control group and statistically significant difference in the whorls (P = 0.001 were found using Student′s t-test. The comparison of dental anomalies was accomplished using Chi-square test and hypodontia (50% was seen maximum in cleft patients. Conclusion: Any deviation in dermatoglyphics features indicates a genetic etiology.

  1. Clinical and genetic study on 356 Brazilian patients with a distinct phenotype of cleft lip and palate without alveolar ridge involvement.

    Science.gov (United States)

    Alvarez, Camila Wenceslau; Guion-Almeida, Maria Leine; Richieri-Costa, Antonio

    2014-12-01

    Oral clefts include cleft lip (CL), cleft lip with cleft palate (CLP) and cleft palate (CP), with wide variations in clinical presentation and degree of severity. We described a sample of individuals with CL and CP without alveolar arch involvement (CL + CP) to verify if the characteristics of this group are distinct from those with CL with or without CP (CL/P) described in literature. The sample was composed of 356 patients with CL + CP, registered at HRCA-USP, Bauru-SP-Brazil. The following characteristics were investigated: sex ratio, parental age at the time of conception, parental consanguinity, familial recurrence, laterality of the cleft and associated anomalies. A subgroup of 30 individuals with microforms of CL and CP were taken from the sample and compared with the remaining cases. Statistical differences were found between this CL + CP sample and the literature data for groups with CL/P regarding laterality, sex ratio, consanguinity, familial recurrence, and the presence of associated anomalies. The microform sample showed a statistical difference in paternal age. In most evaluated aspects, this sample presents similar characteristics to the consulted literature data for CL/P; as do the group of microform cleft cases when compared with the remaining CL + CP sample in this study. Microforms of cleft can represent a target group for investigation into the embryogenetic mechanisms of oral clefts and their phenotypic variability.

  2. Velopharyngeal function assessment in patients with cleft palate: perceptual speech assessment versus nasopharyngoscopy.

    Science.gov (United States)

    Ma, Li; Shi, Bing; Li, Yang; Zheng, Qian

    2013-07-01

    There is no doubt that perceptual speech assessment and instrumental examination could provide different diagnostic information on patients with cleft palate (CP), but not all patients simultaneously need the 2 examinations. So the purposes of this study were to explore a simple and effective evaluation method to assess velopharyngeal function and to investigate speech traits that affect the diagnosis of velopharyngeal function in patients with CP. The investigators implemented a retrospective study, and 247 postoperative patients with CP were selected, including 155 boys and 92 girls, with a mean (SD) age of 13 years and 2 months (7 years and 7 months). All of these patients were assessed by perceptual speech evaluation and nasopharyngoscopy after surgery, and the result was divided into velopharyngeal closure (VPC), velopharyngeal insufficiency, and marginal VPC. The number of diagnostic consistency patients was 170 (VPC, 51 patients; velopharyngeal insufficiency, 115 patients; marginal VPC, 4 patients), and the consistent ratio was 68.83%. There was no significant difference between perceptual speech assessment and nasopharyngoscopy. Furthermore, the difference in distribution of hypernasality between the consistent group and the inconsistent group was significant. In addition, the correlation analysis indicated that surgical age, hypernasality, nasal emission, and compensatory articulation were correlated with the velopharyngeal function (P velopharyngeal function. Much more attention should be paid to the surgical age, the alteration of hypernasality, nasal emission, and compensatory articulation during CP therapy.

  3. Amelogenin gene influence on enamel defects of cleft lip and palate patients

    Directory of Open Access Journals (Sweden)

    Fernanda Veronese OLIVEIRA

    2014-08-01

    Full Text Available The aim of this study was to investigate the occurrence of mutations in the amelogenin gene (AMELX in patients with cleft lip and palate (CLP and enamel defects (ED. A total of 165 patients were divided into four groups: with CLP and ED (n=46, with CLP and without ED (n = 34, without CLP and with ED (n = 34, and without CLP or ED (n = 51. Genomic DNA was extracted from saliva followed by conducting a Polymerase Chain Reaction and direct DNA sequencing of exons 2 through 7 of AMELX. Mutations were found in 30% (n = 14, 35% (n = 12, 11% (n = 4 and 13% (n = 7 of the subjects from groups 1, 2, 3 and 4, respectively. Thirty seven mutations were detected and distributed throughout exons 2 (1 mutation – 2.7%, 6 (30 mutations – 81.08% and 7 (6 mutations – 16.22% of AMELX. No mutations were found in exons 3, 4 or 5. Of the 30 mutations found in exon 6, 43.34% (n = 13, 23.33% (n = 7, 13.33% (n = 4 and 20% (n = 6 were found in groups 1, 2, 3 and 4, respectively. c.261 C > T (rs2106416, a silent mutation, was detected in 26 subjects, and found more significantly (p = 0.003 in patients with CLP (groups 1 and 2 – 23.75%, compared with those without CLP (groups 3 and 4 – 8.23%. In the groups without ED, this silent mutation was also found more significantly (p = 0.032 among subjects with CLP (17.65% in group 2, compared with those without CLP (7.8% in group 4. In conclusion, this study suggested that AMELX may be a candidate gene for cleft lip and palate.

  4. Association of Single Nucleotide Polymorphisms in IRF6 and TGFA Genes With Nonsyndromic Cleft Lip With Or Without Cleft Palate in Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    Ya Shen; Yugui Cu; Weidong Wan; Xiaoping Zhou; Lu Cheng; Zuhong Lu; Jiayin Liu

    2009-01-01

    Objective:Nonsyndromic cleft lip with or without cleft palate(NSCL/P) is a common birth defect with unclear etiology.Both genetic and environmental factors may contribute to NSCL/P.Many genes have been identified as candidate genes associated with this disease.Interferon regulatory factor6(IRF6) gene and transforming growth factor-a(TGFA) gene seem to be cmcial in the predisposition of NSCL/P.Here we evaluated some single nucleotide polymorphisms(SNPs) loci of TGFA and IRF6 genes in Chinese nuclear families consisting of fathers,mothers and affected offspring with NSCL/P.Methods:Fifty patients of NSCL/P were confirmed by the plastic surgeons.They and their parents were included in the study,all with the informed consents.SNPs loci of TGFA and IRF6 genes were analyzed by microarray technology.Some PCR products were randomly chosen and sequenced to check microarray results.The distribution of gene type and allele frequency between patient group and parents group were compared.Then a Haplotype Relative Risk(HRR) and Transmis-sion Disequilibrium Test(TDT) were performed.Results:The sequences of randomly selected PCR products were all consistent with the microarray results.All loci were in Hardy-Weinberg equilibrium.There were no significant differences in the distribution of genotypes and alleles between patients and their parents.Using HRR and TDT analyses the V2741 of IRF6 was associated with NSCL/P,while another SNP locus of IRF6 was not.Strong evidence of linkage disequilibrium was found between the2 SNP loci of TGFA and disease with the HRR analysis,but not with the TDT analysis.Conclusion:Our study confirms the contribution of IRF6 in the etiology of NSCL/P in populations of Asian ancestry.The association of TGFA with NSCL/P requires further research.

  5. Lip movement in patients with a history of unilateral cleft lip.

    NARCIS (Netherlands)

    Rutjens, C.A.W.; Spauwen, P.H.M.; Lieshout, P.H.H.M. van

    2001-01-01

    OBJECTIVE: The influence of a repaired cleft lip on the stability of coordination between upper and lower lip in nonspeech and speech tasks was investigated. DESIGN: First, we looked at the effects of a secondary cleft lip repair in three individuals. Second, we compared subjects with a history of r

  6. Cleft Lip and Palate

    Science.gov (United States)

    Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They ... during pregnancy. A baby can have a cleft lip, a cleft palate, or both. A cleft lip happens if ...

  7. An alternative clinical approach to achieve greater anterior than posterior maxillary expansion in cleft lip and palate patients.

    Science.gov (United States)

    Oliveira, Dauro Douglas; Bartolomeo, Flávia Uchôa Costa; Cardinal, Lucas; Figueiredo, Daniel Santos Fonseca; Palomo, Juan Martin; Andrade, Ildeu

    2014-11-01

    Cleft lip and palate patients commonly present maxillary constriction, particularly in the anterior region. The aim of this case report was to describe an alternative clinical approach that used a smaller Hyrax screw unconventionally positioned to achieve greater anterior than posterior expansion in patients with complete unilateral cleft lip and palate. The idea presented here is to take advantage of a reduced dimension screw to position it anteriorly. When only anterior expansion was needed (patient 1), the appliance was soldered to the first premolar bands and associated to a transpalatal arch cemented to the first molars. However, when overall expansion was required (patient 2), the screw was positioned anteriorly, but soldered to the first molar bands. Intercanine, premolar, and first molar widths were measured on dental casts with a digital caliper. Pre-expansion and postexpansion radiographs and tomographies were also evaluated. A significant anterior expansion and no intermolar width increase were registered in the first patient. Although patient 2 also presented a greater anterior than posterior expansion, a noteworthy expansion occurred at the molar region. The alternative approach to expand the maxilla in cleft patients reported here caused greater anterior than posterior expansion when the Mini-Hyrax was associated to a transpalatal arch, and its reduced dimension also minimized discomfort and facilitated hygiene.

  8. Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

    Energy Technology Data Exchange (ETDEWEB)

    Sutthiprapaporn, Pipop; Kongsomboon, Supaporn; Limmonthol, Saowaluck; Pisek, Poonsak; Keinprasit, Chutimaporn [Khon Kaen University, Khon Kaen (Thailand); Tanimoto, Keiji; Nakamoto, Takashi [Dept. of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan)

    2012-09-15

    This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either 'non-cleft side' or 'cleft side'. The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. The pixel area showed a significant difference between the 'non-cleft side' and 'cleft side' in group 0 (404.27{+-}103.72/117.73{+-}92.25; p=0.00), group 1 (434.29{+-}86.70/388.31{+-}109.51; p=0.01), and group 4 (430.98{+-}98.11/366.71{+-}154.59; p=0.02). No significant differences were found in group 2 (423.57{+-}98.12/383.47{+-}135.88; p=0.06) or group 3 (433.02{+-}116.07/384.16{+-}146.55; p=0.19). Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

  9. Stabilization of premaxilla repositioned during secondary bone grafting in complete bilateral cleft lip and palate patients.

    Science.gov (United States)

    Behnia, Hossein; Mesgarzadeh, Abolhasan; Tehranchi, Azita; Morad, Golnaz; Samieerad, Sahand; Younessian, Farnaz

    2014-07-01

    Secondary bone grafting simultaneous to premaxillary repositioning is a well-recognized surgical procedure for the management of bilateral cleft lip and palate patients. Proper stabilization of the repositioned premaxilla is considered as a key factor for the success of secondary bone grafting because the mobility of the premaxillary segment jeopardizes graft integration. This case series reports a reliable method of premaxillary stabilization that incorporated the intrasurgical application of resin bone cement to cover and reinforce the arch bars or orthodontic brackets applied on the maxillary teeth. Occlusal loads were reduced by application of posterior bite blocks on the mandibular teeth. The stabilization method was performed on 7 patients (5 women and 2 men) with a mean age of 12.4 years. During postsurgery follow-ups, the repositioned premaxillary segments did not show mobility in any of the patients. The palatal fistulae were completely closed. Panoramic radiographies taken 2 months after surgery demonstrated acceptable graft integration. The patients have now been followed up to 5 years. No evidence of relapse has been observed. This technique seemed to be undemanding, included minimal laboratory procedure, and maintained the labial mucosa overlying the repositioned segment intact.

  10. Novel findings of left ventricular non-compaction cardiomyopathy, microform cleft lip and poor vision in patient with SMC1A-associated Cornelia de Lange syndrome.

    Science.gov (United States)

    Wenger, Tara L; Chow, Penny; Randle, Stephanie C; Rosen, Anna; Birgfeld, Craig; Wrede, Joanna; Javid, Patrick; King, Darcy; Manh, Vivian; Hing, Anne V; Albers, Erin

    2017-02-01

    Relatively few patients with Cornelia de Lange syndrome (CdLS) due to SMC1A mutation have been reported, limiting understanding of the full extent of the phenotype. Compared to children with classic NIPBL-associated CdLS, patients with SMC1A-associated CdLS have a milder physical phenotype with prominent intellectual disability, high rate of cleft palate and absence of limb reductions. We present a patient with SMC1A-associated CdLS who had typical features including developmental delay, seizure disorder, feeding difficulties, hirsutism, and cleft palate. She also was found to have three novel features: (i) left ventricular non-compaction (LVNC) cardiomyopathy; (ii) microform cleft lip; and (iii) severe hyperopia and astigmatism. These features have implications regarding potential insight into the pathogenesis of the disorder, screening, and medical management. Hypertrophic cardiomyopathy has previously been reported in SMC1A-associated CdLS, but to our knowledge this is the first reported child with LVNC. Previous reports have included children with isolated clefts of the palate without involvement of the lip. When cleft palate alone is associated with a disorder, the underlying pathophysiology for clefting is sometimes secondary due to mechanical blocking of the fusion of the palatal shelves with the developing tongue. The presence of microform cleft lip in this patient suggests that the pathophysiology of clefting in SMC1A is primary rather than secondary. Few studies report ophthalmologic findings specific to SMC1A. Based on these findings, LVNC cardiomyopathy and cleft lip should be considered features of SMC1A-associated CdLS. All patients should receive echocardiogram and undergo thorough ophthalmologic evaluation as part of routine CdLS care. © 2016 Wiley Periodicals, Inc.

  11. Lip Repair Surgery for Bilateral Cleft Lip and Palate in a Patient Diagnosed with Trisomy 13 and Holoprosencephaly.

    Science.gov (United States)

    Akamatsu, Tadashi; Hanai, Ushio; Nakajima, Serina; Kobayashi, Megumi; Miyasaka, Muneo; Matsuda, Shinichi; Ikegami, Mariko

    2015-06-20

    We report a case of lip repair surgery performed for bilateral cleft lip and palate in a patient diagnosed with trisomy 13 and holoprosencephaly. At the age of 2 years and 7 months, the surgery was performed using a modified De Hann design under general anesthesia. The operation was completed in 1 h and 21 min without large fluctuations in the child's general condition. The precise measurement of the intraoperative design was omitted, and the operation was completed using minimal skin sutures. It is possible to perform less-invasive and short surgical procedures after careful consideration during the preoperative planning. Considering the recent improvements in the life expectancy of patients with trisomy 13, we conclude that surgical treatments for non-life threatening malformations such as cleft lip and palate should be performed for such patients.

  12. Selected aspects of the oral environment in cleft palate patients – a problem evidently beyond dentists’ scope

    Directory of Open Access Journals (Sweden)

    Joanna AntoszewskaABCD

    2010-12-01

    Full Text Available Introduction:The oral cavity is a specialized ecosystem composed of dentition and mucosa exposed to the effects of saliva and gingival liquid. Its structure provides advantageous conditions for various microorganisms, both aerobic streptococci and anaerobic bacilli. The dynamic balance of the oral cavity ecosystem can be threatened by various factors. Lip and palatal clefts are the most frequent disorders in embryonic facial development. The aim of the study was to evaluate whether Streptococcus mutans and Lactobacillus acidophilus and oral cavity hygiene in patients with cleft palate treated orthodontically are significantly different compared with patients without these congenital malformations.Material/Methods:The study group consisted of 200 patients aged 6–21 who were divided into two groups depending on the presence of cleft palate and treatment method. Group C (control consisted of 50 orthodontically untreated patients with occlusal dental defects. The performed studies consisted of 2 parts: the clinical-laboratory part and statistical analysis.Clinical-laboratory partResults:High bacteria levels of Streptococcus mutans and Lactobacillus acidophilus in saliva of patients were comparably frequent between groups, but there were statistically significant differences in inter-group comparisons.Conclusions:As the orthodontic treatment changes the oral environment, control of proper hygienic behavior is an essential element of health education. Introduction of preventive programs is also very important.

  13. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

    Science.gov (United States)

    Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

    2013-10-01

    The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

  14. Psychological issues in cleft lip and cleft palate

    Directory of Open Access Journals (Sweden)

    Sousa Avinash

    2009-01-01

    Full Text Available Vocational and social issues affect rehabilitation and development of patients with cleft lip and cleft palate. However, psychological problems like lowered self esteem and difficulties in social interaction have also been noted in them. Not many pediatric reconstructive surgery teams have a psychiatrist on their panel. It is likely that psychological problems are higher in incidence than literature actually suggests. Hence it is very essential that such cases are identified by the surgical team to maximize positive outcome of surgery and rehabilitation. This study discusses psychological issues revolving around cleft lip and cleft palate along with lacunae in many psychological research studies.

  15. Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function.

    Science.gov (United States)

    Chua, H D P; Whitehill, T L; Samman, N; Cheung, L K

    2010-07-01

    This clinical randomized controlled trial was performed to compare the effects of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) on velopharyngeal function and speech outcomes in cleft lip and palate (CLP) patients. Twenty-one CLP patients who required maxillary advancement ranging from 4 to 10 mm were recruited and randomly assigned to either CO or DO. Evaluation of resonance and nasal emission, nasoendoscopic velopharyngeal assessment and nasometry were performed preoperatively and at a minimum of two postoperative times: 3-8 months (mean 4 months) and 12-29 months (mean 17 months). Results showed no significant differences in speech and velopharyngeal function changes between the two groups. No correlation was found between the amount of advancement and the outcome measures. It was concluded that DO has no advantage over CO for the purpose of preventing velopharyngeal incompetence and speech disturbance in moderate cleft maxillary advancement.

  16. Survey of the patients with cleft lip and palate in China who were funded for surgery by the Smile Train Program from 2000 to 2002

    Institute of Scientific and Technical Information of China (English)

    ZHOU Qiao-juan; SHI Bing; SHI Zong-dao; ZHENG Qian; WANG Yan

    2006-01-01

    Background Cleft lip (CL) and cleft palate (CP) are two of the most frequent congenital malformations.Many epidemiologic studies on this deformity have been conducted worldwide, often producing inconsistent results. This study assessed epidemiology and some genetic aspects of cleft lip and palate in a Chinese sample from the Smile Train Program and to compare with other methodologically sound surveys.Methods The general information, family history, classification of cleft and associated malformations of 8000CL and CP surgery patients were analyzed.Results Of the 8000 cases, 7812 had complete data. The distribution of cleft types is 17.04% with CP, 23.39%with CL and 59.58% with cleft lip and palate (CLP). Unilateral clefts were more common than bilateral, with involved 29 CP cases, 41 CL and 156 CLP. The frequency of associated malformations in CLP (3.35%) was higher than CL (2.24%) and CP (2.22%) (P<0.05). Patients with CP or CLP were born less often in the winter than in the summer (P<0.05). A history of family members having clefts occurred in 6.84% of patients. The proportion of CLP cases (7.56%) was significantly higher than that of CL cases (5.64%) (P<0.05).Conclusions The different types of clefts appeared in the highest proportion in CLP and lowest proportion in CP. Males are more common with CL and CLP and less common with CP. These characteristics are the same as those of other Chinese surveys but different from some European reports.

  17. Factors related to quality of life and satisfaction with nasal appearance in patients treated for unilateral cleft lip and palate.

    Science.gov (United States)

    Mani, Maria; Reiser, Erika; Andlin-Sobocki, Anna; Skoog, Valdemer; Holmström, Mats

    2013-07-01

    Objective : To identify factors related to quality of life (QoL) and satisfaction with nasal appearance among patients treated for unilateral cleft lip and palate (UCLP). Design : Cross-sectional population study with long-term follow-up. Patients/Settings : All patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, were invited (n  =  109); 86 (79%) participated. Mean follow-up time was 35 years. Main Outcome Measures : Quality of life was measured with Short Form-36 (SF-36) and analyzed using mental and physical cluster scores (MCS and PCS). Nasal appearance was self-assessed with the "Satisfaction With Appearance" questionnaire and by panel judgment. Multivariate regression analyses explored endogenous factors (age, gender, infancy cleft width, nasal function, nasolabial appearance) and exogenous factors (marital status, number of children, education level, operation method, number of rhinoplasties performed). Results : A larger cleft width in infancy was associated with less satisfaction with nasal appearance as adults. A lower mental health QoL was associated with less satisfaction with nasal appearance. Despite female gender being linked to less satisfaction with nasal appearance, it was associated with higher mental health QoL. Higher resistance during nasal breathing was associated with lower physical health QoL. Conclusions : Gender and infant cleft width may affect QoL and satisfaction with nasal appearance among adults. They are potential predictive factors for satisfaction with nasal appearance and QoL during adulthood. The correlation of nasal function impairment and decreased physical health QoL underlines the importance of treatment of nasal symptoms in these patients.

  18. Patient with syndromic cleft lip-palate, mosaic karyotype and cytogenetically abnormal brother

    OpenAIRE

    Šliužas, Vytautas; Cimbalistienė, Loreta; Kučinskas, Vaidutis

    2006-01-01

    Objective. Cleft lip with or without cleft palate (CLP) is a common congenital abnormality involving genetic and non-genetic factors in its etiology. Although many studies have been made to find the genetic pattern of this malformation, there is still no precise answer. There have been suggested several models of inheritance where a few major loci are influenced by the number of modifiers. The number of modifiers is still unknown and could be scattered all over the genome. Chromosome rearrang...

  19. Treatment Approach for Maxillary Hypoplasia in Cleft Patients: Class III Elastics with Skeletal Anchorage (Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Arezoo Jahanbin

    2016-05-01

    Full Text Available Introduction: Treatment ofcleft lip and palate patients requires a multidisciplinary plan. These patients usually have a hypoplastic maxilla due to the prior surgical scars. Orthognathic surgery to advance the maxilla in these patients is not very efficient; therefore, orthopedic interventions during an appropriate age seems to be essential.   Case Report: In this article, two cleft lip and palate patients have been treated with Class III elastics anchored to the maxillary posterior and mandibular anterior miniplates in order to induce maxillary advancement.   Conclusion: Both cases showed a significant improvement in their profiles with minimal dentoalveolar compensations. A counterclockwise rotation of the mandible occurred.

  20. Dental anomalies in different cleft groups related to neural crest developmental fields contributes to the understanding of cleft aetiology

    DEFF Research Database (Denmark)

    Riis, Louise Claudius; Kjær, Inger; Mølsted, Kirsten

    2014-01-01

    , radiographs, dental casts, and medical records. PATIENTS: Ninety individuals (30 cleft lip, 30 cleft palate, and 30 combined cleft lip and palate), aged 5-27 years. MAIN OUTCOME MEASURES: Visual evaluation of tooth number and tooth morphology. RESULTS: Cleft lip: Dental deviations were predominantly observed...... in the frontonasal field. Supernumerary lateral incisors occurred significantly more often in cleft lip compared to other cleft types. Cleft palate: Dental deviations were observed in the maxillary and palatal fields indicating that both fields are involved in the development of cleft palate. Malformed roots were...... seen significantly more often in cleft palate. Combined cleft lip and palate: Number and type of dental deviations differed significantly from deviations in other cleft types, e.g. significantly more ageneses. CONCLUSIONS: Cleft lip seems to be caused by a disorder in neural crest migration...

  1. 完全性唇腭裂患者术前正畸治疗85例%Cleft lip and cleft palate patients before orthodontic treatment in 85 cases

    Institute of Scientific and Technical Information of China (English)

    马敬斋; 姜瑞中; 张景霞; 郝杰兵; 王猛虎

    2012-01-01

      Objective:To observe the patients with complete cleft lip and palate preoperative orthodontic treatment effect. Methods:85 cases of cleft lip and cleft palate patients, before and after the treatment of alveolar cleft by measuring the distance changes, observe the therapeutic effect of nasal shape; with the evaluation criteria for postoperative patients a preliminary evaluation. Results:after 75-180 days of treatment,50cases of patients with unilateral cleft lip and palate alveolar fracture width than before treatment was reduced by4.0mm before and after treatment, width of a mean reduction of 3.7mm; nasal shape a better evaluation. In 35 patients with bilateral cleft lip and palate alveolar fracture width than before treatment was reduced by3.5mm, and width is before treatment was reduced by4.7MM, nose shape a better evaluation. Conclusion:the patients with complete cleft lip and palate do preoperative orthodontic treatment, were easy to adapt, favourable nasal development, can reduce the difficulty of operation, improve the repairing effect.%  目的:观察完全性唇腭裂患者术前正畸治疗的效果.方法:对85例完全性唇腭裂患者,通过测量矫治前后牙槽裂距的改变,观察治疗效果;用鼻外形的评价标准对术后患儿进行初步评价.结果:经过75-180天的治疗,50例单侧完全性唇腭裂患者牙槽突裂隙左右宽度较矫治前平均缩小4.0mm,前后宽度较矫治前平均缩小3.7mm;鼻外形评价较好.35例双侧完全性腭裂牙槽突裂隙左右宽度较矫治前平均缩小3.5mm,前后宽度较矫治前平均缩小4.7mm,鼻外形评价较好.结论:对完全性唇腭裂患者做术前正畸治疗,患儿易适应,有利鼻发育,可减小手术的难度,提高整复效果.

  2. Fracture of the Vomero-Premaxillary Junction in a Repaired Bilateral Cleft Lip and Palate Patient

    Science.gov (United States)

    Zwahlen, Roger Arthur; Jayaratne, Yasas Shri Nalaka; Htun, Su Yin; Bütow, Kurt-Wilhelm

    2014-01-01

    Although dental trauma is common in bilateral cleft lip and palate (BCLP), patients' reports on bony fractures of the vomero-premaxillary junction cannot be found. The aim of this report is to illustrate clinical findings and the technique of fracture fixation in a child suffering from a fractured vomero-premaxillary junction as well as subsequent columella lengthening. A 4-year-old girl with a repaired BCLP presented with an open mucosal laceration and fractured vomero-premaxillary junction. Open reduction and fixation of the dislocated premaxilla was performed under general anesthesia. Fractured bone pieces of the vomero-premaxillary junction were removed and sharp bone edges at the vomer and the premaxilla were grinded. The repositioned premaxilla was fixed to the lateral alveolar arches with two mucoperiosteal sutures on each side. Additional columella lengthening was performed 2 years later. All family members were very happy about the new aesthetics of the girl. Although rare, fractures of the vomero-premaxillary junction present several challenges to clinicians related to anatomical, physiological, and psychological issues. Immediate and minimal invasive treatment strategies are recommended when managing such cases. PMID:25383152

  3. Patients and professionals have different views on online patient information about cleft lip and palate (CL/P).

    Science.gov (United States)

    van den Bosch, S; Koudstaal, M; Versnel, S; Maal, T; Xi, T; Nelen, W; Bergé, S; Faber, M

    2016-06-01

    Parents of children with a cleft lip and/or palate (CL/P) and patients with CL/P actively search for online information about CL/P. The quality of this information has not been sufficiently evaluated. The aim of this study was to define quality criteria for online information about CL/P and assess the quality of frequently accessed websites. Patients, parents, and professionals were equally involved in all stages of this study. A literature review was performed to obtain known quality criteria for online information. These criteria were prioritized by patients, parents, and professionals. The most important criteria were used to rate the quality of four websites on CL/P. Forty-two quality items were extracted from the literature. Patients, parents, and professionals agreed on the importance of 16 of these items. New groups of patients, parents, and professionals assessed four websites on CL/P. Although the groups were like-minded in their overall assessment of the quality of the websites, distinct differences emerged between the groups in relation to certain items. This study shows the importance of patient participation in healthcare research, as well as a feasible approach to do so. Involving patients in composing online health information will set different priorities, which is necessary in establishing high quality information.

  4. Late detection of cleft palate

    NARCIS (Netherlands)

    Hanny, K H; de Vries, I A C; Haverkamp, S J; Oomen, K P Q; Penris, W M; Eijkemans, M J C; Kon, M; Mink van der Molen, A B; Breugem, C C

    2016-01-01

    Cleft palate only (CPO) is a common congenital malformation, and most patients are diagnosed within the first weeks after birth. Late diagnosis of the cleft palate (CP) could initially result in feeding and growth impairment, and subsequently speech and hearing problems later in life. The purpose of

  5. MORPHOLOGICAL OUTCOME OF PRIMARY L IP REPAIR IN PATIENTS WITH UNILAT ERAL CLEFT LIP - PALATE WITH THE USE OF INFERIOR TURBINATE F LAP

    Directory of Open Access Journals (Sweden)

    Vijaya Kumar

    2015-06-01

    Full Text Available BACKGROUND: Cleft lip and palate deformity poses problems at every stage of growth and development of the child. Repair of cleft lip - nose complex is a major challenge for the operating surgeon as well the manner in which the deficient tissues are replenished. The major issue which still remains to be tackled is achieving a acceptable nasal correction. In the quest for tissues to bring about a better repair especially in the region of nostril floor and a lar base , the hypertrophied inferior turbinate on the cleft side appears to be a good option. OBJECTIVE: The objective of the study is to evaluate long term aesthetic and morphological outcome of lip and nose in patients with unilateral cleft lip and palate deformity. MATERIALS AND METHOD : A Group of 41 patients were taken in the study and they were randomize d into two groups , Study group 21 cases who underwent primary lip repair with inferior turbinate flap and Control Group B , 20 cases without inferior turbinate flap. Age , sex , side of cleft and photographic evaluation of was done at 2 years and above post o peratively for nostril height , nostril width , nostril basal width and alar base level. RESULTS : On photographic evaluation group a showed statistically significant symmetry in the nasal architecture , and the long term follow up of these patients is necessa ry to comment on the aesthetic outcome. CONCLUSION : Inferior turbinate flap provides an adequate tissue during nostril floor reconstruction and helped in augmenting the depressed alar base on the cleft side.

  6. 1435例非综合征唇腭裂的发病特点%Pathogenetic characteristics of non-syndromic cleft lip with or without cleft palate: clinical analyses of 1435 patients

    Institute of Scientific and Technical Information of China (English)

    邬文莉; 王洪涛; 陈亦阳; 黎凡; 刘佳玉; 郝建锁

    2015-01-01

    Objective To investigate the characteristics of patients with non-syndromic cleft lip with or without cleft palate (NSCL/P),and to provide the basis for the treatment.Methods 1435 cases of NSCL/P were collected from January 2012 to December 2014.Characteristics of the gender,type and side,blood type,associated malformation,genetic history of the patients were analyzed retrospectively.Results In the 1435 cases,397 cases (27.67%) presented with cleft lip,655 cases (45.64%) with cleft palate,and 383 cases (26.68%) with cleft lip and palate.801 (55.82%) were male,and 634 (44.18%) were female.In cleft lip,male 60.20% (n=239) were more than female 39.80% (n=158);left side was 57.43% (n=228) more than right 27.96% (n=111) and the right were more than bilateral 14.61% (n=58).In cleft lip and palate,male 78.33% (n=300) were more than female 21.67% (n=83),left 41.51% (n=159) were more than right 28.20% (n=108) and bilateral 30.29% (n=116).In cleft palate,female 60.00% (n=393) were more than male 40.00% (n=262).Blood type AB with cleft lip (28/369) were higher than ones with cleft palate (28/627).All of the differences were statistically significant (P<0.05).5.09 % (n =73) patients with malformation were found out of 1435 cases.The patients with congenital heart disease (n=36,2.51%) was the largest number of total deformity.Conclusions In patients with cleft lip,male is more than female;left side is more than right;unilateral clefts are higher that bilateral ones.In cleft lipand palate,male were more than female,left side were higher.In cleft palate,female were more than male.Blood type AB with cleft lip is higher than that of cleft palate.%目的 探讨非综合征唇腭裂的发病特点,为治疗提供依据.方法 收集1435例非综合征唇腭裂病例,对患者的性别、疾病部位、血型、伴发畸形、遗传史等进行回顾性分析.结果 1435例中,单纯唇裂397例(27.67%),单纯腭裂655例(45.64

  7. Weight Comparison of Patients with Cleft Lip and Palate and Normal%唇腭裂患者与正常人体重的比较

    Institute of Scientific and Technical Information of China (English)

    李建平; 吴纪楠; 李运良

    2011-01-01

    Objective The purpose of this study was to compare the weight between patients with cleft lip and palate and normal controls without cleft in a Hunan cohort aged from 3 months to 30 years old, and to analysis the reasons affecting the weight of the congenital cleft patients in all development stages. Methods Weights of different age-groups of 1939 patients with cleft lip and palate were compared to normal controls, while the patients with simple cleft lip were also compared with those with simple cleft palate. Results Weight of patients with cleft lip and palate in different age groups were lower than those of normal control group. There were statistically significant differences ( P< 0.001 - 0.05 ). There was no statistically significance in weight difference between simple cleft lip and simple cleft palate. Conclusion Weight of patients with cleft lip and palate is lower than those of normal control group.%目的 研究3个月~ 30岁唇腭裂患者与正常同龄人的体重差别,分析唇腭裂患者各生长阶段影响其体重的主要因素.方法 唇腭裂患者1 939例,年龄3个月~30岁,按不同年龄分组,与正常对照组分性别进行体重比较,并对单纯性唇裂及单纯性腭裂患者之间体重进行比较,采用t检验.结果 各年龄组唇腭裂患者体重均较正常对照组偏低,差异有统计学意义(P<0.05);各年龄组单纯性唇裂与单纯性腭裂患者体重差异无统计学意义(P>0.05).结论 唇腭裂患者各生长阶段的体重较正常偏低.

  8. Cephalometric comparison of early and late secondary bone grafting in the treatment of patients suffering from unilateral cleft lip and palate.

    Science.gov (United States)

    Brudnicki, Andrzej; Sawicka, Ewa; Brudnicka, Renata; Fudalej, Piotr Stanisław

    2017-04-01

    The study was based on a retrospective cephalometric assessment of 10-year-olds in order to evaluate the influence of early secondary bone grafting on craniofacial development in patients suffering from non-syndromic complete unilateral cleft lip and palate. The study consisted of 79 patients in the early and 67 patients in the late secondary bone grafting group. The mean age at alveolar bone grafting was 2.5 years (SD 0.03) in the first group and 9.8 years (SD 2.3) in the second group. The primary cleft repair of these 146 patients was always performed in accordance with the one-stage method. Additionally, the non-cleft Control group was comprised of 56 children of the same ethnicity and age. The cephalometric analysis performed at age 10 revealed similar overall characteristics of observed growth disturbances in both cleft groups in comparison to the Control group, such as: inhibition of vertical and anterior maxillary development, the tendency of the mandible to rotate clockwise, and a prevalence of vertical over horizontal facial growth. The comparison between the cleft groups revealed a lack of growth differences in the vertical dimension and more pronounced anterior maxillary development inhibition in the early bone grafting group. This study will be followed by a similar evaluation after craniofacial development is complete by a significant number of these patients in order to ascertain our conclusions.

  9. Identification of germline mutations in the cancer predisposing gene CDH1 in patients with orofacial clefts

    NARCIS (Netherlands)

    Vogelaar, I.P.; Figueiredo, J.; Rooij, I.A. van; Simoes-Correia, J.; Post, R.S. van der; Melo, S.; Seruca, R.; Carels, C.E.L.; Ligtenberg, M.J.L.; Hoogerbrugge-van der Linden, N.

    2013-01-01

    Orofacial clefts (OFC) are among the most common birth defects worldwide. The etiology of non-syndromic OFC is still largely unknown. During embryonic development, the cell adhesion molecule E-cadherin, encoded by CDH1, is highly expressed in the median edge epithelium of the palate. Furthermore, in

  10. Craniofacial, craniocervical, and pharyngeal morphology in bilateral cleft lip and palate and obstructive sleep apnea patients

    NARCIS (Netherlands)

    Oosterkamp, B.C.M.; Remmelink, H.J.; Pruim, G.J.; Hoekema, A.; Dijkstra, P.U.

    2007-01-01

    Objective: The aim of this study was to analyze craniofacial, craniocervical, and pharyngeal morphology in surgically treated bilateral cleft lip and palate (BCLP) men, untreated men with obstructive sleep apnea (OSA), and a reference group of men. Subjects and methods: Lateral cephalograms were obt

  11. An assessment of orofacial clefts in Tanzania

    Directory of Open Access Journals (Sweden)

    Mazyala Erick

    2011-02-01

    Full Text Available Abstract Background Clefts of the lip (CL, the palate (CP, or both (CLP are the most common orofacial congenital malformations found among live births, accounting for 65% of all head and neck anomalies. The frequency and pattern of orofacial clefts in different parts of the world and among different human groups varies widely. Generally, populations of Asian or Native American origin have the highest prevalence, while Caucasian populations show intermediate prevalence and African populations the lowest. To date, little is known regarding the epidemiology and pattern of orofacial clefts in Tanzania. Methods A retrospective descriptive study was conducted at Bugando Medical Centre to identify all children with orofacial clefts that attended or were treated during a period of five years. Cleft lip and/or palate records were obtained from patient files in the Hospital's Departments of Surgery, Paediatrics and medical records. Age at presentation, sex, region of origin, type and laterality of the cleft were recorded. In addition, presence of associated congenital anomalies or syndromes was recorded. Results A total of 240 orofacial cleft cases were seen during this period. Isolated cleft lip was the most common cleft type followed closely by cleft lip and palate (CLP. This is a departure from the pattern of clefting reported for Caucasian and Asian populations, where CLP or isolated cleft palate is the most common type. The distribution of clefts by side showed a statistically significant preponderance of the left side (43.7% (χ2 = 92.4, p Conclusions Unilateral orofacial clefts were significantly more common than bilateral clefts; with the left side being the most common affected side. Most of the other findings did not show marked differences with orofacial cleft distributions in other African populations.

  12. International multiphase mixed methods study protocol to develop a cross-cultural patient-reported outcome instrument for children and young adults with cleft lip and/or palate (CLEFT-Q)

    Science.gov (United States)

    Wong Riff, Karen W Y; Tsangaris, Elena; Goodacre, Tim; Forrest, Christopher R; Pusic, Andrea L; Cano, Stefan J; Klassen, Anne F

    2017-01-01

    Introduction Patient-reported outcome (PRO) instruments should be developed according to rigorous guidelines in order to provide clinically meaningful, scientifically sound measurement. Understanding the methodology behind instrument development informs the selection of the most appropriate tool. This mixed methods protocol describes the development of an internationally applicable PRO instrument, the CLEFT-Q, for evaluating outcomes of treatment for cleft lip and/or palate (CL/P). Methods and analysis The study includes three main phases that occur iteratively and interactively. In phase I, we determine what concepts are important to patients regarding their outcome. A conceptual framework for the CLEFT-Q is formed through a systematic review and an extensive international qualitative study. The systematic review ascertains what concepts have previously been measured in patients with CL/P. The qualitative study employs interpretive description and involves in-depth interviews with patients in high-income and lower-middle income countries. Preliminary items are generated from the qualitative data. Preliminary scales are then created for each theme in the framework. Cognitive debriefing interviews and expert clinician input are used to refine the scales in an iterative process. In phase II, the preliminary scales are administered to a large international group of patients with CL/P. The modern psychometric method of Rasch Measurement Theory analysis is employed to define the measurement characteristics. The preliminary scales are shortened based on these results. In phase III, further tests assess reliability, validity and responsiveness of the instrument. Ethics and dissemination The study is approved by Research Ethics Boards for each participating site. Findings from this study will be published in open access peer-reviewed journals and presented at national and international conferences. Integrated knowledge translation is employed to engage stakeholders from

  13. Micro-structured Beta-Tricalcium Phosphate for Repair of the Alveolar Cleft in Cleft Lip and Palate Patients : A Pilot Study

    NARCIS (Netherlands)

    de Ruiter, AP; Janssen, Nard; van Es, Robert; Frank, Michael; Meijer, Gert; Koole, Ron; Rosenberg, Toine

    2015-01-01

    OBJECTIVES: Can a synthetic bone substitute be used to repair the alveolar cleft to bypass donor site morbidity as well as to shorten the operating time? In earlier experimental studies, micro-structured beta-tricalcium phosphate (β-TCP) provided similar bone healing when compared with grafting with

  14. 唇腭裂患者口腔健康状况的研究进展%Research progress on oral health status of patient with oral clefts

    Institute of Scientific and Technical Information of China (English)

    柴丛娜

    2011-01-01

    唇腭裂患者的口腔健康状况为近年来的研究热点之一.大量调查表明,唇腭裂患者是龋病和牙周组织疾病的易患人群.其龋病和牙周组织疾病的发生与外科手术、解剖因素、唇腭裂类型因素等密切相关.不同唇腭裂类型的患者口腔卫生状况不一致,不同国家地区的唇腭裂患者的口腔卫生状况也不尽相同.本文就唇腭裂患者的龋病流行特征、牙周疾病特征和口腔卫生状况等研究进展作一综述.%The oral health status of oral clefts has become a hot research spot in recent years. The survey shows that patients with oral clefts remain in the high-risk group for dental caries and periodontal disease. Surgical interventions combined anatomical defects, and cleft status was major factors for dental caries and periodontal disease in patients with oral clefts. For the past few years, significant difference was found in oral hygiene among different cleft types and in different countries of the cleft subjects. The studies of the caries prevalence, periodontal disease, influencing factors and oral hygiene of patients with oral clefts were summarized.

  15. Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

    Science.gov (United States)

    Yeow, Vincent Kok-Leng

    2014-01-01

    We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects. PMID:24511499

  16. Orthopedic intrusion of premaxilla with distraction devices before alveolar bone grafting in patients with bilateral cleft lip and palate.

    Science.gov (United States)

    Liou, Eric Jein-Wein; Chen, Philip K T; Huang, C Shing; Chen, Y Ray

    2004-03-01

    Surgical repositioning of the downward displaced premaxilla in bilateral cleft lip and palate patients remains a controversial and perplexing issue because of its detrimental effects on the growth of the premaxilla. The purpose of this prospective clinical study was to introduce and evaluate the treatment results of an innovative technique for nonsurgically intruding the downward displaced premaxilla. Eight consecutive cases of bilateral cleft lip and palate at the age of mixed dentition were included for the correction of their premaxillary deformities. A pair of intraoral tooth-borne distraction devices was used for the orthopedic intrusion. Serial lateral and posteroanterior cephalometric radiographs were taken periodically for evaluating the growth of the premaxilla 1 year before the intrusion, changes during the intrusion, and growth/relapse up to 1 year after the intrusion. There was no overgrowth of the premaxilla or overeruption of the maxillary incisors during the 1-year observing period before the orthopedic intrusion. The treatment results revealed that the downward displaced premaxillae were all corrected within 1 month. Cephalometrically, 46 percent of the correction resulted from a true orthopedic intrusion and another 54 percent from a dentoalveolar effect in which the maxillary incisors were intruded and the premaxillary dentoalveolus was shortened. The cephalometric evaluations also implied that what occurred during the orthopedic intrusion was mostly the sutural contraction osteogenesis/osteolysis in the vomeropremaxillary suture combined with slightly mechanical upward displacement of the vomeronasal septum complex and nasal bones. The orthopedic intrusion of the premaxilla with distraction devices is an effective nonsurgical method for correcting the downward displaced premaxilla before alveolar bone grafting in patients with bilateral cleft lip and palate, and the results remained stable after 1 year.

  17. Facts about Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... Information For... Media Policy Makers Facts about Cleft Lip and Cleft Palate Language: English Español (Spanish) Recommend on Facebook ... commonly are called “orofacial clefts”. What is Cleft Lip? The lip forms between the fourth and seventh ...

  18. Cleft palate and ADULT phenotype in a patient with a novel TP63 mutation suggests lumping of EEC/LM/ADULT syndromes into a unique entity: ELA syndrome.

    Science.gov (United States)

    Prontera, Paolo; Garelli, Emanuela; Isidori, Ilenia; Mencarelli, Amedea; Carando, Adriana; Silengo, Margherita Cirillo; Donti, Emilio

    2011-11-01

    Acro-dermato-ungual-lacrimal-tooth (ADULT) syndrome is a rare condition belonging to the group of ectodermal dysplasias caused by TP63 mutations. Its clinical phenotype is similar to ectrodactyly-ectodermal dysplasia-cleft lip/palate (EEC) and limb-mammary syndrome (LMS), and differs from these disorders mainly by the absence of cleft lip and/or palate. We report on a 39-year-old patient who was found to be heterozygous for a c.401G > T (p.Gly134Val) de novo mutation of TP63. This patient had the ADULT phenotype associated with cleft palate. Our findings, rather than extend the clinical spectrum of ADULT syndrome, suggest that cleft palate can no longer be considered an element for differential diagnosis for ADULT, EEC, and LMS. Our data, added to other reports on overlapping phenotypes, support the combining of these three phenotypes into a unique entity that we propose to call "ELA syndrome," which is an acronym of ectrodactyly-ectodermal dysplasia-cleft lip and palate, limb-mammary, and ADULT syndromes.

  19. Bilateral microform cleft lip

    OpenAIRE

    Pace, David; Attard Montalto, Simon; Grech, Victor E.

    2006-01-01

    Microform cleft lip (MCL), also called congenital healed cleft lip or cleft lip "frustré", is a rare congenital anomaly. MCL has been described as having the characteristic appearance of a typical cleft lip which has been corrected in utero. We present a girl with bilateral microform cleft lip associated with a preauricular sinus and bilateral camptodactyly.

  20. Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... help you find community and financial resources and education. For your child You can support your child in many ways: Focus on your child as a person, not on the cleft. Point out positive qualities in others that don't involve physical ...

  1. Refinement of velopharyngoplasty in patients with cleft palate by covering the pharyngeal flap with nasal mucosa from the velum.

    Science.gov (United States)

    Stoll, C; Hochmuth, M; Meister, P; Soost, F

    2000-06-01

    The velopharyngoplasty performed using the popular Sanvenero-Rosselli method improves the speech quality of patients with cleft palate suffering from persistent velopharyngeal insufficiency despite successful closure of the hard and soft palates. However, often a relatively narrow pharyngeal bridge results due to healing not only by granulation and scar contraction, but also due to the insertion of the inferior tip of the flap into a narrow bed. Elevation of two velar flaps with nasal mucosa to cover the exposed muscular undersurface of the pharyngeal flap produces a broader recipient bed into which the pharyngeal flap can be spread. The speech quality of 27 patients treated with this modified method (group B) was compared with that of 27 patients without this modification (group A). Eight weeks after velopharyngoplasty (followed by uneventful wound healing) the speech quality of group B was significantly better than that of group A (pvelum is an important modification of velopharyngoplasty for the improvement of speech quality.

  2. [Cleft lip and palate--problematic cleft speech].

    Science.gov (United States)

    Hortis-Dzierzbicka, M A

    1999-01-01

    The early restoration of facial and palatal morphology in patients with cleft of lip and/or palate provides the anatomical base for good speech outcome. The author gives the up todate overview of the main problems concerning cleft speech, such as velopalatal insufficiency and typical articulation errors. The article describes the modern methods for the evaluation of VPI and current trends in treatment modalities for VPI.

  3. Hard palate-repair technique and facial growth in patients with cleft lip and palate: a systematic review.

    Science.gov (United States)

    Lee, Ying-Hsin; Liao, Yu-Fang

    2013-12-01

    The vomer flap technique for repair of the hard palate is assumed to improve maxillary growth because it causes less scarring in growth-sensitive areas of the palate. The aim of this systematic review was to investigate the effect of techniques using the vomer flap compared with the palatal flap on facial growth in patients with cleft lip and palate. All papers published before 21 July 2012 were sought in the databases PubMed and MEDLINE. Search terms included "facial growth", "cleft lip and palate", "palatal repair technique", and "vomer flap". Additional studies were identified by hand searching the reference lists of the papers retrieved from the electronic search. Two independent reviewers assessed the eligibility of studies for inclusion, extracted the data, and assessed the quality of the methods. Six studies met the selection criteria. Outcomes assessed in 4 studies were dentofacial morphology after vomer or palatal flap, maxillary dental arch in 1 study, and dental arch relations in 2 studies. The quality of the methods used in 3 studies was poor. Contradictory results and a lack of high-quality and long-term outcomes of reviewed studies provided no conclusive scientific evidence about whether the vomer flap technique has more or less of an adverse effect on maxillary growth than the palatal flap. Further well-designed, well-controlled, and long-term studies particularly of the vomer flap (2-stage) and palatal flap (von Langenbeck or two-flap, 1-stage) are needed.

  4. Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

    Directory of Open Access Journals (Sweden)

    José Fernando Scarelli LOPES

    2015-04-01

    Full Text Available A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework, allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

  5. Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report.

    Science.gov (United States)

    Lopes, José Fernando Scarelli; Pinto, João Henrique Nogueira; Lopes, Monica Moraes Waldemarin; Mazottini, Reinaldo; Soares, Simone

    2015-01-01

    A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework), allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

  6. Maxillary distraction osteogenesis for treatment of cleft lip and palate in a patient with X-linked agammaglobulinemia.

    Science.gov (United States)

    Sato, Yutaka; Mishimagi, Takashi; Katsuki, Yuko; Harada, Kiyoshi

    2014-07-01

    X-linked agammaglobulinemia (XLA) is a congenital immune deficiency disorder caused by abnormal antibody production. It is a rare disease with an estimated frequency of 1 in 379,000 that has X-linked recessive heredity and develops only in males. The clinical problems include bacterial infection such as otitis media, sinusitis, and bronchitis. In recent years it has become possible to diagnose XLA in the early stage and intravenous immunoglobulin replacement therapy has permitted survival to adulthood. However, there have been no reports of oral surgery in patients with XLA. Here, we describe a case in which immunoglobulin replacement therapy given pre- and postoperatively was used to control infection in oral surgery and maxillary distraction osteogenesis performed for improving occlusion and appearance of a cleft lip and palate in a patient with XLA.

  7. Feeling Normal? Long-Term Follow-up of Patients with a Cleft Lip-Palate after Rhinoplasty with the Derriford Appearance Scale (DAS-59)

    NARCIS (Netherlands)

    Albers, Andreas E.; Reichelt, Andreas C.; Nolst-Trenité, Gilbert J.; Menger, Dirk Jan

    2016-01-01

    The stigma of nasal deformity due to a congenital cleft lip-palate has an undeniable influence on the affected patient's life. It is therefore of interest to investigate if efforts to reduce esthetic and functional impairments by rhinoplasty (single or multiple) can result in an increased satisfacti

  8. Velopharyngeal function from the age of three to eight years in cleft palate patients.

    Science.gov (United States)

    Pulkkinen, J; Haapanen, M L; Paaso, M; Laitinen, J; Ranta, R

    2001-01-01

    The purpose of this investigation was to study changes of velopharyngeal function between the ages of 3 and 8 years. The subjects were 65 (30 girls and 35 boys) Finnish-speaking non-syndromic children with isolated cleft palate (CP, n = 35) and with unilateral cleft lip and palate (UCLP, n = 30) operated primarily at the age of 1.0-2.0 years. Before the age of 8 years, 16 children required velopharyngoplasty (VPP, ad modum Hoenig). The children were followed up for speech at the age of 3, 6 and 8 years. The perceptual speech characteristics nasal air emission, hypernasality, weakness of pressure consonants and compensatory articulations were registered. Indications for a velopharyngeal flap (by VPP) were identified on the basis of perceptual speech characteristics and confirmed by instrumental examinations. The results indicated that the method and timing of primary palatoplasty and sex did not correlate with the quality of velopharyngeal function. It was good both in children treated conservatively or with VPP at the age of 8 years. The children with a flap required speech therapy significantly more often than other children. No child with VPP and only 12% of the children without VPP had simultaneous nasal air emissions and hypernasality. Compensatory articulation was completely eliminated and weakness of pressure consonants was diagnosed only in 1 child without VPP. The CP children required significantly more often a velopharyngeal flap than the UCLP children. In conclusion, the CP and UCLP children develop a similar velopharyngeal function but in a different way.

  9. Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Wang, Zhongying; Wang, Peihua; Zhang, Yixin; Shen, Guofang

    2017-01-01

    Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12-combined surgery group; 11-control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function.

  10. Soft tissue chondroma of hard palate associated with cleft palate

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Sudhir Sankalecha

    2012-01-01

    Soft tissue chondroma of palate is very rare. It has never been reported in a cleft palate patient. We report a case of 22-year-old male who came with asymptomatic swelling on the palate since birth, along with complete cleft of secondary palate. He had symptoms related to cleft palate only, i.e., nasal regurgitation and speech abnormalities. Swelling was excised and the cleft palate was repaired. Histopathological examination revealed chondroma of the palate. The patient had no recurrence af...

  11. Tessier 30 facial cleft

    Directory of Open Access Journals (Sweden)

    Nirmal C Bhattacharyya

    2012-01-01

    Full Text Available A case of midline cleft of the lower lip with cleft of the mandible and complete duplication of the tongue is reported here. Median cleft of the lower lip, mandible and bifid tongue with ankyloglossia is reported in the literature, but complete duplication of the tongue as part of the Tessier 30 cleft is not yet reported.

  12. Tessier 30 facial cleft

    Science.gov (United States)

    Bhattacharyya, Nirmal C.; Kalita, Kabita; Gogoi, Manoj; Deuri, Pradip K.

    2012-01-01

    A case of midline cleft of the lower lip with cleft of the mandible and complete duplication of the tongue is reported here. Median cleft of the lower lip, mandible and bifid tongue with ankyloglossia is reported in the literature, but complete duplication of the tongue as part of the Tessier 30 cleft is not yet reported. PMID:22529554

  13. A new yardstick for rating dental arch relationship in patients with complete bilateral cleft lip and palate

    NARCIS (Netherlands)

    Ozawa, T.O.; Shaw, W.C.; Katsaros, C.; Kuijpers-Jagtman, A.M.; Hagberg, C.; Ronning, E.; Semb, G.

    2011-01-01

    Objective: To develop yardsticks for assessment of dental arch relationship in young individuals with repaired complete bilateral cleft lip and palate appropriate to different stages of dental development. Participants: Eleven cleft team orthodontists from five countries worked on the projects for 4

  14. Second type of first branchial cleft anomaly

    Directory of Open Access Journals (Sweden)

    Hitesh Verma

    2016-01-01

    Full Text Available First branchial cleft fistula is a rare congenital malformation of the head and neck with an incidence of <8% of all branchial cleft defects. The patient presenting with discharging sinus in the neck with discharging ear should be investigated for a possible branchial cleft anomaly. Rarity and diverse presentation often lead to misdiagnosis and inadequate treatment. Recurrent infection and scarring make intraoperative identification of facial nerve made very difficult. We report a case of a 5-year-old boy with a first branchial cleft fistula, in which discharge was observed through the fistulous opening on the right side of the face and along the ear canal.

  15. Surgical correction of cleft lip and palate.

    Science.gov (United States)

    Jayaram, Rahul; Huppa, Christoph

    2012-01-01

    Surgical cleft repair aims to restore function of the oro-nasal sphincter and oro-nasal soft tissues and re-establish the complex relationship between perioral and perinasal muscle rings without compromising subsequent mid-facial growth and development. Here we review the surgical anatomy of this region, optimal timing for surgical repair and current thinking on the use of surgical adjuncts. In addition, an overview of current surgical techniques available for the repair of cleft lip, cleft palate and velopharyngeal insufficiency is presented. Finally, we briefly discuss nasal revision surgery and the use of osteotomy, including distraction osteogenesis in the cleft patient.

  16. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation.

    Directory of Open Access Journals (Sweden)

    Daniel Lonic

    Full Text Available Although conventional two-dimensional (2D methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method.This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years. All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment.83.3% of 2D plans were modified, mostly concerning yaw (63.3% and midline (36.7% adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation.Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D

  17. Sub mucous cleft palate with fenestration

    OpenAIRE

    Shah, Sheerin; Garg, Ramneesh; Uppal, Sanjeev K.; Mittal, Rajinder K.

    2014-01-01

    Congenital fenestration in sub mucous cleft palate is not a common identity. This patient is a 16-year-old female who presented with nasal speech. On examination, she had associated microform cleft lip with nasal deformity. Successful palatoplasty with intra velar veloplasty was done.

  18. Is an isolated cleft lip an isolated anomaly?

    NARCIS (Netherlands)

    Deelder, J. D.; Breugem, C. C.; de Vries, Iris; de Bruin, M.; van der Molen, A. B. Mink; van der Horst, C. M. A. M.

    2011-01-01

    Introduction: It is well known that patients with cleft lip/palate or cleft palate can have associated anomalies. However, there is a relative paucity of information about the possible anomalies associated with an isolated cleft lip. A recent study (Vallino et al., 2008) showed that children with cl

  19. Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography.

    Science.gov (United States)

    Uçar, Faruk Izzet; Buyuk, Suleyman Kutalmış; Şekerci, Ahmet Ercan; Celikoglu, Mevlut

    2016-11-01

    The purposes of this study were to investigate the position of the mandibular condyle and temporomandibular fossa between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls without any cleft by using cone-beam computed tomography (CBCT). The study sample consisted of 17 patients (7 females and 10 males; mean age, 14.27 ± 2.83 years) affected by BCLP and 17 patients (6 females and 11 males; mean age, 14.27 ± 2.12 years) as age-and sex-matched control group without any cleft. Using cone-beam computed tomography segmented three-dimensional temporomandibular fossa and mandibular condyle images were reconstructed and angular, linear, and volumetric measurements of the patients in both sides of the groups were examined using Paired and Student's t-tests. Comparison of the sides showed that both sides were found to be similar in BCLP and control groups, except the condylar angulation of the right side was found to be higher compared to that of the left side in both groups (p condylar angulation in the right side (BCLP group had less angulation compared to controls; p condylar volume was found to be slightly less in the BCLP group in both sides compared to the controls (p > 0.05). The positions of the mandibular condyle and temporomandibular fossa were found to be similar in patients affected by BCLP and control group of without any cleft. SCANNING 38:720-726, 2016. © 2016 Wiley Periodicals, Inc.

  20. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... correct a physical defect caused by a cleft lip or cleft palate, which occur once in every 600 live ... recommend additional treatment for complications caused by cleft lip and cleft palate. Additional treatments may include: • Surgery to correct ...

  1. Comparative study of three techniques of palatoplasty in patients with cleft of lip and palate via instrumental and auditory-perceptive evaluations

    OpenAIRE

    Paniagua, Lauren Medeiros; Collares, Marcus Vinícius Martins; Costa, Sady Selaimen da

    2010-01-01

    Introduction: Palatoplasty is a surgical procedure that aims at the reconstruction of the soft and/or hard palate. Actually, we dispose of different techniques that look for the bigger stretching of the soft palate joint to the nasofaryngeal wall to contribute in the appropriate operation of the velopharyngeal sphincter. Failure in its closing brings on speech dysfunctions. Objective: To compare the auditory-perceptive' evaluations and instrumental findings in patients with cleft lip and pala...

  2. Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mariana Maciel Tinano

    2015-02-01

    Full Text Available OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28 attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I and individuals with cleft lip and palate (P > 0.017. The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015. Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A in comparison to the control group (P < 0.001. No significant differences were found in the mandible (Co-Gn of the control group and individuals with cleft lip and palate (P = 1.000. CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

  3. A longitudinal three-center study of craniofacial morphology at 6 and 12 years of age in patients with complete bilateral cleft lip and palate.

    Science.gov (United States)

    Bartzela, Theodosia; Katsaros, Christos; Rønning, Elisabeth; Rizell, Sara; Semb, Gunvor; Bronkhorst, Ewald; Halazonetis, Demetrios; Kuijpers-Jagtman, Anne Marie

    2012-08-01

    In this longitudinal study, the craniofacial morphology and evaluated soft tissue profile changes, at 6 and 12 years of age in patients with complete bilateral cleft lip and palate (CBCLP) were compared. Lateral cephalograms from 148 patients with CBCLP, treated consecutively at three European cleft centers, Gothenburg (n (A) = 37), Nijmegen (n (B) = 26), and Oslo (n (C) = 85), were evaluated. Eighteen hard tissue and ten soft tissue landmarks were digitized. Paired t test, Pearson's correlation coefficients, and multiple regression models were applied for statistical analysis. ANOVA and Tukey-B, as a post hoc test, were used to evaluate the increments and compare centers. Hard and soft tissue data were superimposed using the generalized Procrustes analysis. For Nijmegen, the increments of the variables SNA, ANB, SN-NL, SN-ML, NL-ML, Snss, and Snpg were significantly different than the two other centers (p = 0.041 to cleft centers followed different treatment protocols, but the main differences in craniofacial morphology until 12 years of age were the growth pattern and the maxillary and upper incisor variables. Follow-up of these patients until facial growth has ceased, which may elucidate components for improving treatment outcome.

  4. 单侧完全性唇(腭)裂患者术后上唇特征的研究%The study of characteristics of upper lip after lip repair in patients with complete cleft lip with or without cleft palate

    Institute of Scientific and Technical Information of China (English)

    左晖; 石冰; 张萍; 邓典智; 郑广宁

    2001-01-01

    Objective In order to understand the characteristics of upper lipafter lip repair in complete unilateral cleft lip with or without cleft palate.Methods The area of the upper lip,height of upper white lip,height of upper red lip,width of the mouth,as well as,the protruding of nose floor,upper and lower lip respectively were measured on the front and lateral standard photographs of patients with complete unilateral cleft lip and patients with complete unilateral cleft lip and palate who only had lip repaired or had both lip and palate repaired.Results The area and height of upper lip in both complete unilateral cleft lip group and cleft lip and palate group decreased significantly than that of normal group.The index of protruding of upper and lower lip in complete unilateral cleft lip and palate group was significantly smaller than that of normal group and complete unilateral cleft lip group.Conclusion The heigh of upper lip in patients with complete unilateral cleft lip and or palate would decrease significantly compared to normal group.The relationships of upper and lower lip positions were correlated to the senousness of retrusion and collapse of hard tissues supporting the upper lip in the unilateral cleft lip and or palate.%目的 了解单侧完全性唇(腭)裂患者术后上唇的形态特征。方法 将单侧完全性唇裂组和唇腭裂组患者,以及正常对照组的正、侧位标准相片上的上唇白唇面积,上唇白唇高,上唇红唇高,口裂宽,以及鼻底凸度,上唇和下唇凸度进行测量分析。结果 单侧完全性唇裂和唇腭裂患者唇裂术后的上唇面积和上白唇高均明显小于正常对照组。唇腭裂患者的唇突指数,明显小于正常对照组和唇裂组。结论 单侧完全性唇(腭)裂患者术后唇高短于正常对照组;唇突指数可较好地反映唇(腭)裂患者上唇支持硬组织凹陷畸形的程度。

  5. Cleft Palate Foundation

    Science.gov (United States)

    ... available in English , Spanish , and Mandarin ! Information on Cleft Lip and Palate Our booklets and factsheets address a variety of issues related to cleft lip and palate, such as speech, hearing, genetics, and what to ...

  6. Cleft lip repair - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100010.htm Cleft lip repair - series—Normal anatomy To use the sharing ... abnormal opening in the middle of the upper lip. A cleft palate is an opening in the roof of ...

  7. Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population.

    Science.gov (United States)

    Alam, M K; Iida, J; Sato, Y; Kajii, Takashi S

    2013-12-01

    We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology.

  8. TAR syndrome with orofacial clefting.

    Science.gov (United States)

    Midro, A; Hubert, E; Preferansow, J; Iwaszkiewicz-Pawłowska, A

    1993-01-01

    A case of TAR syndrome with bilateral cleft lip and palate is presented. Bilateral symmetric focomelia, normal thumbs among five fingers of hands, synostosis of IVth and Vth metacarpal bones and some defects of lower limbs with associated thrombocytopenia were noted. Dysmorphic facial features included hypertelorism, epicanthus, blue sclerae, broad nasal root, micrognathia, low-set ears, sparse blond hair. To our knowledge this patient represents an unusual association of TAR syndrome with orofacial clefting. A common background of TAR and Roberts/SC syndrome is suggested.

  9. [Team management of orofacial clefts].

    Science.gov (United States)

    Kuijpers-Jagtman, A M; Borstlap-Engels, V M; Spauwen, P H; Borstlap, W A

    2000-11-01

    In the Netherlands 15 centres provide multidisciplinary care for cleft lip and palate patients. Usually the following disciplines participate in such teams: paediatrics, plastic and reconstructive surgery, orthodontics, genetics, social work or nursing, ENT, speech therapy, maxillofacial surgery, prosthetic dentistry, psychology and oral hygiene. An overview is given of the treatment protocol from birth until 20 years of age for a child with a complete UCLP or BCLP. It is concluded that properly designed prospective clinical trials are rare, resulting in a lack of evidence based care in the field of cleft lip and palate. Furthermore it should be investigated whether it is preferable to centralise the cleft care in less centres than the present 15 ones.

  10. The clinical research of one-stage cleft lip and hard palate repair in patients with unilateral complete cleft lip and palate%单侧完全性唇腭裂唇裂及硬腭一期修复临床观察

    Institute of Scientific and Technical Information of China (English)

    熊清华; 刘诚; 雷伟; 汪丹凤; 张建芳

    2016-01-01

    Objective To observe the clinical effect of one-stage cleft lip and hard palate crack repair in unilateral complete cleft lip and palate patient. Methods Thirty patient with unilateral complete cleft lip and palate simultaneously received repair of cleft lip and closure of cleft hard palate with vomer lfaps when they were 4-6 months old. We would observe the wound healing of hard palate and presence or absence of oronasal ifstula in follow-up. Results All operations were successful,and the wound of hard palate healed well,no wound infection occurred. The hard palate crack were fully closed when the cleft palate surgery of second phase were in implementation at 12-18 months old. The oronasal ifstula of patients were inexistent. Conclusion Simultaneous repairs of cleft lip and closure of cleft hard palate are safe and feasible for patients with unilateral complete cleft lip and palate.It contribute to push back the soft palate.The patients had a better function of velopharyngeal closure.%目的:观察单侧完全性唇腭裂患儿在唇裂修复时一期行硬腭裂隙封闭的临床效果。方法:选择30例年龄为4.0~6.0月龄的单侧完全性唇腭裂患儿在唇裂修复时一期行硬腭裂隙犁骨瓣封闭,后期观察硬腭创面愈合及口鼻瘘存在与否。结果:所有患儿的手术均顺利完成,无硬腭创口感染及裂开。至患儿12~18个月龄二期腭裂手术时见硬腭部裂隙已完全关闭,无口鼻瘘存在。结论:单侧完全性唇腭裂患儿唇裂及硬腭一期修复安全、可行,利于腭裂手术时的软腭后退,使患儿有更好的腭咽闭合。

  11. Alveolar bone grafting in association with polyostotic fibrous dysplasia and bisphosphonate-induced abnormal bone turnover in a bilateral cleft lip and palate patient: a case report.

    Science.gov (United States)

    Kodama, Yasumitsu; Ogose, Akira; Oguri, Yoshimitsu; Ubaidus, Sobhan; Iizuka, Tateyuki; Takagi, Ritsuo

    2012-09-01

    A case is presented of extensive alveolar bone grafting in a patient with bilateral cleft lip and palate and polyostotic fibrous dysplasia. The patient previously underwent bisphosphonate therapy. Because of an abnormal and often decreased bone turnover caused by the fibrous dysplasia and the bisphosphonate therapy, bone grafting in such a patient poses several potential difficulties. In addition, the histomorphometric analysis of the bone grafts showed markedly decreased bone turnover. However, alveolar bone grafting using the iliac crest was performed successfully. Sufficient occlusion was achieved by postoperative low-loading orthodontic treatment.

  12. Primary unilateral and bilateral cleft lip and nose in an older population.

    Science.gov (United States)

    Rai, Kimit

    2005-01-01

    A one-stage procedure to reconstruct complete and incomplete unilateral/bilateral cleft lip and nose deformities is presented. Emphasis was made on closure of the lip muscles, correction of the nostril floor, correction of the alveolar cleft as well as reconstruction of the nose through an intranasal approach, with a supported suture technique for nasal correction. No dental or orthodontic treatment was available or performed in this older population. Emphasis was on primary closure of the muscles, using the rotation advancement principle. The repair that was performed was near anatomical, reconstructing the labial sulcus, the nostril floor, the alveolar cleft and the nasal deformity all in one stage. There was a high level of satisfaction both from the patient's and surgeon's point of view.

  13. Possible sex-discriminant variables in craniofacial growth in clefting.

    Science.gov (United States)

    Long, R E; Jain, R B; Krogman, W M

    1982-11-01

    In this investigation, 174 patients with orofacial clefts were examined for identification of possible sex differences in craniodentofacial measurements. The patients were selected from the longitudinal growth files of the H. K. Cooper Clinic. Records available for analysis were serial lateral cephalometric radiographs from the age of 1 month to 10 years. Patients were grouped by cleft type and sex within each cleft group (78 cleft palate only, 64 unilateral cleft of lip and palate, 32 bilateral cleft of lip and palate). Stepwise discriminant analysis of fourteen linear and angular craniofacial dimensions was used to identify those variables which contributed to sex differences within each cleft group over the growth/time intervals examined. Results suggested the possibility of sex-related differences in growth timing, that is, earlier maturation and growth in females in several craniofacial areas which did not appear to be related to the presence, absence, or type of cleft but which could possibly modify cleft-specific responses to treatment (cranial base dimensions, face heights). Other sex-related differences appeared to be more specifically related to known sex differences in original cleft type and severity (mandibular size and position, midfacial dimensions). The manner in which these various sex factors interface with environmental and therapeutic influences in producing the ultimate craniodentofacial morphology in a given sex and cleft type is discussed.

  14. Bone grafting of cleft lip and palate patients for placement of endosseous implants

    NARCIS (Netherlands)

    Jansma, J; Raghoebar, GM; Batenburg, RHK; Stellingsma, C; van Oort, RP

    1999-01-01

    Objective: Fixation of a prosthesis or single tooth replacement using osseointegrated implants has the potential to overcome functional and psychological inconveniences that many patients experience from such appliances. However, the dimensions of the recipient site are relatively often inadequate f

  15. Cleft Palate; A Multidiscipline Approach.

    Science.gov (United States)

    Stark, Richard B., Ed.

    Nineteen articles present a multidisciplinary approach to the management of facial clefts. The following subjects are discussed: the history of cleft lip and cleft palate surgery; cogenital defects; classification; the operation of a cleft palate clinic; physical examination of newborns with cleft lip and/or palate; nursing care; anesthesia;…

  16. Clinical and Statistical Analysis of 528 Patients with Cleft Lip and Palate%先天性唇腭裂528例临床分析

    Institute of Scientific and Technical Information of China (English)

    王道和; 陈阳; 顾建英

    2013-01-01

    Objective:To investigate the status of patients with cleft lip and palate treated in a hospital of Shanghai City in recent years.Methods:The clinical datum of 528 cases of cleft lip and palate hospitalized in Therapy and Research Center of Cleft Lip and Palate of Shanghai Jiaotong University School of Medicine from Jun 2006 to Nov 2007 were collected,classified and analyzed statistically.Results:In 528 cases,there were 313 male cases and 215 female cases(male ∶ femail =1.46 ∶ 1).The number of Shanghai and non-Shanghai cases were 83 and 445.The operating age varied from 2 months old to 36 years old with an average of 6.95 years old.The postoperation-hospital-stay varied from 1 to 15 days with an average of 5.54 days.The numbers of malformations which hadn't been treated varied from 0 to 3,and the average value was 0.44.The cleft morphology was classified as follows:lip cleft in 197 cases(37.31 %),palate cleft in 217 cases(41.10 %),alveolar cleft in 48 cases(9.10 %),transverse facial cleft in 9 cases(1.70 %),velopharyngeal incompetence in 35 cases(6.63 %),velo-cardio-facial syndrome(VCFS) in 19 cases(3.60 %),Robin sequence syndrome in 5 cases(0.95 %).In all the classifications,left were more than right(left ∶right =2.10 ∶ 1).Conclusions:Cleft lip and palate are common malformations of oral and maxillofacial regions.There is a tendency of more cleft palate than cleft lip in recent years,which may due to the popularization of prenatal examination and cleft palate operation in primary hospital.%目的:了解近年来在上海地区就诊的先天性唇腭裂患者的现状.方法:对上海交通大学医学院唇腭裂治疗研究中心2006年6月-2007年11月收治的528例先天性唇腭裂与面裂患者的临床资料进行分类整理,并进行回顾性统计分析.结果:528例患者中,男性313例,女性215例,男女比1.46∶1;本地患者83例,非本地患者445例;手术时年龄2个月~36岁,平均年龄6.95

  17. A Retrospective Study of Cleft lip and palate Patients´ Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

    Directory of Open Access Journals (Sweden)

    Kristian Andersen

    2012-06-01

    Full Text Available Objectives: To compare cleft lip and palate patients’ satisfaction with aesthetics and functional parameters after conventional advancement of the maxilla or by the use of distraction osteogenesis.Material and methods: Case series observational study. Group of distraction osteogenesis (DO consisted of 15 patients treated with distraction osteogenesis while group conventional (CONV included 10 patients treated with traditional advancement of the maxilla. Patients were asked to fill out a questionnaire about their subjective evaluation of satisfaction with facial aesthetics and functional parameters on a continuous visual analog-scale (VAS when the treatment was finished.Results: The total response rate was 76%. Preoperatively the two groups did not differ significantly according to group characteristics. At follow-up both groups were satisfied with aesthetics and functional parameters. The DO group was less satisfied with the duration of the treatment than the CONV group. There were no statistically significant differences among the groups regarding functional parameters or facial aesthetics.Conclusions: Cleft lip and palate patients experienced a high level of satisfaction with functional parameters and aesthetics as a result of surgical maxillary advancement. The patients treated with distraction osteogenesis were less satisfied with the duration of the treatment. Further studies are needed.

  18. Protocols for Late Maxillary Protraction in Cleft Lip and Palate Patients at Childrens Hospital Los Angeles

    Science.gov (United States)

    Yen, Stephen L-K

    2011-01-01

    This paper describes the protocols used at Childrens Hospital Los Angeles (CHLA) to protract the maxilla during early adolescence. It is a modification of techniques introduced by Eric Liou with his Alternate Rapid Maxillary Expansion and Constriction (ALT-RAMEC) technique. The main differences between the CHLA protocol and previous maxillary protraction protocols are the age the protraction is attempted, the sutural loosening by alternating weekly expansion with constriction and the use of Class III elastics to support and redirect the protraction by nightly facemask wear. The CHLA protocol entirely depends on patient compliance and must be carefully taught and monitored. In a cooperative patient, the technique can correct a Class III malocclusion that previously would have been treated with LeFort 1 maxillary advancement surgery. Thus, it is not appropriate for patients requiring 2 jaw surgeries to correct mandibular prognathism, occlusal cants or facial asymmetry. The maxillary protraction appears to work by a combination of skeletal advancement, dental compensation and rotation of the occlusal planes. Microscrew/microimplant/temporary anchorage devices have been used with these maxillary protraction protocols to assist in expanding the maxilla, increasing skeletal anchorage during protraction, limiting dental compensations and reducing skeletal relapse. PMID:21765629

  19. Implementing the Brazilian Database on Orofacial Clefts

    Directory of Open Access Journals (Sweden)

    Isabella Lopes Monlleó

    2013-01-01

    Full Text Available Background. High-quality clinical and genetic descriptions are crucial to improve knowledge of orofacial clefts and support specific healthcare polices. The objective of this study is to discuss the potential and perspectives of the Brazilian Database on Orofacial Clefts. Methods. From 2008 to 2010, clinical and familial information on 370 subjects was collected by geneticists in eight different services. Data was centrally processed using an international system for case classification and coding. Results. Cleft lip with cleft palate amounted to 198 (53.5%, cleft palate to 99 (26.8%, and cleft lip to 73 (19.7% cases. Parental consanguinity was present in 5.7% and familial history of cleft was present in 26.3% subjects. Rate of associated major plus minor defects was 48% and syndromic cases amounted to 25% of the samples. Conclusions. Overall results corroborate the literature. Adopted tools are user friendly and could be incorporated into routine patient care. The BDOC exemplifies a network for clinical and genetic research. The data may be useful to develop and improve personalized treatment, family planning, and healthcare policies. This experience should be of interest for geneticists, laboratory-based researchers, and clinicians entrusted with OC worldwide.

  20. Objective Assessment of Hypernasality in Patients with Cleft Lip and Palate with the NasalView System: A Clinical Validation Study.

    Science.gov (United States)

    Wermker, Kai; Jung, Susanne; Joos, Ulrich; Kleinheinz, Johannes

    2012-01-01

    Introduction. The objective of this investigation was to evaluate the reliability and validity of the NasalView system as a screening tool for hypernasality within the scope of a routine diagnostic procedure in cleft lip and palate patients. Material and Methods. In a collective of 95 patients with cleft and lip palate ranging from 4 to 25 years of age, hypernasality was exploited perceptually, patients were classified in four degrees, and nasalance was measured objectively with the NasalView system. Speech stimuli existed in one nasal and one nonnasal sentence; nasalance ratio and distance were calculated. Results. The test-retest error was within a range of 2%. Sensitivity ranged from 83.3% to 91.1% for the nonnasal sentence, from 70% to 78.4% for nasalance ratio and from 68.1% to 81.1% for nasalance distance. Specifity ranged from 87% to 93.1% for the nonnasal sentence, from 69.6% to 97.5% for nasalance ratio, and from 70.7% to 73.9% for nasalance distance. Conclusions. With a quick and gentle screening procedure, it is easily possible to identify hypernasal patients by an objective diagnostic tool of hypernasality, the NasalView system, with good reliability and validity.

  1. Cleft lip and palate repair

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002979.htm Cleft lip and palate repair To use the sharing features on this page, please enable JavaScript. Cleft lip and cleft palate repair is surgery to fix birth defects ...

  2. Cleft Lip and Palate (For Parents)

    Science.gov (United States)

    ... or genes that cause cleft palate or cleft lip. Clefts happen more often in children of Asian, Latino, ... with a facial birth defect like a cleft lip or cleft palate. Related Health Problems As you might imagine, ...

  3. Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP Part 4: Oral Rehabilitation

    Directory of Open Access Journals (Sweden)

    Jose Alberto de Souza FREITAS

    2013-06-01

    Full Text Available Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

  4. Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: oral rehabilitation.

    Science.gov (United States)

    Freitas, José Alberto de Souza; Almeida, Ana Lúcia Pompéia Fraga de; Soares, Simone; Neves, Lucimara Teixeira das; Garib, Daniela Gamba; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Lauris, Rita de Cássia Moura Carvalho; Oliveira, Thais Marchini; Pinto, João Henrique Nogueira

    2013-01-01

    Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

  5. Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences.

    Science.gov (United States)

    Trindade-Suedam, Ivy Kiemle; Gaia, Bruno Felipe; Cheng, Cheong Kuo; Trindade, Paulo Alceu Kiemle; Bastos, José Carlos da Cunha; Mattos, Beatriz Silva Câmara

    2012-02-01

    Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1) to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2) to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3) to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate.

  6. Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences

    Directory of Open Access Journals (Sweden)

    Ivy Kiemle Trindade-Suedam

    2012-02-01

    Full Text Available Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1 to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2 to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3 to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate.

  7. Principles of thromboprophylaxis in surgical patients.

    Science.gov (United States)

    Husted, S E

    1991-01-01

    Thromboprophylactic treatment during surgery reduces mortality and morbidity. The type of prophylaxis may be individualized according to type of operation and presence of major risk factors, such as prior thromboembolism, malignancy, long duration of immobilization, and medical conditions. All patients over the age of 40, or even younger, who have major risk factors, and whose operations will last for more than 1 hour, may benefit from thromboprophylaxis. Available prophylactic methods allow for treatment with an acceptably low level of side effects and economic cost, when compared with the cost of diagnostics and treatment of thromboembolism.

  8. Congenital heart defects in children with oral clefts

    Directory of Open Access Journals (Sweden)

    Nahvi H.

    2007-09-01

    Full Text Available   Background: Oral clefts are among the most common congenital anomalies. Infants with oral clefts often have other associated congenital defects, especially congenital heart defects. The reported incidences and the types of associated malformations and congenital heart defects vary between different studies. The purpose of this study was to assess the incidence of associated congenital heart defects in children with oral clefts. Methods: All infants with cleft lip and palate referred to the Children's Medical Center and Bahramy; the teaching Hospitals of the Tehran University of Medical Sciences from 1991 to 2005 were prospectively enrolled in this study group. All patients were examined and noted by an academic cleft team contain; a pediatrician and a pediatric surgeon, and received cardiac consultation and echocardiography by a pediatric cardiologist. non cardiac associated anomalies, still born and patients without echocardiography were excluded from the study.  Data including age, gender, exposure to contagions and high risk elements ,consanguinity and familial history of oral cleft, type of oral cleft, results of cardiac consultation and echocardiography and associated cardiac anomalies were cumulated and analyzed by SSPS version 13.5Results: Among the 284 infants with oral clefts, 162 were male (57% and 122 were female (43%. Seventy-nine patients (27.8% had cleft lip, 84 (29.5% had cleft palate and 121 (42.6% had both cleft lip and palate. Of all the patients, 21.1% had congenital heart defects. the most common type Of these congenital heart defects(28.3%  was atrial septal defect.Conclusions: For patients with cleft lip and palate, we recommend preoperative cardiac consultation, careful examination and routine echocardiography for associated cardiac anomalies, as well as appropriate management and prophylactic antibiotic therapy for those with associated congenital heart anomaly.

  9. Maternal genes and facial clefts in offspring

    DEFF Research Database (Denmark)

    Jugessur, Astanand; Shi, Min; Gjessing, Håkon Kristian;

    2010-01-01

    BACKGROUND: Fetal conditions can in principle be affected by the mother's genotype working through the prenatal environment. METHODOLOGY/PRINCIPAL FINDINGS: Genotypes for 1536 SNPs in 357 cleft candidate genes were available from a previous analysis in which we focused on fetal gene effects [1]. ...

  10. Comparative study of three techniques of palatoplasty in patients with cleft of lip and palate via instrumental and auditory-perceptive evaluations

    Directory of Open Access Journals (Sweden)

    Paniagua, Lauren Medeiros

    2010-03-01

    Full Text Available Introduction: Palatoplasty is a surgical procedure that aims at the reconstruction of the soft and/or hard palate. Actually, we dispose of different techniques that look for the bigger stretching of the soft palate joint to the nasofaryngeal wall to contribute in the appropriate operation of the velopharyngeal sphincter. Failure in its closing brings on speech dysfunctions. Objective: To compare the auditory-perceptive' evaluations and instrumental findings in patients with cleft lip and palate operate through three distinctive techniques of palatoplasty. Method: A prospective transversal study of a group of patients with complete unilateral cleft lip and palate. Everybody was subjected to a randomized clinical essay, through distinctive techniques of palatoplasty performed for a single surgeon, about 8 years. In the period of the surgery, the patients were divided in three distinctive groups with 10 participants each one. The present study has evaluates: 10 patients of the Furlow technique, 7 patients of the Veau-Wardill-Kilner+Braithwaite technique and, 9 patients of the Veau-Wardill-Kilner+Braithwaite+Zetaplasty technique; having a total sample of 26 individuals. All the patients were subjected to auditory-perceptive evaluation through speech recording. An instrumental evaluation was also performed through video endoscopy exam. Results: The findings were satisfactory in the three techniques, in other words, the majority of the individuals does not present hyper nasality, compensatory articulatory disturbance and audible nasal air emission. In addition, in the instrumental evaluation, the majority of the individuals of the three techniques of palatoplasty present an appropriate velopharyngeal function. Conclusion: Was not found statistically significant difference between the palatoplasty techniques in both evaluations

  11. Cleft Lip and Palate

    Science.gov (United States)

    ... With Cleft Lip or Cleft Palate en español Labio leporino y paladar hendido Tilt your head back a bit and look in the mirror. Do you see the way your nose connects to your upper lip? Now open your mouth. Do you see the ...

  12. Smile Train: The ascendancy of cleft care in India

    Directory of Open Access Journals (Sweden)

    Singh Subodh

    2009-10-01

    Full Text Available Though India has an estimated population of one million untreated cleft patients, facilities for its treatment have been limited and are not evenly distributed across the country. Furthermore, a paucity of committed cleft surgeons in fewer hospitals to provide quality surgical treatment to these patients, poverty, illiteracy, superstitions and poor connectivity in some remote regions severely limit the chances of an average cleft lip patient born in India from receiving rational and effective comprehensive treatment for his/her malady. The Smile Train Project with its singular focus on cleft patients started its philanthropic activities in India in the year 2000. It made hospitals and included clefts surgeon equal partners in this programme and helped them treat as many cleft patients as they possibly could. The Project encouraged improvement of the training and infrastructure in various centres across the length and breadth of the region. The Project received an unprecedented success in terms of growth of number of centres, cleft surgeons and quantum of cleft patients reporting for treatment. The G S Memorial Hospital is one such partner hospital. It started innovative outreach programmes and took a holistic view of the needs of these patients and their families. With the support of the Smile Train, it has not only succeeded in providing treatment to more than 14,500 patients in 5 years, but has also devised innovative outreach programmes and seamlessly incorporated salient changes in the hospital system to suit the needs of the target population.

  13. Effect of Nasal Floor Closure on the Size of Alveolar Cleft in Complete Unilateral or Bilateral Primary Cleft Palate

    Directory of Open Access Journals (Sweden)

    M Moghadaszadeh

    2012-10-01

    Full Text Available Introduction: Cleft lip (CL and cleft palate (CP are among the most common congenital anomalies. Constituting 65% of head and neck anomalies in isolated or syndromic forms, they are considered as the most common head and neck congenital deformities in children. Methods: 15 children from the Tabriz Children Hospital were evaluated in this descriptive-analytic cross sectional study that possessed unilateral and bilateral cleft lip and palate with inclusion criteria. The effect of nasal floor reconstruction on the size of alveolar cleft and palatal anterior fistula formation were evaluated in primary unilateral and bilateral cleft palate. Results: There were 11 (73.3% male and only 4 (26.7% female patients in the sample group. The mean duration from first consult to reconstructive surgery was 3.4±1.8 months (1 to 9 months range. The width of alveolar cleft and alveolar ridge angle on cleft side compared to normal side in sagittal and coronal axis was significant after nasal floor reconstruction (P=0.001, P=0.02, while septal angle changes were not significant (P=0.26, which means no increase in septal deviation has been documented. Conclusion: Considering the significant changes of alveolar cleft width and alveolar ridge angle on cleft side compared to normal side in sagittal and coronal axis after nasal floor closure, this method can be applied as a new interventional surgery in primary unilateral and bilateral cleft palate.

  14. Post septorhinoplasty custom-made unilateral nasal stent for nasal cleft deformity

    OpenAIRE

    Manu Rathee; Mohaneesh Bhoria; Priyanka Boora

    2015-01-01

    Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case repo...

  15. Diagnosis and presurgical orthopedics in infants with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Fundagul Bilgic

    2015-01-01

    Full Text Available Cleft lip and palate are one of the most common congenital craniofacial malformations. While preoperative treatment for infants with cleft lip and palate is still a scientific debate, patients with this malocclusion usually have to be treated from infancy to adulthood. Orthodontist plays an important role in the treatment of patients with cleft lip and palate. The purpose of this review is to give information about cleft lip and palate and presurgical nasoalveolar molding.

  16. TREATMENT OF SOFT TISSUE INJURY BY PUNCTURING CLEFT-POINTS

    Institute of Scientific and Technical Information of China (English)

    Xu Yunxiang; Chen Guizhen

    2001-01-01

    Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft)-points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft-point group (264 cases) and Ashipoint group (control group, 71 cases) randomly. In Cleft-point group, the 16 Cleft-points were used in combination with Ahshi points. In control group, only local Ahshi-points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed.Results: Results showed that the therapeutic effect of cleft-point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft-point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi-point.

  17. Ectodermal dysplasias associated with clefting: significance of scalp dermatitis.

    Science.gov (United States)

    Fosko, S W; Stenn, K S; Bolognia, J L

    1992-08-01

    Several clinical syndromes are characterized by ectodermal dysplasia (ED) in association with clefting of the lip and/or palate. The three most commonly recognized entities are (1) the EEC syndrome (ectodermal dysplasia, ectrodactyly, cleft lip/palate); (2) the Rapp-Hodgkin syndrome with ectodermal dysplasia, cleft lip/palate, and mid facial hypoplasia; and (3) the Hay-Wells or AEC syndrome (ankyloblepharon, ectodermal defects, cleft lip/palate). The clinical characteristics of these entities as well as several less common syndromes are reviewed and summarized. The presence of scalp dermatitis in patients with the AEC syndrome and less often the Rapp-Hodgkin syndrome is emphasized.

  18. Acute Liver Failure and Hepatic Encephalopathy After Cleft Palate Repair.

    Science.gov (United States)

    Kocaaslan, Nihal Durmuş; Tuncer, Fatma Betul; Tutar, Engin; Celebiler, Ozhan

    2015-09-01

    Paracetamol is the most commonly used analgesic after cleft palate repair. It has rarely caused acute hepatic failure at therapeutic or supratherapeutic doses. Only one case of therapeutic paracetamol toxicity after cleft palate repair had been reported previously. Here, we present a similar patient who developed acute liver failure and hepatic encephalopathy after an uncomplicated cleft palate surgery. Lack of large prospective trials in young children due to ethical concerns increases the value of the case reports of acetaminophen toxicity at therapeutic doses. The dosing recommendations of paracetamol may need to be reconsidered after cleft palate surgery.

  19. A Preliminary Three-Dimensional Analysis of Nasal Aesthetics Following Le Fort I Advancement in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Davidson, Edward; Kumar, Anand R

    2015-10-01

    Nasal aesthetic changes after cleft orthognathic surgery remain understudied. Previous scarring associated with prior cleft surgery may affect the predictability of outcomes after jaw surgery. This study evaluates changes in nasal aesthetics using three-dimensional photography after Le Fort I advancement in patients with nonsyndromic cleft-related maxillary hypoplasia. Cephalometric parameters were recorded pre- and postoperatively. Three-dimensional photogrammetric imaging analyzed changes in interalar width (IAW), internostril width (INW), nasal tip projection (NTP), collumelar length (CL), nasal labial angle (NLA), and nasal length (NL). Statistical significance between pre- and postoperative data was determined using T-tests for each parameter. Eleven patients underwent either single piece Le Fort I osteotomy and advancement, (3 bilateral, 4 unilateral cleft lip, and palate), or 2-piece advancement (2 bilateral, 2 unilateral). Average nasal soft tissue changes were IAW 1.9 mm (0.4-4.2), INW -0.2 mm (-2.8 to 1.6), NTP -1.0 mm (-4.0 to 2.0), CL -0.7 mm (-2.9 to 1.5), NLA -0.2° (-13.9 to 15.1), and NL -0.7 mm (-4.3 to 1.5), (P = 0.001, 0.6, 0.08, 0.01, 0.9, 0.2). For single-piece osteotomy alone changes were IAW 2.1 mm (0.6-4.1), INW -0.6 mm (-2.8 to 1.7), NTP -1.9 mm (-4.0 to 0.3), CL -1.2 mm (-2.9 to 0.03), NLA -1.3° (-13.9 to 15.0), and NL -1.1 mm (-4.3 to 0.7), (P = 0.007, 0.3, 0.009, 0.0002, 0.7, 0.2). For 2-piece osteotomy alone changes were IAW 1.6 mm (-0.4 to 3.3), INW 0.5 mm (0.4-1.6), NTP 0.5 mm (-1.1-2.0), CL 0.2 mm (-1.4 to 1.5), NLA 2.8° (-7.6 to 10.1), and NL -0.1 mm (-1.4 to 1.5), (P = 0.2, 0.4, 0.5, 0.6, 0.5, 0.9). Cleft-related scarring and malposition affect changes in nasal aesthetics following maxillary advancement that are different to the noncleft population. Two-piece Le Fort I increases variability of changes in nasal aesthetics compared with single-piece advancement.

  20. Transverse facial cleft: A series of 17 cases

    Directory of Open Access Journals (Sweden)

    L K Makhija

    2011-01-01

    Full Text Available Introduction: Transverse facial cleft (Tessier type 7 or congenital macrostomia is a rare congenital anomaly seldom occurring alone and is frequently associated with deformities of the structures developing from the first and second branchial arches. The reported incidence of No. 7 cleft varies from 1 in 60,000 to 1 in 300,000 live births. Material and Methods: Seventeen patients of transeverse facial cleft who presented to us in last 5 years were included in the study. Their history regarding familial and environmental predispositions was recorded. The cases were analysed on basis of sex, laterality, severity, associated anomalies and were graded according to severity. They were operated by z plasty technique and were followed up for 2 years to look for effectiveness of the technique and its complications. Result: Out of the seventeen patients of transverse cleft, none had familial predilection or any environmental etiology like antenatal radiological exposure or intake of drugs of teratogenic potential. Most of the patients (9/17 were associated with hemifacial microsomia and 1 patient was associated with Treacher Colin′s Syndrome. Out of the 6 cases of Grade I clefts, 4 were isolated transverse clefts and of the 10 patients of Grade II clefts, 7 were associated with hemifacial microsomia. We encountered only one case of Grade III Transverse Cleft which was not only associated with hemifacial microsomia but also had cardiac anomaly. Out of the17 cases, 15 were operated and in most of them the outcome was satisfactory.

  1. Molecular contribution to cleft palate production in cleft lip mice.

    Science.gov (United States)

    Sasaki, Yasunori; Taya, Yuji; Saito, Kan; Fujita, Kazuya; Aoba, Takaaki; Fujiwara, Taku

    2014-05-01

    Cleft palate following cleft lip may include a developmental disorder during palatogenesis. CL/Fr mice fetuses, which develop cleft lip and palate spontaneously, have less capability for in vivo cell proliferation in palatal mesenchyme compared with CL/Fr normal fetuses. In order to know the changes of signaling molecules contributing to cleft palate morphogenesis following cleft lip, the mRNA expression profiles were compared in palatal shelves oriented vertically (before elevation) in CL/Fr fetuses with or without cleft lip. The changes in mRNA profile of cleft palate morphogenesis were presented in a microarray analysis, and genes were restricted to lists contributing to cleft palate development in CL/Fr fetuses with cleft lip. Four candidate genes (Ywhab, Nek2, Tacc1 and Frk) were linked in a gene network that associates with cell proliferation (cell cycle, MAPK, Wnt and Tgf beta pathways). Quantitative real-time RT-PCR highlighted the candidate genes that significantly changed in CL/Fr fetuses with cleft lip (Ywhab, Nek2 and Tacc1). The results of these molecular contributions will provide useful information for a better understanding of palatogenesis in cleft palate following cleft lip. Our data indicated the genetic contribution to cleft palate morphogenesis following cleft lip.

  2. Laryngo-tracheo-oesophageal clefts

    Directory of Open Access Journals (Sweden)

    Leboulanger Nicolas

    2011-12-01

    Full Text Available Abstract A laryngo-tracheo-esophageal cleft (LC is a congenital malformation characterized by an abnormal, posterior, sagittal communication between the larynx and the pharynx, possibly extending downward between the trachea and the esophagus. The estimated annual incidence of LC is 1/10,000 to 1/20,000 live births, accounting for 0.2% to 1.5% of congenital malformations of the larynx. These incidence rates may however be underestimated due to difficulty in diagnosing minor forms and a high mortality rate in severe forms. A slightly higher incidence has been reported in boys than in girls. No specific geographic distribution has been found. Depending on the severity of the malformation, patients may present with stridor, hoarse cry, swallowing difficulties, aspirations, cough, dyspnea and cyanosis through to early respiratory distress. Five types of laryngo-tracheo-esophageal cleft have been described based on the downward extension of the cleft, which typically correlates with the severity of symptoms: Type 0 laryngo-tracheo-esophageal cleft to Type 4 laryngo-tracheo-esophageal cleft. LC is often associated with other congenital abnormalities/anomalies (16% to 68%, mainly involving the gastro-intestinal tract, which include laryngomalacia, tracheo-bronchial dyskinesia, tracheo-bronchomalacia (mostly in types 3 and 4, and gastro-esophageal reflux disease (GERD. The syndromes most frequently associated with an LC are Opitz/BBB syndrome, Pallister Hall syndrome, VACTERL/VATER association, and CHARGE syndrome. Laryngeal clefts result from failure of fusion of the posterior cricoid lamina and abnormal development of the tracheo-esophageal septum. The causes of the embryological developmental anomalies leading to LC are not known but are thought to be multifactorial. LC appears to be mostly sporadic although some familial cases with suspected autosomal dominant transmission have been reported. The age of diagnosis depends mainly on the severity of

  3. The Clinical Hearing Results of 256 Patients with Cleft Palate%256例腭裂患者临床听力学研究

    Institute of Scientific and Technical Information of China (English)

    姚晓琳; 丁瑞英; 王鸿南; 吴玮; 王佩林; 周丽斌; 屈昌北; 马莲; 韩浩伦; 李保卫

    2015-01-01

    目的:通过对腭裂患者行畸变产物耳声发射(Distortion Product Oto-acoustic Emission, DPOAE)、声导抗测试(Acoustic Immittance Measurement,AIM)、听性脑干反应(Auditory Brainstem Response, ABR)研究,探讨这类患者临床听力学特点,以及性别、年龄、手术等因素对患者听力的影响。方法回顾分析256例腭裂患者(术前243例、术后13例)临床听力学数据。将术前2岁内患者174例按性别分为男、女组,所有术前者243例按年龄分为≤2岁组(A组)、>2岁≤6岁组(B组)、>6岁组(C组),术后≥5年者13例编为D组。DPOAE检查选择1818、2730、3616、5434Hz 4个频点有≥3个频点通过即为该耳通过。AIM以A型图为正常,其它类型均为异常。ABR阈值检查以能重复引出V波的最小刺激强度为ABR阈值,ABR阈值>35 dB nHL即为该耳异常。结果腭裂患者不同性别间DPOAE、AIM、ABR阈值无明显差异(P>0.05),A组DPOAE、AIM、ABR阈值较C组差异显著(P0.05),B、C组DPOAE差异显著(P0.05)。C、D组年龄相仿,AIM、ABR检查示差异显著(P2 y≤6 y);and group C (>6 y);to evaluate the effects of surgery, we compared group C to 13cases who had received cleft-closure opera⁃tion (group D), because the ages of these two groups were similar. For DPOAE, at least the pass of≥3 frequencies at 1818;2730;3616;5434Hz was defined as pass. For AIM, type A was considered to be normal. Part of these cases were also tested by ABR, and the threshold of waveⅴ≥35 dB nHL was received to be abnormal.Results 174 Patients (≤2 y, group A)showed no differences in DPOAE, AIM and ABR between sexes (p>0.05). Between group A and group C, DPOAE, AIM and ABR showed significant difference (p0.05). Between group C and group D, whose ages were similar, only AIM and ABR showed significant difference(p<0.05). In group A,B and C together, the pass rate of DPOAE was higher than the normal rate of ABR (p<0

  4. Craniofacial and anthropometric phenotype in ankyloblepharon-ectodermal defects-cleft lip/palate syndrome (Hay-Wells syndrome) in a cohort of 17 patients.

    Science.gov (United States)

    Sutton, V Reid; Plunkett, Katie; Dang, Diane X; Lewis, Richard A; Bree, Alanna F; Bacino, Carlos A

    2009-09-01

    Ankyloblepharon-ectodermal dysplasia-cleft lip/palate (AEC) syndrome and Rapp-Hodgkin syndrome are well-characterized clinical entities caused by mutations in the TP63 gene. While AEC and Rapp-Hodgkin had been thought to be clinically distinct entities, the elucidation of their molecular etiology confirmed that they are a clinical continuum as opposed to distinct disorders. We have evaluated 17 patients with AEC syndrome using a systematic clinical approach. In our study, we have identified new features and others that were thought to occur only rarely. These include short stature and poor weight gain with preservation of head circumference in nearly all subjects, trismus in 35% and hypospadias in 78% of males. In addition, we describe the frequency of phenotypic features and demonstrate the extreme clinical variability in the largest cohort of AEC individuals reported in the literature thus far.

  5. Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Agnieszka Machorowska-Pieniążek

    2016-01-01

    Full Text Available Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste’s effect on plaque index (PLI and gingival index (GI in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P<0.01 was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft.

  6. Difference in the Surgical Outcome of Unilateral Cleft Lip and Palate Patients with and without Pre-Alveolar Bone Graft Orthodontic Treatment

    Science.gov (United States)

    Chang, Chun-Shin; Wallace, Christopher Glenn; Hsiao, Yen-Chang; Chiu, Yu-Ting; Pai, Betty Chien-Jung; Chen, I.-Ju; Liao, Yu-Fang; Liou, Eric Jen-Wein; Chen, Philip Kuo-Ting; Chen, Jyh-Ping; Noordhoff, M. Samuel

    2016-04-01

    Presurgical orthodontic treatment before secondary alveolar bone grafting (SABG) is widely performed for cleft lip/palate patients. However, no randomized controlled trial has been published comparing SABG outcomes in patients with, and without, presurgical orthodontic treatment. This randomized, prospective, single-blinded trial was conducted between January 2012 and April 2015 to compare ABG volumes 6 months postoperatively between patients with and without presurgical orthodontic treatment. Twenty-four patients were enrolled and randomized and 22 patients completed follow-up. Patients who had presurgical orthodontics before SABG had significantly improved inclination (p < 0.001) and rotation (p < 0.001) of the central incisor adjacent to the defect, significantly improved ABG fill volume (0.81 ± 0.26 cm3 at 6 months compared to 0.59 ± 0.22 cm3 p < 0.05) and less residual alveolar bone defect (0.31 ± 0.08 cm3 at 6 months compared to s 0.55 ± 0.14 cm3 p < 0.001) compared to patients who did not have presurgical orthodontic treatment. In conclusion, orthodontic treatment combined with SABG results in superior bone volume when compared with conventional SABG alone.

  7. 桂中地区先天性唇腭裂1021例发病因素分析%Analysis of Risk Factors of 1 021 Patients with Congenital Cleft Lip and Palate in Central Region of Guangxi

    Institute of Scientific and Technical Information of China (English)

    王伯钧; 韦元强; 玉铭; 秦小云; 韦进

    2012-01-01

    Objective To explore the risk factors of congenital cleft lip and palate in central region of Guangxi, and to investigate the preventive methods of congenital cleft lip and palate. Methods A clinical data of 1021 patients with congenital cleft lip and palate in central region of Guangxi were analyzed in the study. Results Of 1 021 patients, there were 652 men and 369 women, the ratio of male to female was 1.77 : 1,609 patients( 59.65 % ) with cleft lip, 299 patients ( 29.29% ) with cleft palate,113 patientsC 11.07% ) with cleft lip and palate. 940 patientsC 92.07% ) came from rural areas,81 patientsC 7.93% ) from towns;The proportion of patients from rural areas was significantly higher than that of patients from the city. The risk factors ranked in the top three as follows: flu occurred in the first 3 months of pregnancy ( 53. 57% ), pregnancy malnutrition( 14. 40% ), medicine intake during pregnancy( 9. 40% ). 954 patients ( 93. 43% ) with congenital cleft lip and palate experienced risk factors in the early stage of pregnancy,46 patients ( 4.50% ) had familial genetic history. Conclusion Virus infection and nutritional factors are the major risk factors of incidence of congenital cleft lip and palate. It should be paid more attention to universal health care knowledge during pregnancy to reduce the incidence of congenital cleft lip and palate.%目的 分析桂中地区先天性唇腭裂的发病因素,探讨先天性唇腭裂的预防方法.方法 对桂中地区先天性唇腭裂1 021例患者的临床资料进行分析.结果 1 021例患者中,男652例,女369例,男女之比为1.77:1;唇裂609例(59.65%),腭裂299例(29.29%),唇腭裂113例(11.07%).患者来自农村 940例(92.07%),城镇81例(7.93%),农村比例明显高于城市.发病因素前3位分别是妊娠前3个月感冒(53.57%)、孕期营养缺乏(14.40%)、孕期服药(9.30%).孕早期经历危险因素954例占93.43%,有家族遗传病史者46例占4.51%.结论 病毒感染及营养因素是先

  8. Creating long-term benefits in cleft lip and palate volunteer missions.

    Science.gov (United States)

    Ruiz-Razura, A; Cronin, E D; Navarro, C E

    2000-01-01

    The authors present their experience with 15 years of organizing cleft lip and palate surgical volunteer missions in Latin America. The history, basic principles, and objectives of Operation San Jose, a volunteer goodwill program from Christus St. Joseph Hospital in Houston, Texas, are covered. This report addresses the different problems encountered and solutions found. Following the principles set by Operation San Jose, CIRPLAST is a Peruvian foundation for plastic surgery that travels to remote areas in Peru, operating on patients with cleft lip and palate deformities. This report highlights the importance of working with local plastic surgeons and their residents, and emphasizes that the program should be organized by and the operations performed by accredited plastic surgeons and with the auspices and support of the national plastic surgery society and the local medical board. Operation San Jose promotes the creation of long-term benefits by offering a program to teach local surgeons cleft lip and palate repair techniques and to set up guidelines to organize local surgeons so that they can continue this effort by treating their own patients in their own countries.

  9. Cleft characteristics and treatment outcomes in hemifacial microsomia compared to non-syndromic cleft lip/palate.

    Science.gov (United States)

    Dentino, K M; Valstar, A; Padwa, B L

    2016-06-01

    The goal of this study was to describe the clinical characteristics and treatment outcomes of patients with hemifacial microsomia (HFM) and cleft lip/palate (CL/P), and to compare them to a historic cohort of patients with non-syndromic CL/P treated at the same centre. A retrospective review of patients with HFM and CL/P was performed; the main outcome measures assessed were cleft type/side, surgical outcome, midfacial retrusion, and speech. Twenty-six patients (13 male, 13 female; mean age 22.7±14.9, range 1-52 years) with cleft lip with/without cleft palate (CL±P) were identified: three with cleft lip (12%), two with cleft lip and alveolus and an intact secondary palate (8%), and 21 with cleft lip and palate (CLP) (81%; 15 unilateral and six bilateral). Four patients (19%) had a palatal fistula after palatoplasty. Twelve of 22 patients aged >5 years (55%) had midfacial retrusion and two (9%) required a pharyngeal flap for velopharyngeal insufficiency (VPI). Fisher's exact test demonstrated a higher frequency of complete labial clefting (P=0.004), CLP (P=0.009), midfacial retrusion (P=0.0009), and postoperative palatal fistula (P=0.03) in HFM compared to non-syndromic CL±P. There was no difference in VPI prevalence. This study revealed that patients with HFM and CL±P have more severe forms of orofacial clefting than patients with non-syndromic CL±P. Patients with HFM and CL±P have more severe midfacial retrusion and a higher palatal fistula rate compared to patients with non-syndromic CL±P.

  10. Unilateral cleft lip/nose repair using an equal bows /straight line advancement technique - A preliminary report and postoperative symmetry-based anthropometry.

    Science.gov (United States)

    Hakim, Samer George; Aschoff, Horst Heinrich; Jacobsen, Hans-Christian; Sieg, Peter

    2014-04-01

    In the evolution of cleft lip repair there has been continuous attempt to minimize local trauma, improve lip and nasal appearance and, especially, prevent conspicuous scars. The surgical technique presented meets these criteria, resulting in an appropriate scar course in children with a specific philtral ridge shape. Postoperative digital anthropometry was performed in 18 patients who underwent unilateral cleft lip repair using the equal bows/straight line advancement technique and in matched healthy control individuals. Symmetry values were assessed for lip length, philtral ridge length, vermilion height, width of the alar base, nasocanthal length, circumference of the nostrils, nostril width and height in both cleft and control groups. Evaluation revealed no significant differences in the symmetry values between cleft patients and control group (lip length: p = 0.71, philtral ridge length: p = 0.52, vermilion height: p = 0.23, alar base width: p = 0.69, nasocanthal length: p = 0.25, nostril circumference: p = 0.17, nostril width: p = 0.34, nostril height: p = 0.33). Principles of cleft lip repair can be achieved using the described technique which provides adequate lip length and natural nasal appearance in patients with a parallel-shaped philtral ridge.

  11. Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique

    Science.gov (United States)

    Rodrigues, Ian AS; Shah, Brinda; Goyal, Saurabh

    2017-01-01

    ABSTRACT Aim We present a novel surgical technique for repair of persistent and symptomatic cyclodialysis clefts refractory to conservative or minimally invasive treatment. Background Numerous surgical techniques have been described to close cyclodialysis clefts. The current standard approach involves intraocular repair of cyclodialysis clefts underneath a full-thickness scleral flap. Technique Our technique employs intraoperative use of a direct gonioscope to guide a nonpenetrating surgical repair. Subsequently, a significantly less invasive, nonpenetrating technique utilizing a partial-thickness scleral flap can be performed that reduces potential risks associated with intraocular surgery. The direct gonioscope is also used for confirmation of adequate surgical closure of the cyclodialysis cleft prior to completion of surgery. This technique has been successfully carried out to repair traumatic chronic cyclodialysis clefts associated with hypotony in two patients. There were no significant adverse events as a result of using this technique. Conclusion The novel technique described increases the likelihood of successful and permanent repair of cyclodialysis clefts with resolution of symptoms associated with hypotony, through direct intraoperative visualization of the cleft. Clinical significance Gonioscopically guided nonpenetrating cyclodialysis cleft repair offers significant benefits over previously described techniques. Advantages of our technique include gonioscopic cleft visualization, enabling accurate localization of the area requiring repair, and subsequent confirmation of adequate closure of the cleft. Using a partial-thickness scleral flap is also less invasive and reduces risks associated with treatment of this potentially challenging complication of ocular trauma. How to cite this article Rodrigues IAS, Shah B, Goyal S, Lim S. Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique. J Curr Glaucoma Pract 2017

  12. Crecimiento sagital maxilar en fisurados unilaterales operados funcionalmente Sagittal maxillary growth in unilateral cleft lip and palate patients following functional surgery

    Directory of Open Access Journals (Sweden)

    F. Donoso Hofer

    2007-06-01

    Full Text Available Objetivo. Comparar el crecimiento sagital maxilar en pacientes con fisura labio-máxilo-palatina unilateral operados a los 6 meses con criterio funcional con pacientes normales que tengan relación consanguínea directa con los anteriores. Diseño del estudio. Análisis arquitectural y craneofacial de Delaire en telerradiografías de perfil en ambos grupos de pacientes cuyas edades fluctúan actualmente entre los 7 y los 12 años, determinando el crecimiento sagital del maxilar a través de la medida del ángulo del pilar maxilar anterior (C1/F1, sometiendo las medidas al test T de Student con una significación del 99,5%. Resultados.Se determinó el valor real y esperado para el ángulo del pilar maxilar anterior en todos los casos. Al comparar estadísticamente los resultados, no se encontraron diferencias significativas en los valores promedios obtenidos. Conclusiones.El crecimiento sagital maxilar de los pacientes con fisura labio-máxilo-palatina unilateral operados a los 6 meses con criterio funcional no difiere del de aquellos pacientes normales.Objective. To compare the sagittal maxillary growth between unilateral cleft lip and palate patients operated under functional criterion at the age of 6 months and normal patients who were blood-related. Design. Delaire’s Architectural and Structural craniofacial analysis in conventional lateral radiographs of all the patients with an age range of 7-12 years, determining the sagittal maxillary growth by the anterior maxillary pillar angle (C1/F1. These measurements were analyzed using the T-test with a 99.5% significance. Results. The real and expected value of the anterior maxillary pillar angle was determined in all cases. By comparing the results statistically, no significant differences were found in the mean values obtained. Conclusion. Maxillary sagittal growth in unilateral cleft lip and palate patients operated at the age of 6 months under functional criterion, does not differ from the

  13. Resultados del manejo multidisciplinario del labio y paladar fisurado unilateral Results of the multidisciplinary management of unilateral cleft lip and palate patients

    Directory of Open Access Journals (Sweden)

    M. Estrada Sarmiento

    2007-06-01

    Full Text Available Se diseñó un modelo para evaluar el protocolo y la estrategia del equipo multidisciplinario para el tratamiento del labio y paladar fisurado unilateral en el Servicio de Cirugía Máxilo Facial del Hospital Provincial Universitario "Carlos Manuel de Céspedes" de Bayamo. Cuba. El estado presente de 60 pacientes de 14-22 años de edad fue evaluado por un cirujano máxilo facial, un ortodoncista y un foníatra. Los resultados indicaron que más de la mitad de esos pacientes tenían completado el tratamiento por uno de los especialistas. Solo 27 pacientes (16,2% habían completado el tratamiento por los tres especialistas. Los factores que contribuyeron a este porcentaje fueron discutidos.A model was designed to evaluate the protocol and strategy of the interdisciplinary team treating unilateral cleft lip and palate patients at the Maxillofacial Surgery department of the "University Provincial Hospital Carlos Manuel de Cespedes" Bayamo, Granma, Cuba. A maxillofacial surgeon, an orthodontist and a phoniatrician evaluated the current state of 60 patients with ages ranging between 14 and 22. The results showed that more than half of the patients had finished their treatment by one of the specialists. Only 27 patients (16.2% had completed their treatment by the three specialists. The factors contributing to these percentages are discussed.

  14. Submucous cleft palate and the general practitioner

    Science.gov (United States)

    Lowry, R. B.; Courtemanche, A. D.; MacDonald, C.

    1973-01-01

    Submucous cleft palate refers to a situation where the soft palate is largely composed of mucosa with little or no muscle. The defect is often not obvious on inspection of the mouth and pharynx. There is considerable clinical variation, with speech ranging from normal or minimal nasality to severe nasality and defective articulation. Many patients who have latent submucous cleft palate have the condition unmasked by an adenoidectomy because the adenoid pad had served as a compensatory factor in effecting palatopharyngeal closure. All physicians who perform tonsillectomy and adenoidectomy should be aware of the signs and symptoms which may suggest the diagnosis. ImagesFIG. 2 PMID:4758872

  15. The cleft-columellar angle: a useful variable to describe the unilateral cleft lip-associated nasal deformity.

    Science.gov (United States)

    Meltzer, Noah E; Vaidya, Dhananjay; Capone, Randolph B

    2013-01-01

    Objective : To study a method for quantification of the severity of either the unilateral cleft lip deformity or the associated cleft nasal deformity. A standard method would be useful for defining surgical outcomes. Design : Using a developed rating questionnaire and patient photographs, 26 nonexpert volunteers rated 14 children with untreated unilateral cleft lip according to the severity of their overall deformity, as well as the individual lip and nose deformities. The cleft-columellar angle was measured as defined by the intersection of a line in the parasagittal plane and a line perpendicular to the columellar base along the midcolumellar line. The association between deformity ratings and the cleft-columellar angle was modeled using mixed-model regression analysis. Setting : Tertiary care academic medical center. Results : After accounting for within-rater and within-child effects, the cleft-columellar angle explained a statistically significant portion of the variance in the rated severity for lip deformity (49%, p  =  .0012), nasal deformity (57%, p  =  .0001), and overall deformity (57%, p  =  .0005). Conclusions : Measurement of the cleft-columellar angle in two-dimensional digital photography is simple and correlative, capturing a substantial portion of nonexpert severity ratings of the constellation of deformities seen with the unilateral cleft lip deformity. Given its ease of application, the cleft-columellar angle is a useful variable in the description of the unilateral cleft lip deformity and may find utility across institutions as cleft surgeons seek to advance surgical care through outcomes research.

  16. 唇裂修复术对上颌骨生长发育影响的初步探讨%The effect of lip repair on maxillary growth in patients with complete unilateral cleft lip and(or) palate

    Institute of Scientific and Technical Information of China (English)

    石冰; 邓典智; 郑广宁; 左晖

    2001-01-01

    目的进一步了解唇裂修复手术对唇裂伴牙槽突裂和唇腭裂患者上颌骨生长发育影响方面的差异及其机制。方法将84例唇裂修复术后患者分为唇裂伴牙槽突裂、唇腭裂唇裂修复组和唇腭裂均修复组,并设健康对照组,摄定位头颅X线片并测量分析。结果唇裂修复手术对唇腭裂组上颌骨生长发育的影响明显大于唇裂伴牙槽突裂组。结论唇腭裂的裂隙与组织缺损是导致唇裂修复影响上颌骨生长的重要原因。%Objective To investigate the different effects of lip repair on maxillary growth among patients with cleft lip and(or) palate, and also the possible mechanisms accounting for that differences. Methods The lateral cephalometric analysis was applied to 84 Chinese patients with unilateral cleft lip and(or) palate at the early stage of permanent dentition, which included 32 UCLA, 20 UCLP (CP unrepaired), and 32 UCLP, and 37 normal Chinese of the same age as controls. Results The patients with unilateral cleft lip and palate who had lip repaired while the palate was left unrepaired exhibited the similar inhibition on maxillary growth to those who had both lip and palate repaired but the patients with unilateral cleft lip and alveolus had much less inhibition on their maxilla. Conclusions The cleft and tissue defect of patients with cleft lip and palate might be the main cause that induced the inhibitive effects of lip repair on maxillary growth.

  17. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mohammed Zuhaib

    2016-01-01

    Full Text Available Context: Presurgical nasoalveolar moulding (PNAM is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1 To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM. (2 To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM. (3 To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle

  18. Branchial cleft cyst

    Directory of Open Access Journals (Sweden)

    Vaishali Nahata

    2016-01-01

    Full Text Available Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity.

  19. Laryngeal cleft type 1

    Directory of Open Access Journals (Sweden)

    Danilo de Assis Pereira

    2015-06-01

    Full Text Available The clinical itinerary and the institution of conservative therapy in a case of laryngeal cleft type 1 refers to a child born by cesarean section, Apgar 9 and 10, a history of placental nd abruption in the 2 month of pregnancy, with respiratory nd distress on the 2 day of life and difficulty in breast feeding mothers. Presented evidence of aspiration pneumonia. The videodeglutogram showed aspiration of large amounts of material contrasted during swallowing. In bronchoscopy was visualized formation of threadlike small slit making the diagnosis of laryngeal cleft. We then decided, by institution of conservative treatment with enteral nutrition training and thickened with swallowing.

  20. Feeling Normal? Long-Term Follow-up of Patients with a Cleft Lip-Palate after Rhinoplasty with the Derriford Appearance Scale (DAS-59).

    Science.gov (United States)

    Albers, Andreas E; Reichelt, Andreas C; Nolst-Trenité, Gilbert J; Menger, Dirk Jan

    2016-04-01

    The stigma of nasal deformity due to a congenital cleft lip-palate has an undeniable influence on the affected patient's life. It is therefore of interest to investigate if efforts to reduce esthetic and functional impairments by rhinoplasty (single or multiple) can result in an increased satisfaction with appearance and a self-perception similar to the noncleft population. Retrospective scoring before and after rhinoplasty using the validated Derriford Appearance Scale (DAS-59) and subsequent statistical evaluation and comparison to datasets available in the literature for further classification was used. Of the 61 patients who underwent at least one rhinoplasty, 26 responded to all questions. The mean age of responders was approximately 30 years of age and the male:female ratio was 1:1.2. The scale showed a significant overall improvement after surgery. The full scale and all subscale scores of the DAS-59 were significantly reduced after surgery demonstrating an improvement in the respective categories. Most importantly, if postoperative results were compared with a population concerned and unconcerned about appearance, no difference "facial self-consciousness" of appearance was apparent. Also postoperative subscores for "general self-consciousness" (GSC) and "social self-consciousness" of appearance (SSC) showed no difference from those obtained from the population concerned about appearance. The postoperative subscore for "sexual and bodily self-consciousness" of appearance (SBSC) indicated improvement beyond the level found in the concerned control population. Due to only a low improvement in the difference compared with the subscore representing a "negative self-concept," a statistically significant difference to the concerned population remained, possibly indicating that therapy beyond surgery is needed for improvement. After rhinoplasty, the investigated group of cleft lip-palate patients with nasal deformities showed an improvement in their self

  1. Syndromes associated with labiopalatine clefting: A report of three cases

    Directory of Open Access Journals (Sweden)

    Thomas A

    2008-06-01

    Full Text Available Clefts of the lip and palate are a common craniofacial anomaly, The etiology is thought to be multifactorial, with both genetic and environmental factors playing a role. Because of the frequent manifestation of cleft lip and palate in association with some syndromes, it is essential that a detailed examination of these patients be carried out. This facilitates early formulation of preventive and treatment advice and aids in overcoming gross deformities in the early stages of development. In this paper, we review three such patients who presented with cleft lip and palate in association with a syndrome.

  2. A retrospective analysis of 215 Uyghur patients with cleft lip and palate%215例维吾尔族唇腭裂患者的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    多力昆·吾甫尔; 木合塔尔·霍加; 米热古丽·吾马尔; 李军; 闫广鹏; 卡米力·买买提明

    2013-01-01

    目的通过回顾性分析本院维吾尔族唇腭裂患儿的临床资料,为唇腭裂的预防提供临床资料。方法对2009年1月-2012年8月间新疆维吾尔自治区人民医院口腔颌面外科手术治疗的215例维吾尔族唇腭裂住院患者进行回顾性分析。结果本组病例中单侧唇裂18例、唇裂伴腭裂115例、单纯腭裂80例,单侧唇腭裂多于双侧,所有患者中出生于7-9月者均少于其他季度,患者父母多来自农村,母亲经历过危险因素的有55例。结论维吾尔族唇腭裂发病以唇裂合并腭裂居多,且以单侧发病多于双侧,男性多于女性。发生唇腭裂的病因除遗传因素外,出生家庭来源及胚胎的环境因素是其致病的危险因素。%Objective??This?study?aims?to?analyze?the?clinical?data?of?Uyghur?cases?of?cleft?lip?and?palate?to?provide?more information?on?the?prevention?for?this?malformation.??Methods??Two?hundred?and?twenty-five?cases?were?collected?from?patients?treated?in?the?People’s?Hospital?of?Xinjiang?Uyghur?Autonomous?Region,?from?January?2009?to?August?2012.?A?retrospective?clinic?study?was?carried?out.?Results??The?study?included?18?cases?of?cleft?lip,?115?cases?of?cleft?lip?with?cleft?palate,?and?80?cases?of?cleft?palate.?The?cases?of?unilateral?cleft?lip?with?or?without?palate?cases?were?higher?than?the?bilateral?cases.?In?all?cases,?patients?who?were?born?in?July?to?September?were?fewer?than?those?born?in?other?seasons.?Most?of?the?parents?of?the?patients?were?from?the?countryside.?Fifty-five?cases?had?mothers?underwent?danger?factor.?Conclusion???The?ratio?of?cleft?lip?with?cleft?palate?was?higher?than?the?other?types?in?Uyghur?patients.?The?cases?of?unilateral?cleft?lip?with?or?without?palate?cases?were?more?than?the?bilateral?cases,?and?males?were?more?than?females.?The?cleft?lip?and/or?palate?formation?may?be?related?with?multiple?genes?and?environmental?condition?in?the?early?stage?of?the?embryo.

  3. Prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate

    Directory of Open Access Journals (Sweden)

    João Paulo Schwartz

    2014-01-01

    Full Text Available OBJECTIVE: This study aimed at carrying out a radiographic analysis on the prevalence of dental anomalies of number (agenesis and supernumerary teeth in permanent dentition, in different subphenotypes of isolated cleft palate pre-adolescent patients. METHODS: Panoramic radiographs of 300 patients aged between 9 and 12 years, with cleft palate and enrolled in a single treatment center, were retrospectively analyzed. The sample was divided into two groups according to the extension/severity of the cleft palate: complete and incomplete . The chi-square test was used for intergroup comparison regarding the prevalence of the investigated dental anomalies (P < 0.05. RESULTS: Agenesis was found in 34.14% of patients with complete cleft palate and in 30.27% of patients with incomplete cleft palate. Supernumerary teeth were found in 2.43% of patients with complete cleft palate and in 0.91% of patients with incomplete cleft palate. No statistically significant difference was found between groups with regard to the prevalence of agenesis and supernumerary teeth. There was no difference in cleft prevalence between genders within each study group. CONCLUSION: The prevalence of dental anomalies of number in pre-adolescents with cleft palate was higher than that reported for the general population. The severity of cleft palate did not seem to be associated with the prevalence of dental anomalies of number.

  4. The cleft team social worker.

    Science.gov (United States)

    Kaye, Alison; Lybrand, Sandra

    2016-04-01

    The birth of a child with significant medical problems poses challenges for most families. Congenital orofacial clefting is a common condition affecting families worldwide. Orofacial clefting requires long-term medical care and can affect multiple body systems. Having a child with a chronic medical condition such as cleft lip or palate creates many psychosocial ramifications for a family. This article describes the importance of medical social work involvement in the coordinated care for children with cleft lip and palate. Specific cases spanning prenatal care through adolescence are used to highlight the variety of complex psychosocial situations encountered in the multidisciplinary cleft team setting.

  5. Progress of study on detection and analysis methods of voice anomaly in patients with cleft lip and palate%唇腭裂患者的语音异常检测及分析方法研究进展

    Institute of Scientific and Technical Information of China (English)

    秦世玉; 李冬爽(综述); 孙晋虎(审校)

    2014-01-01

    Congenital cleft lip and palate will cause abnormal voice function of patients .The research of de-tection and analysis method of voice anomaly helps the correction of voice function .This article will review the recent detection and analysis methods of voice anomaly in patients with cleft lip and palate .%先天性唇腭裂会造成患者语音功能异常,唇腭裂患者语音异常检测及分析方法的研究有助于对语音功能的矫正。该文就近期对唇腭裂患者语音检测及分析的方法作一综述。

  6. Stress-coping and cortisol analysis in patients with non-syndromic cleft lip and palate: an explorative study.

    Directory of Open Access Journals (Sweden)

    Volker Gassling

    Full Text Available BACKGROUND: Non-syndromic clefts of the orofacial region occur in approximately 1 per 500 to 2,500 live births, depending on geographical area and ethnicity. It can be supposed that the disruption of the normal facial structure and the long-standing pressure of treatment from birth to adulthood bring about a range of life stressors which may lead to a long-lasting impact on affected subjects throughout their lives. Therefore, the present study aimed to assess different aspects of psychosocial stress in affected individuals. METHODS: The study was divided into two parts: first, the Trier Social Stress Test which involves uncontrollability and high levels of social-evaluative stress under real conditions and second, the query of various aspects of coping with psychosocial stress. The test group consisted of 30 affected adult subjects, and an equally sized control group of unaffected volunteers. Cortisol dysregulation was determined by saliva samples before and after stress induction. Meanwhile, participants were asked to complete the SVF 120 stress-coping questionnaire. RESULTS: The analysis of saliva samples showed a similar baseline concentration as well as a similar increase in cortisol levels after stress induction for both groups. Subsequently, the decline in cortisol concentrations was significantly faster in the CLP group (course: p<0.001; groups: p = 0.102; interaction: p = 0.167. The evaluation of the stress-coping questionnaire revealed a significantly shorter rumination about a stressful event in individuals with CLP-related malformations (p = 0.03. CONCLUSION: We conclude that adults with CLP have significantly better stress-coping strategies than their healthy peers. TRIAL REGISTRATION: German Clinical Trials Organization DRKS00003466.

  7. Cleft size at the time of palate repair in complete unilateral cleft lip and palate as an indicator of maxillary growth.

    Science.gov (United States)

    Liao, Y-F; Prasad, N K K; Chiu, Y-T; Yun, C; Chen, P K-T

    2010-10-01

    Cleft size at the time of palate repair might affect the difficulty of surgical repair and, thus, indirectly postoperative maxillary growth. This retrospective study aimed to determine whether a correlation existed between the cleft size at the time of palate repair and the growth of the maxilla. Maxillary dental casts of 39 infants with non-syndromic complete unilateral cleft lip and palate, taken at the time of palate repair, were used to measure cleft size. Cleft size was defined as the percentage of the total palatal area. The later growth of the maxilla was determined using lateral and postero-anterior cephalometric radiographs taken at 9 years of age. The Pearson correlation analysis was used for statistical analysis. The results showed negative correlations between cleft size and the maxillary length (PMP-ANS, PMP-A) and the maxillary protrusion (S-N-ANS, SNA). These data suggest that in patients with complete unilateral cleft lip and palate there is a significant correlation between the cleft size at the time of palate repair and the maxillary length and protrusion. Patients with a large cleft at the time of palate repair have a shorter and more retrusive maxilla than those with a small cleft by the age of 9 years.

  8. Facial aesthetics and perceived need for further treatment among adults with repaired cleft as assessed by cleft team professionals and laypersons.

    Science.gov (United States)

    Foo, Peter; Sampson, Wayne; Roberts, Rachel; Jamieson, Lisa; David, David

    2013-06-01

    The objectives of this study were to compare the ratings of professionals and laypeople with and without a cleft regarding the facial aesthetics of adult patients previously treated for orofacial clefting. The necessity for further treatment, as perceived by the respective groups, is also compared. The design of the study was a cross-sectional study. Professionals (two plastic surgeons, one dentist, one orthodontist, and one psychologist) and laypeople (one male and one female adult without a cleft and one male and one female adult with a cleft) were recruited to rate photographs of 80 non-syndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009. Facial aesthetics were measured by a visual analogue scale (VAS; 0-100 mm). High values indicated good aesthetics. Necessity for further treatment was also measured by a VAS (0-100 mm). High values indicated high perceived need for further treatment. The professionals rated facial aesthetics significantly lower and had a lower perception of need for further treatment than the raters with and without a cleft. The laypeople with a cleft rated facial aesthetics significantly higher and had a lower perceived need for further treatment than laypeople without a cleft. The non-surgical professionals rated facial aesthetics significantly lower and had a lower perceived need for further treatment than the surgical professionals. Differences exist in the facial aesthetics ratings and perceived need for further surgery between professionals and laypeople with and without a cleft. This should be considered when managing cleft treatment expectations.

  9. Initial size of cleft does not correlate with size and function of nasal airway in adults with unilateral cleft lip and palate.

    Science.gov (United States)

    Reiser, Erika; Andlin-Sobocki, Anna; Mani, Maria; Holmström, Mats

    2011-06-01

    The noses of patients with clefts are often functionally inadequate. The aim of the present study was to evaluate the correlation between size of the maxillary cleft in infancy and size and function of the nasal airway in adults with unilateral cleft lip and palate (UCLP). This is a long-term follow up study including 53 patients with UCLP born between 1960 and 1987 and treated at the Cleft Lip and Palate Centre, Uppsala University Hospital, Sweden. Lip repair was performed at 3-4 months of age followed by either a one-stage or a two-stage palatal closure. The size of the cleft was measured on infant maxillary dental casts. Nasal minimum cross-sectional area (cm(2)) and volume (cm(3)) (acoustic rhinometry), air flow resistance (Pa s/cm(3)) (rhinomanometry), peak inspiratory flow (l/min) (peak nasal inspiratory flow) and number of identified odours (Scandinavian odor-identification test) were assessed in adulthood. The size of the maxillary cleft varied considerably at infancy. The size of the nasal airway and its function on the cleft side in adulthood were reduced compared with the non-cleft side, but no correlations were found between size of the initial cleft in infancy and size and function of the nasal airway in adulthood. In adults born with UCLP, therefore, size of the maxillary cleft in infancy does not seem to affect size and function of the nasal airway in adulthood.

  10. Root development of permanent lateral incisor in cleft lip and palate children: A radiographic study

    Directory of Open Access Journals (Sweden)

    Amarlal Deepti

    2007-01-01

    Full Text Available Objective: The objective of this study was to compare the root development of lateral incisor on the cleft side with the root development of its contralateral tooth in cleft lip and palate children. Setting: Cleft lip and palate wing, Meenakshi Ammal Dental College and Hospital, Chennai, South India. Materials and Methods: A sample of 96 orthopantamograms of patients with unilateral or bilateral cleft lip and/or cleft palate was selected, regardless of sex and race. Main Outcome Measure: Orthopantamograms were analyzed for root development of lateral incisor on the cleft and noncleft side. Associated anomalies like hypodontia, supernumerary teeth, malformed lateral incisors and root development of canine, if present, were recorded. Findings and Conclusions: Root development of permanent lateral incisor was delayed on the cleft side compared to the noncleft side. There was a statistically significant relationship between levels of root development of lateral incisors on the cleft side within the different study groups ( P < 0.05. Incidence of hypodontia increased in proportion to cleft severity. Frequency of missing second premolars, supernumerary teeth and malformed lateral incisors increased in cleft lip and palate patients. Root development of canine showed a slight delay on the cleft side when compared to the canine on the noncleft side.

  11. Isolated cleft of the ala nasi: A report of seven cases

    Directory of Open Access Journals (Sweden)

    J Rajesh Jinka

    2012-01-01

    Full Text Available Craniofacial clefts other than cleft lip & palate are reported to be 1.4 to 4.9 per 100,000 live births. Of these, clefts of nose are usually associated with other clefts. Isolated cleft of Ala is rare, 0.7% of all clefts reported by Monasterio. In an analysis of photographic records of 3,500 consecutive patients with craniofacial clefts including cleft lip & palate registered with us between 1985- 2012 which were accessed through our data base, 13 patients with nasal clefts were identified, seven out of which had Isolated cleft of the Ala. All were treated by a rotation flap of the Ala with good results with the longest follow up of 14Yrs. The authors have emphasised the rarity of the condition and presented a simple surgical procedure for correction. In the opinion of the authors this very simple procedure which can be performed by the junior surgeon gives a good long term result in the management of cleft Ala.

  12. Clinical Outcomes of Primary Palatal Surgery in Children with Nonsyndromic Cleft Palate with and without Lip

    Directory of Open Access Journals (Sweden)

    Seunghee Ha

    2015-01-01

    Full Text Available This study presents clinical outcomes of primary cleft palate surgery, including rate of oronasal fistula development, rate of velopharyngeal insufficiency (VPI requiring secondary surgery, and speech outcomes. We examined the effect of cleft type on the clinical outcomes. Retrospective analysis was performed using clinical records of all patients who received a primary palatoplasty at the Cleft Palate Clinic at Seoul Asan Medical Center, South Korea, between 2007 and 2012. The study included 292 patients with nonsyndromic overt cleft palate (±cleft lip. The results revealed that the rate of oronasal fistula was 7.9% and the incidence of VPI based on the rate of secondary palatal surgery was 19.2%. The results showed that 50.3% of all the patients had received speech therapy and 28.8% and 51.4% demonstrated significant hypernasality and articulatory deficits, respectively. The results of the rate of VPI and speech outcomes were significantly different in terms of cleft type. Except for the rate of oronasal fistula, patients with cleft palate generally exhibited better clinical outcomes compared to those with bilateral or unilateral cleft lip and palate. This study suggests that several factors, including cleft type, should be identified and comprehensively considered to establish an optimal treatment regimen for patients with cleft palate.

  13. 正颌联合术后正畸矫治唇腭裂术后的牙颌面畸形%Orthognathic Surgery and Postsurgical Orthodontics for Correction of Secondary Dentofacial Deformities in Cleft Lip and Palate Patients

    Institute of Scientific and Technical Information of China (English)

    孙晓梅; 滕利; 丁波; 归来

    2012-01-01

    目的 探讨应用正颌手术联合术后正畸矫治唇腭裂术后牙颌面畸形的方法.方法 2002年1月至2010年8月,共收治25例唇腭裂术后颌骨畸形患者.男11例,女14例;年龄16~33岁;单侧唇腭裂19例,双侧6例.所有患者术前均未接受过正畸治疗.本组患者均联合应用正颌手术和术后正畸建(牙合)矫治唇腭裂术后颌骨畸形.结果 25例患者经过3~12个月的术后正畸治疗,均建立了良好的咬(牙合)关系,恢复正常咬合功能.随访6个月至3年,术后疗效稳定.结论 唇腭裂术后颌骨畸形采用正颌手术联合术后正畸能够有效矫治牙颌面畸形.%Objective To investigate an effective method of orthognathic surgery and postsurgical orthodontics for correction of secondary dentofacial deformities in cleft lip and palate patients. Methods From January 2002 to August 2010, 25 cleft patients suffering from secondary dentofacial deformities were treated. There were 11 males and 14 females, aged from 16 to 33 years (mean age: 22 years), 19 patients were unilateral cleft and 6 were bilateral cleft. All patients had not received presurgical orthodontics and were treated by orthognathic surgery accompanied with postsurgical orthodontics for deformities correction. Results All 25 patients were satisfied with their appearances and dental articulation after operation. All patients got the normal occlusion and the satisfactory intermaxillary relationship with orthodontics treatment of 3-12 months. After a follow up of 6 months to 3 years,the results of the treatment were stable. Conclusion The orthognathic surgery and postsurgical orthodontics is efficient for correction of secondary dentofacial deformities in cleft patients.

  14. Branchial cleft cyst: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Surekha Chavan

    2014-01-01

    Full Text Available First branchial cleft anomaly is a rare disease of the head and neck. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. In this article, we present a case of type II first branchial cleft anomaly. A middle-aged woman who had suffered from swelling on lower jaw visited our department with the chief complaint of a swelling. She underwent complete excision of the lesion with preservation of the facial nerve. The patient recovered well and had no recurrence at 1-year of follow up.

  15. [The basic principles of the antibiotic therapy of burn patients].

    Science.gov (United States)

    Leseva, M; Khadzhiĭski, O; Grigorov, G; Dimitrova, A

    1995-01-01

    Proceeding from many years experience with antibiotic treatment of bacterial infections in burnt patients, accumulated in the Section of Burns and Plastic Surgery, and pertinent literature reports, the basic principles of antibacterial therapy in this contingency of patients are set forth. A detailed protocol is presented, based on: 1) presence of clinical and laboratory evidence of infection and its location, and the most likely causing agents involved, 2) bacteriological data on the commonest causing agents of local and systemic infection in burns, and their sensitivity to antibiotics, 3) duration and surface, deepness and location of the burn injury, and 4) spectrum of action, pharmacokinetics, pharmacodynamics and side effects of the various groups of antibiotics, consistent with the age and concomitant diseases of the patients. A number of antibiotic constellations in cases presenting sepsis where resorting to "blind" therapy is necessitated, are recommended. It is underscored that the protocol suggested is open for modifications, and also that antibiotic therapy efficiency may be anticipated only when combined with adequate infusional and operative management.

  16. Radiology of Cleft Lip and Palate: Imaging for the Prenatal Period and throughout Life.

    Science.gov (United States)

    Abramson, Zachary R; Peacock, Zachary S; Cohen, Harris L; Choudhri, Asim F

    2015-01-01

    Recent advances in prenatal imaging have made possible the in utero diagnosis of cleft lip and palate and associated deformities. Postnatal diagnosis of cleft lip is made clinically, but imaging still plays a role in detection of associated abnormalities, surgical treatment planning, and screening for or surveillance of secondary deformities. This article describes the clinical entities of cleft lip with or without cleft palate (CLP) and isolated cleft palate and documents their prenatal and postnatal appearances at radiography, ultrasonography (US), magnetic resonance (MR) imaging, and computed tomography (CT). Imaging protocols and findings for prenatal screening, detection of associated anomalies, and evaluation of secondary deformities throughout life are described and illustrated. CLP and isolated cleft palate are distinct entities with shared radiologic appearances. Prenatal US and MR imaging can depict clefting of the lip or palate and associated anomalies. While two- and three-dimensional US often can depict cleft lip, visualization of cleft palate is more difficult, and repeat US or fetal MR imaging should be performed if cleft palate is suspected. Postnatal imaging can assist in identifying associated abnormalities and dentofacial deformities. Dentofacial sequelae of cleft lip and palate include missing and supernumerary teeth, oronasal fistulas, velopharyngeal insufficiency, hearing loss, maxillary growth restriction, and airway abnormalities. Secondary deformities can often be found incidentally at imaging performed for other purposes, but detection is necessary because they may have considerable implications for the patient.

  17. [A case of EEC (ectrodactyly, ectodermal dysplasia, and cleft lip) syndrome].

    Science.gov (United States)

    Nakamura, K; Yoshimasu, H; Komuro, C; Kobayashi, A; Moon, K; Sato, M; Yamashiro, M; Arai, N; Shioiri, S; Amagasa, T

    1991-12-01

    EEC syndrome is a rare congenital malformation characterized by ectrodactyly, ectodermal dysplasia, cleft lip and/or palate. We reported a case of EEC syndrome with cleft palate. The patient was a 15-month-old girl. She had split hands of the upper extremities, syndactyly and polydactyly of the right lower extremity, ectodermal dysplasia including sparse hair, enamel hypoplasia and cleft palate. The patient underwent palatoplasty at the age of 18 months.

  18. Cleft Lip Repair, Nasoalveolar Molding, and Primary Cleft Rhinoplasty.

    Science.gov (United States)

    Bhuskute, Aditi A; Tollefson, Travis T

    2016-11-01

    Cleft lip and palate are the fourth most common congenital birth defect. Management requires multidisciplinary care owing to the complexity of these clefts on midface growth, dentition, Eustachian tube function, and lip and nasal cosmesis. Repair requires planning, but can be performed systematically to reduce variability of outcomes. The use of primary rhinoplasty at the time of cleft lip repair can improve nose symmetry and reduce nasal deformity. Use of nasoalveolar molding ranging from lip taping to the use of preoperative infant orthopedics has played an important role in improving functional and cosmetic results of cleft lip repair.

  19. Children's Listening with Cleft Lip and Palate in the School

    Directory of Open Access Journals (Sweden)

    Manoel, Rosana Ribeiro

    2010-09-01

    Full Text Available Introduction: A great similarity between the patients with cleft lip and palate' behavior and those with auditory processing disorder are related by parents and professors. Objective: To verify the listening in children with cleft lip and palate in six conditions of listening. Method: Professors of 224 students (7 to 11 years old with cleft completed a questionnaire aiming to judge the student listening in the noise, ideal condition, with multiple stimulus, in the silence, when it is solicited to remember the listened information and during a lengthy period of listening, comparing it to the other of the same age and listening condition, without cleft. A Prospective Study. Results: The mean of the trial (-0, 08, standard deviation of 0,27 of the students with cleft, performed by professor was about the "same difficulty" (zero, when compared with the student without cleft. It was not found statistical significance to anyone conditions, neither to the total value of the questionnaire, considering the gender nor the school year level. Conclusion: The listening characteristics of the students with cleft lip and palate were similar to the other without this craniofacial deformity of the same age and similar listening condition. In the noise, the conditions more difficult occurred when the memory and the auditory attention were required.

  20. Atendimento fonoaudiológico intensivo em pacientes operados de fissura labiopalatina: relato de casos Intensive speech therapy in patients operated for cleft lip and palate: case report

    Directory of Open Access Journals (Sweden)

    Maria do Rosário Ferreira Lima

    2007-09-01

    Full Text Available Devido à carência de fonoaudiólogos para atendimento ao paciente com fissura labiopalatina em várias regiões do Brasil, novos programas de atendimento devem ser desenvolvidos para esses indivíduos. A terapia intensiva de fala tem sido relatada na literatura como uma modalidade alternativa. Este trabalho relata a experiência com alguns casos de atendimento fonoaudiológico intensivo, e compara o desempenho na produção da fala de quatro pacientes operados de fissura palatina, antes e após a terapia fonoaudiológica intensiva. Foram atendidos, no período de férias escolares, três adultos e um adolescente que apresentavam distúrbios articulatórios compensatórios. O atendimento teve duração de três horas diárias para cada paciente, durante dez dias, divididos em terapia individual e em grupo. No início e fim do período de terapia, os pacientes foram avaliados por uma fonoaudióloga que não participou dos atendimentos. Também foi gravada em vídeo uma amostra de fala espontânea, contagem de 1 a 20 e repetição de uma lista de palavras e frases com fonemas oclusivos orais e fricativos. Todos os pacientes mostraram evolução satisfatória na terapia intensiva, com adequação dos fonemas trabalhados na fala dirigida, necessitando ainda de acompanhamento fonoterápico para sua automatização. A terapia intensiva mostrou ser uma alternativa eficaz e viável nesses casos, podendo também ser uma estratégia durante o início do tratamento fonoaudiológico convencional.Due to the lack of speech therapists at various regions of Brazil to assist patients with cleft lip and palate, new intervention programs must be developed for these individuals. Intensive speech therapy has been cited in literature as an alternative modality. This article relates the experience of four cleft lip patients, comparing their speech performances before and after the intensive intervention. The subjects, three adults and one adolescent with compensatory

  1. Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

    Directory of Open Access Journals (Sweden)

    Simona Stoicescu

    2013-12-01

    Full Text Available Introduction: Although cleft lip and palate (CLP is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66% and twenty-seven (34% patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery

  2. Cleft lip and palate repair - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000004.htm Cleft lip and palate repair - discharge To use the sharing ... Elsevier Saunders; 2015:chap 8. Read More Cleft lip and palate Cleft lip and palate repair Review Date 5/9/ ...

  3. Clefting in pumpkin balloons

    Science.gov (United States)

    Baginski, F.; Schur, W.

    NASA's effort to develop a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, focuses on a pumpkin shape super-pressure design. It has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired stable state instead. Hoop stress considerations in the pumpkin design leads to choosing the lowest possible bulge radius, while robust deployment is favored by a large bulge radius. Some qualitative understanding of design aspects on undesired equilibria in pumpkin balloons has been obtained via small-scale balloon testing. Poorly deploying balloons have clefts, but most gores away from the cleft deploy uniformly. In this paper, we present models for pumpkin balloons with clefts. Long term success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and means for quantitative assessment of measures that prevent their occurrence. This paper attempts to determine numerical thresholds of design parameters that distinguish between properly deploying designs and improperly deploying designs by analytically investigating designs in the vicinity of criticality. Design elements which may trigger the onset undesired equilibria and remedial measures that ensure deployment are discussed.

  4. Medical management of patients after bariatric surgery: Principles and guidelines

    Institute of Scientific and Technical Information of China (English)

    Abd; Elrazek; Mohammad; Ali; Abd; Elrazek; Abduh; Elsayed; Mohamed; Elbanna; Shymaa; E; Bilasy

    2014-01-01

    Obesity is a major and growing health care concern. Large epidemiologic studies that evaluated the relationship between obesity and mortality, observed that a higher body-mass index(BMI) is associated with increased rate of death from several causes, among them cardiovascular disease; which is particularly true for those with morbid obesity. Being overweight was also associated with decreased survival in several studies. Unfortunately, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. All obese patients(BMI ≥ 30 kg/m2) should receive counseling on diet, lifestyle, exercise and goals for weight management. Individuals with BMI ≥ 40 kg/m2 and those with BMI > 35 kg/m2 with obesity-related comorbidities; who failed diet, exercise, and drug therapy, should be considered for bariatric surgery. In current review article, we will shed light on important medical principles that each surgeon/gastroenterologist needs to know about bariatric surgical procedure, with special concern to the early post operative period. Additionally, we will explain the common complications that usually follow bariatric surgery and elucidate medical guidelines in their management. For the first 24 h after the bariatric surgery, the postoperative priorities include pain management, leakage, nausea and vomiting, intravenous fluid management, pulmonary hygiene, and ambulation. Patients maintain a low calorie liquid diet for the first few postoperative days that is gradually changed to soft solid food diet within two or three weeks following the bariatric surgery. Later, patients should be monitored for postoperative complications. Hypertension, diabetes, dumping syndrome, gastrointestinal and psychosomatic disorders are among the most important medical conditions discussed in this review.

  5. Medical management of patients after bariatric surgery: Principles and guidelines.

    Science.gov (United States)

    Elrazek, Abd Elrazek Mohammad Ali Abd; Elbanna, Abduh Elsayed Mohamed; Bilasy, Shymaa E

    2014-11-27

    Obesity is a major and growing health care concern. Large epidemiologic studies that evaluated the relationship between obesity and mortality, observed that a higher body-mass index (BMI) is associated with increased rate of death from several causes, among them cardiovascular disease; which is particularly true for those with morbid obesity. Being overweight was also associated with decreased survival in several studies. Unfortunately, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. All obese patients (BMI ≥ 30 kg/m(2)) should receive counseling on diet, lifestyle, exercise and goals for weight management. Individuals with BMI ≥ 40 kg/m(2) and those with BMI > 35 kg/m(2) with obesity-related comorbidities; who failed diet, exercise, and drug therapy, should be considered for bariatric surgery. In current review article, we will shed light on important medical principles that each surgeon/gastroenterologist needs to know about bariatric surgical procedure, with special concern to the early post operative period. Additionally, we will explain the common complications that usually follow bariatric surgery and elucidate medical guidelines in their management. For the first 24 h after the bariatric surgery, the postoperative priorities include pain management, leakage, nausea and vomiting, intravenous fluid management, pulmonary hygiene, and ambulation. Patients maintain a low calorie liquid diet for the first few postoperative days that is gradually changed to soft solid food diet within two or three weeks following the bariatric surgery. Later, patients should be monitored for postoperative complications. Hypertension, diabetes, dumping syndrome, gastrointestinal and psychosomatic disorders are among the most important medical conditions discussed in this review.

  6. Post septorhinoplasty custom-made unilateral nasal stent for nasal cleft deformity

    Directory of Open Access Journals (Sweden)

    Manu Rathee

    2015-01-01

    Full Text Available Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case report provides a novel technique for fabrication of esthetic nasal stent after postseptorhinoplasty for secondary cleft nose deformity correction. Conclusion: This case report presents a simple, convenient technique for nasal stent fabrication for prevention of restenosis for cleft nose deformity post secondary septorhinoplasty. Provision of nasal stent allows breathing, maintains esthetics, comfort, nasal patency, and contour with minimal discomfort.

  7. Is alveolar cleft reconstruction still controversial? (Review of literature

    Directory of Open Access Journals (Sweden)

    Sameh A. Seifeldin

    2016-01-01

    Full Text Available Cleft lip and palate (CL/P is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

  8. 3D finite element model for treatment of cleft lip

    Science.gov (United States)

    Jiao, Chun; Hong, Dongming; Lu, Hongbing; Wang, Jianqi; Lin, Qin; Liang, Zhengrong

    2009-02-01

    Cleft lip is a congenital facial deformity with high occurrence rate in China. Surgical procedure involving Millard or Tennison methods is usually employed for treatment of cleft lip. However, due to the elasticity of the soft tissues and the mechanical interaction between skin and maxillary, the occurrence rate of facial abnormality or dehisce is still high after the surgery, leading to multiple operations of the patient. In this study, a framework of constructing a realistic 3D finite element model (FEM) for the treatment of cleft lip has been established. It consists of two major steps. The first one is the reconstruction of a 3D geometrical model of the cleft lip from scanning CT data. The second step is the build-up of a FEM for cleft lip using the geometric model, where the material property of all the tetrahedrons was calculated from the CT densities directly using an empirical curve. The simulation results demonstrated (1) the deformation procedure of the model step-by-step when forces were applied, (2) the stress distribution inside the model, and (3) the displacement of all elements in the model. With the computer simulation, the minimal force of having the cleft be repaired is predicted, as well as whether a given force sufficient for the treatment of a specific individual. It indicates that the proposed framework could integrate the treatment planning with stress analysis based on a realistic patient model.

  9. Craniofacial clefting and sutural dystopia.

    Science.gov (United States)

    Moore, M H; Edwards, T J; David, D J

    1991-07-01

    Sutural anomalies in conjunction with craniofacial clefting are unusual. A case of median frontal clefting is presented in which there was an absence of a normal metopic suture and replacement by paramedian frontal sutures. The association of an underlying brain anomaly, with attendant surgical difficulties, is noted, as are the radiological techniques of preoperative diagnosis.

  10. Genetic determinants of facial clefting

    DEFF Research Database (Denmark)

    Jugessur, Astanand; Shi, Min; Gjessing, Håkon Kristian

    2009-01-01

    BACKGROUND: Facial clefts are common birth defects with a strong genetic component. To identify fetal genetic risk factors for clefting, 1536 SNPs in 357 candidate genes were genotyped in two population-based samples from Scandinavia (Norway: 562 case-parent and 592 control-parent triads; Denmark...

  11. Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

    NARCIS (Netherlands)

    Kuijpers, M.A.R.; Chiu, Y.T.; Nada, R.M.; Carels, C.E.L.; Fudalej, P.S.

    2014-01-01

    BACKGROUND: Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising. OBJECTIVE: To identify 3D imaging methods for quantitative assessment of soft tissue

  12. Perfil epidemiológico dos portadores de fissuras orofaciais atendidos em um Centro de Referência do Nordeste do Brasil Epidemiological characteristics of patients with orofacial clefts attending a Referral Center in Northeast Brazil

    Directory of Open Access Journals (Sweden)

    André Luiz Figueiredo Coutinho

    2009-06-01

    Full Text Available OBJETIVOS: descrever a frequência dos tipos de lesão dos portadores de fissura lábio-palatina, verificar a associação entre os fatores demográficos com essas lesões e identificar os fatores associados à idade em que foi realizado o primeiro atendimento médico especializado. MÉTODOS: este é um estudo do tipo série de casos, com 1216 crianças 24 meses quando realizou o primeiro atendimento médico especializado. As crianças cujo primeiro atendimento especializado ocorreu antes dos 12 meses de vida procederam com maior frequência do Agreste e Sertão. Das crianças portadoras de fissura submucosa, 55% só foram atendidas após os cinco anos de idade. CONCLUSÕES: observou-se que os dados obtidos estão de acordo com os da literatura, no aspecto geral das fissuras. Necessita-se que os profissionais de saúde sejam melhor preparados para atender e diagnosticar as fissuras lábio-palatinas.OBJECTIVES: to describe the frequency of types of lesions in patients with cleft lip and/or palate, in order to confirm the association between demographic factors and cleft lesions and to identify the factors associated with age on first receiving specialized medical attention. METHODS: a case-series study was conducted with 1,216 children aged 24 months when they first received a specialized medical consultation. A higher percentage of children whose first specialized medical care occurred at an age of less than one year was found for the Agreste and Sertão regions. Around 55% of children with submucosa cleft first received care at an age greater than five years. CONCLUSIONS: it was observed that the overall distribution of clefts accords with that presented in the literature. There is a need for a greater knowledge on the part of health professionals to allow them to provide adequate care and diagnose clefts.

  13. A preliminary study of psychological intervention in patients with cleft lip and palate%唇腭裂患者心理干预影响的初步研究

    Institute of Scientific and Technical Information of China (English)

    王歆; 陈仁吉; 穆月; 杨增杰

    2011-01-01

    Objective To investigate the effects of psychological intervention on adult patients with cleft lip and palate. Methods Adult patients with cleft lip and palate were divided into two groups: control group ( 17 ) and experimental group (17 ). The control group only underwent surgery, and the experimental group received psychological intervention before and after operation during hospitalization. The patients received psychological test before and after psychological intervention to evaluate the effects of psychological intervention on adult clefts patients. Testing tool included interaction anxiousness scale,self-esteem scale and the social support scale. Results There was no significant difference in these parameters between experimental and the control group before intervention , but the scores of social support in experimental group were higher than those of the control group after psychological intervention ( P < 0. 05 ). Conclusion The level of social support significantly improved after psychological intervention for adult patients with clefts.%目的 探讨心理干预对成人唇腭裂患者心理状况的影响.方法 对34例住院成人唇腭裂患者按照随机分组原则分为对照组和干预组.对照组在住院期间仅进行手术治疗,干预组在进行手术治疗的同时接受心理干预.人院后、出院前分别对两组患者进行测评,以评价心理干预对成人唇腭裂患者心理状况的影响.施测工具为交往焦虑量表、自尊量表及社会支持量表.结果 干预组、对照组患者干预前各项指标间无明显差异.心理干预组干预前后社会支持总分差值显著高于对照组(P<0.05),其余各因子得分差值无显著差异.结论 心理干预后成年唇腭裂患者的社会支持感明显提高.该结果为进一步探讨心理干预对成人唇腭裂患者心理状况的影响提供一定的参考依据.

  14. Clinical Experience of 30 Cases of Oral Rehabilitation in Patients With Cleft Lip%唇腭裂患者口腔修复治疗30例临床经验总结

    Institute of Scientific and Technical Information of China (English)

    孙青

    2015-01-01

    目的:探析唇腭裂患者行口腔修复治疗的效果。方法择取我科2014年5月~2015年5月,接收入院的唇腭裂患者,共计30例。采取随机分组法,将30例患者等分成三组,分别标号为1组、2组与3组。其中,1组实施固定桥修复治疗,2组实施活动义齿修复治疗,3组实施双重牙列修复治疗。对比分析三组的治疗效果。结果治疗后,三组患者唇腭裂的恢复效果都比较好,且每例患者的发音情况也都得到了改善,心理状况良好。结论在唇腭裂中,对患者实施最基本的口腔修复治疗,能缩短治疗的时间,促进患者康复。%ObjectiveTo study the effect of oral rehabilitation in patients with cleft lip.MethodsFrom May 2014 to May 2015 in our department,the hospital received a total of 30 cases of patients with cleft lip. 30 patients were divided into three groups,1 group,2 group and 3 group. Among them,the 1 group was in the implementation of fixed bridge repair treatment,the 2 group was in the implementation of removable partial denture restoration,and the 3 group was in the implementation of double dentition repair. Comparative analysis of the three groups of treatment effect.Results After treatment,three groups of patients with cleft lip,the recovery effect is better,and the pronunciation of each case has been significantly improved,and had good mental health. Conclusion The most basic oral rehabilitation treatment for the cleft lip, can shorten the time of treatment,promote the recovery of patients.

  15. The impact of cleft lip and palate repair on maxillofacial growth

    Institute of Scientific and Technical Information of China (English)

    Bing Shi; Joseph E Losee

    2015-01-01

    Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate;Veau’s pushback palatoplasty and Langenbeck’s palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth;timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.

  16. 正畸结合上颌前部牵引成骨矫治严重骨性畸形唇腭裂患者%Treatment of maxillary deficiency with orthodontics and maxillary distraction osteogenesis in cleft patient

    Institute of Scientific and Technical Information of China (English)

    贾绮林; 伊彪; 李自力

    2011-01-01

    Objective To treat cleft patient with maxillary deficiency by means of orthodontics and maxillary distraction osteogenesis. Method Maxillary distraction osteogenesis was performed to increase bone mass and orthodontic treatment was carried out after surgery. Results The cleft patient with maxillary deficiency was treated successfully, ANB was increased by 9° and good occlusal relationship was achieved. Conclusions The cleft patient with maxillary deficiency could be treated successfully with maxillary distraction osteogenesis and orthodontics.%目的 探讨采用正畸结合部分上颌骨牵引成骨的方法,治疗上颌骨严重发育不足的唇腭裂患者.方法 使用正畸结合上颌骨部分牵引成骨的方法,首先进行上颌骨前部牵引成骨,增加上颌骨的骨量,再进行正畸治疗排齐牙齿,最终解决上颌骨发育不足和牙齿拥挤的问题.结果 患者矫治后ANB角增加9°,面型明显改善,(牙合)关系良好.结论 采用正畸结合上颌骨部分牵引成骨这一新技术,矫治上颌骨发育严重不足的唇腭裂患者能够获得良好的治疗效果.

  17. The effect of speech training on the speech intelligibility of older patients with cleft palate after operation%语音训练对大龄腭裂患者术后语音清晰度的影响

    Institute of Scientific and Technical Information of China (English)

    路晓淼; 赵莉莉; 张凯

    2014-01-01

    目的::探讨有效提高大龄腭裂患者术后语音清晰度的方法。方法:对34例大龄腭裂术后患者进行录音评估,制定治疗计划,在强化腭咽闭合功能训练后,根据不同发音类型进行个性化的语音训练。结果:34例患者经过语音训练辅导后,语音清晰度由训练前的(44.67±14.23)%提高至(91.11±6.76)%,差异有统计学意义(P<0.01)。结论:个性化的语音训练有助于矫正大龄腭裂患者的不良发音习惯,提高腭裂患者的语音清晰度。%Objective:To explore the effective method for increasing the speech intelligibility of older patients with cleft palate after operation. Methods:The treatment plans of 34 older patients with cleft palate after operation were formulated according to their voice evaluation. The personalized speech training was implemented according to their different types of pronunciation after strengthening palatopharyngeal closure function training. Results:Compared with before treatment, the speech intelligibility was improved from (44.67±14.23)% to(91. 11 ±6. 76)% after speech training(P <0. 01). Conclusions:The personalized speech training can effectively improve the ill pronouncing habit and speech intelligibility of older patients with cleft palate after operation.

  18. Patrones de cierre velofaringeo: Estudio comparativo entre población sana y pacientes con paladar hendido Patterns of velopharyngeal closure: comparative study between healthy population and patients with cleft palate

    Directory of Open Access Journals (Sweden)

    J.R. Prada Madrid

    2010-12-01

    its frequency of appearance in a non-probabilistic sample with healthy volunteers and to compare these findings with the ones obtained in patients with surgically repaired cleft lip and palate. We designed a descriptive study of cross section. The evaluations were made in a fourth level hospital and in the Rehabilitation Centre for Children with Cleft lip and Palate (FISULAB, Santa fe de Bogotá (Colombia. One hundred healthy volunteers (university students and 82 patients with surgically repaired cleft palate participated in the study. Videonasopharyngoscopy was performed to determine patterns of velopharyngeal closure present and their frequency of appearance. The statistical analysis indicate that there is no difference in the frequency of presentation of the patterns of velopharyngeal closure between healthy volunteers and the patients with cleft palate. In the healthy group, the most frequently found pattern was the circular (56% of the sample, followed by the coronal (29 % and circular with Passavant´s ridge (15 %. In the group of patients with cleft lip and palate, the circular pattern also prevails (39,02 %, followed by the coronal pattern (24,39 %, and the circular pattern with Passavant´s ridge (19,51 %. In neither group was found the sagittal pattern. As a conclusion, there was not any statistical difference in the frequency of presentation of the patterns of velopharyngeal closure between the healthy volunteers and the patients with cleft palate.

  19. Patient education. Timeless principles of learning: a solid foundation for enhancing chronic disease self-management.

    Science.gov (United States)

    Suter, Paula M; Suter, W Newton

    2008-02-01

    The use of evidence-based principles of learning can contribute to the empowerment of patients as they adopt self-management skills aligned with healthy behaviors. This article, jointly written by a nurse and an educator, describes these timeless principles and how home care clinicians and patients benefit from their use.

  20. CLEFT PALATE. FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    Science.gov (United States)

    RUTHERFORD, DAVID; WESTLAKE, HAROLD

    DESIGNED TO PROVIDE AN ESSENTIAL CORE OF INFORMATION, THIS BOOK TREATS NORMAL AND ABNORMAL DEVELOPMENT, STRUCTURE, AND FUNCTION OF THE LIPS AND PALATE AND THEIR RELATIONSHIPS TO CLEFT LIP AND CLEFT PALATE SPEECH. PROBLEMS OF PERSONAL AND SOCIAL ADJUSTMENT, HEARING, AND SPEECH IN CLEFT LIP OR CLEFT PALATE INDIVIDUALS ARE DISCUSSED. NASAL RESONANCE…

  1. Alveolar cleft closure by osseodistraction: pitfalls and troubleshooting.

    Science.gov (United States)

    Pichelmayer, Margit; Zemann, Wolfgang

    2012-03-01

    Segmental maxillary osseodistraction is a proper method to close alveolar gaps in patients with clefts of lip, palate, and alveolus. The technique is mainly used in very wide clefts after failure of conventional bone grafting procedures. The aim of the study was to analyze problems that may occur during the distraction process. Patients with uncommon wide alveolar clefts or recurrent oronasal fistulas and patients with bilateral clefts of lip, plate, and alveolus and an additional vertical deficit of the posterior cleft segment underwent distraction procedures. The patients were subdivided according to the vector of distraction: linear (following the dental arch) and vertical. The devices for horizontal distraction were tooth-borne and manufactured to the specific clinical situation. For vertical distraction, standard devices were used. Of this sample, patients with complications occurring during or after surgery and during the distraction period were selected as the study participants. On the basis of the data collected on these complications, the need for additional bone grafting procedures was evaluated. Results suggest that modifications in preoperative planning and the construction of the distraction devices may be necessary to prevent unexpected problems in segmental maxillary distraction procedures. Considerations concerning the placement of distraction devices are discussed.

  2. Molecular basis of cleft palates in mice

    Institute of Scientific and Technical Information of China (English)

    Noriko; Funato; Masataka; Nakamura; Hiromi; Yanagisawa

    2015-01-01

    Cleft palate, including complete or incomplete cleft palates, soft palate clefts, and submucosal cleft palates, is the most frequent congenital craniofacial anomaly in humans. Multifactorial conditions, including genetic and environmental factors, induce the formation of cleft palates. The process of palatogenesis is temporospatially regulated by transcription factors, growth factors, extracellular matrix proteins, and membranous molecules; a single ablation of these molecules can result in a cleft palate in vivo. Studies on knockout mice were reviewed in order to identify genetic errors that lead to cleft palates. In this review, we systematically describe these mutant mice and discuss the molecular mechanisms of palatogenesis.

  3. 大龄腭裂患者咽后壁组织瓣咽成形术后语音特征%Articulatory characteristics of cleft palate patients over eight years old after pharyngoplasty with posterior pharyngeal flap

    Institute of Scientific and Technical Information of China (English)

    秦瑞峰; 胡开进; 封兴华; 吴炜

    2005-01-01

    surgery for these patients to improve palate form and articulatory function. OBJECTIVE: To study the characteristics of the cleft palate in patients of over 8 years old and the effects of palate repair and posterior pharyngeal flap transplantation (PPFT) on articulation. DESIGN:A controlled study with children patients as subjects. SETTING: Department of Maxillofacial Surgery, Medical College of Stomatology, Fourth Military Medical University of Chinese PLA PARTICIPANTS: Twenty-four children patients of cleft palate who were treated in the Department of Maxillofacial Surgery ,Medical College of Stomatology, Fourth Military Medical University of Chinese PLA from January 2000 through December 2003 were enrolled in the study. Fourteen were male and ten female. Their ages varied from 8 to 20 years old (mean 13.8 years). Three cases were bilateral complete cleft palate and twelve cases were unilateral complete cleft palate. Nine were incomplete cleft palate. METHODS :Two flap palatoplasty and upper pedicle PPFT were conducted in all the patients. In thirty days after surgical treatment, the patients were asked to repeat the words of a doctor in the phonetic lab with his or her lips 10 cm away from microphone. The words of the patients were recorded and evaluated subjectively by 5 doctors specialized in pathologic phones. MAIN OUTCOME MEASURES :The palatopharynx was observed with nasopharyngoscope before and after operation. And the improvement of nasal gas leakage and enhanced rhinophonia were also evaluated. RESULTS: The repaired cleft palate was healed in the first intention in all the patients. The soft palate retreated satisfactorily and the palatopharynx was apparently closed, which created good preconditions for articulation. The patients' articulation was also improved in different degrees. All the 24 patients had the fourth grade of enhanced rhinophonia and nasal gas leakage before repairing. After palate repair and PPFT, the enhanced rhinophonia and nasal gas leakage

  4. Surgical Repair of a Median Cleft of the Upper Lip via a Pfeifer Incision: A Case Report

    Science.gov (United States)

    Pandey, Rajeev; Gupta, Rajat; Bhagat, Nitin; Verma, Aviral

    2016-01-01

    Median cleft is the midline cleft of the lip. It develops due to incomplete or failed fusion of the median nasal prominence. It can present with minimal deformities such as involvement of the vermilion border, or complex clefting of the midline structures and brain. Median clefts are broadly classified as true and false clefts. This case report describes a rare case of median cleft of the upper lip involving the white roll, which was not associated with any other deformities. Treatment included reconstruction of the philtrum and the cupid's bow while maintaining vermilion fullness and continuity, and minimizing scar formation. Various techniques have been advocated for treatment of this type of median upper lip cleft. Here we describe a technique using Pfeifer incision to correct our patient's defect. Pfeifer incision consists of wavy lines and its use has been advocated for correction of various craniofacial abnormalities. PMID:27928243

  5. Patient safety principles in family medicine residency accreditation standards and curriculum objectives

    Science.gov (United States)

    Kassam, Aliya; Sharma, Nishan; Harvie, Margot; O’Beirne, Maeve; Topps, Maureen

    2016-01-01

    Abstract Objective To conduct a thematic analysis of the College of Family Physicians of Canada’s (CFPC’s) Red Book accreditation standards and the Triple C Competency-based Curriculum objectives with respect to patient safety principles. Design Thematic content analysis of the CFPC’s Red Book accreditation standards and the Triple C curriculum. Setting Canada. Main outcome measures Coding frequency of the patient safety principles (ie, patient engagement; respectful, transparent relationships; complex systems; a just and trusting culture; responsibility and accountability for actions; and continuous learning and improvement) found in the analyzed CFPC documents. Results Within the analyzed CFPC documents, the most commonly found patient safety principle was patient engagement (n = 51 coding references); the least commonly found patient safety principles were a just and trusting culture (n = 5 coding references) and complex systems (n = 5 coding references). Other patient safety principles that were uncommon included responsibility and accountability for actions (n = 7 coding references) and continuous learning and improvement (n = 12 coding references). Conclusion Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID:27965349

  6. Incidence of cleft Lip and palate in the state of Andhra Pradesh, South India

    Directory of Open Access Journals (Sweden)

    Reddy Srinivas

    2010-01-01

    Full Text Available Objective: To assess the incidence of cleft lip and palate defects in the state of Andhra Pradesh, India. Design Setting: The study was conducted in 2001 in the state of Andhra Pradesh, India. The state has a population of 76 million. Three districts, Cuddapah, Medak and Krishna, were identified for this study owing to their diversity. They were urban, semi-urban and rural, respectively. Literacy rates and consanguinity of the parents was elicited and was compared to national averages to find correlations to cleft births. Type and side of cleft were recorded to compare with other studies around the world and other parts of India. Results: The birth rate of clefts was found to be 1.09 for every 1000 live births. This study found that 65% of the children born with clefts were males. The distribution of the type of cleft showed 33% had CL, 64% had CLP, 2% had CP and 1% had rare craniofacial clefts. Unilateral cleft lips were found in 79% of the patients. Of the unilateral cleft lips 64% were left sided. There was a significant correlation of children with clefts being born to parents who shared a consanguineous relationship and those who were illiterate with the odds ratio between 5.25 and 7.21 for consanguinity and between 1.55 and 5.85 for illiteracy, respectively. Conclusion: The birth rate of clefts was found to be comparable with other Asian studies, but lower than found in other studies in Caucasian populations and higher than in African populations. The incidence was found to be similar to other studies done in other parts of India. The distribution over the various types of cleft was comparable to that found in other studies.

  7. Segment distraction to reduce a wide alveolar cleft before alveolar bone grafting.

    NARCIS (Netherlands)

    Binger, T.; Katsaros, C.; Rucker, M.; Spitzer, W.J.

    2003-01-01

    OBJECTIVE: To demonstrate a method for reduction of wide alveolar clefts prior to bone grafting. This method aims to facilitate bone grafting and achieve adequate soft tissue coverage of the graft with attached gingiva. CASE REPORT: Treatment of a patient with bilateral cleft lip and palate with a s

  8. Strategies to improve regeneration of the soft palate muscles after cleft palate repair

    NARCIS (Netherlands)

    Carvajal Monroy, P.L.; Grefte, S.; Kuijpers-Jagtman, A.M.; Wagener, F.A.D.T.G.; Hoff, J.W. Von den

    2012-01-01

    Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. These patients are unable to separate the nasal from the oral cavity leading to air loss during speech. Although surgical repair ameliorates soft palate function by joining the clefted muscles of the sof

  9. Median cleft of the upper lip associated with a mass: a rare case.

    Science.gov (United States)

    Jian, Xin-Chun; Zheng, Lian; Xu, Pu; Liu, De-Yu

    2014-12-01

    Median cleft lip is a midline vertical cleft through the upper lip. This is a very rare anomaly described in the literature. Median cleft lip is caused by the failure of fusion of the medial nasal prominences. In this case report, a 4-month-old boy with a median cleft associated with a mass of the upper lip is presented. The patient has no other anomalies of the nose or alveolus. The patient has normotelorism. A Z-plasty technique was used on the skin of the base of the columella. A vertical excision of the cleft with muscle approximation was performed on the white roll and the wet-dry border of either side of the defect of the upper lip. Postoperatively, the patient had a satisfactory result. The incisive scars were not visible. Cupid's bow was appropriately aligned, and the height of the upper lip was equal on both sides.

  10. The development of maxilla in children with congenital unilateral complete cleft lip, alveolus and palate ( from birth till 5 years of age)

    OpenAIRE

    Linkevičienė, Laura

    2010-01-01

    Subject of dissertation: The development of maxilla in children with congenital unilateral complete cleft lip, alveolus and palate ( from birth till 5 years of age) Key words groups: congenital unilateral total cleft lip, alveolus and palate, development of maxilla from birth till 5 years of age, cleft severity, lip surgery, palate surgery, maxillary dental casts, occlusion. Objects of dissertation: maxillary dental cast of patients with congenital unilateral complete cleft lip, al...

  11. Bilateral condylar morphology in adult patients with unilateral cleft lip and palate%成人单侧完全性唇腭裂双侧髁突的形态特点

    Institute of Scientific and Technical Information of China (English)

    李增才; 刘新强

    2015-01-01

    BACKGROUND:The characteristics of condylar morphology should be first understood in patients with unilateral cleft lip and palate. OBJECTIVE:To investigate the bilateral condylar morphology in adult patients with unilateral cleft lip and palate. METHODS:This study included 25 patients with unilateral cleft lip and palate (study group), and 25 normal volunteers (control group). The upper condylar height, ramal height, condylar height and condylar width were measured on panoramic radiographs. The ratio of the upper condylar height to the ramal height and the ratio of the condylar height to the condylar width were calculated. RESULTS AND CONCLUSION:Compared with the control group, upper condylar height, condylar width, condylar height and the ratio of the upper condylar height to the ramal height were reduced in the study group between the normal and affected sides (P0.05). No significant difference in upper condylar height, ramal height, condylar width, condylar height, the ratio of the upper condylar height to the ramal height, the ratio of the condylar height to the condylar width, and condylar morphology was detectable between the normal and affected sides in the experimental group (P>0.05). These data show that adult patients with unilateral cleft lip and palate presented short condylar process and narrow neck, and the condylar process is shorter than ramus, which provides clinical evidence for patients with unilateral cleft lip and palate.%背景:对单侧完全性唇腭裂患者进行正畸治疗,应首先了解其髁突形态的特点。目的:探索成人单侧完全性唇腭裂患者双侧髁突形态的特点。方法:收集临床单侧完全性唇腭裂患者和正常志愿者各25例,分别作为实验组和对照组,通过全颌曲面断层片,测量髁突上部高度、升支高度、髁突高度、髁突颈部宽度,并计算髁突上部高度/升支高度和髁突高度/髁突颈部宽度。结果与结论:与对照组相比,实

  12. Oral Clefts and Academic Performance in Adolescence

    DEFF Research Database (Denmark)

    Clausen, Nicola G; Pedersen, Dorthe A; Pedersen, Jacob K

    2017-01-01

    OBJECTIVE:   Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to ......:   Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.......OBJECTIVE:   Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group...

  13. Stability after Cleft Maxillary Distraction Osteogenesis or Conventional Orthognathic Surgery

    DEFF Research Database (Denmark)

    Andersen, Kristian; Svenstrup, Martin; Pedersen, Thomas Klit

    2015-01-01

    OBJECTIVES: To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. MATERIAL AND METHODS: INCLUSION CRITERIA: 1) cleft lip and palate, 2) advancement > 8 mm. Eleven patients comprised the distraction.......98 mm (P = 0.002) was observed in DOG. Horizontal overjet increased 11.62 mm (P = 0.001). A point-nasion-B point (ANB) angle increased 8.82° (P = 0.001). Aesthetic plane to upper lip was reduced 5.44 mm (P = 0.017) and the naso-labial angle increased 16.6° (P = 0.001). Vertical overbite (VOB) increased...

  14. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Science.gov (United States)

    Ysunza, Pablo Antonio; Repetto, Gabriela M.; Pamplona, Maria Carmen; Calderon, Juan F.; Shaheen, Kenneth; Chaiyasate, Konkgrit; Rontal, Matthew

    2015-01-01

    Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI). Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management. PMID:26273595

  15. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Directory of Open Access Journals (Sweden)

    Pablo Antonio Ysunza

    2015-01-01

    Full Text Available Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI. Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management.

  16. Expression analyses of human cleft palate tissue suggest a role for osteopontin and immune related factors in palatal development

    DEFF Research Database (Denmark)

    Jakobsen, Linda P; Borup, Rehannah; Vestergaard, Janni

    2009-01-01

    Cleft lip and/or palate (CL/P) is a common congenital malformation with a complex etiology which is not fully elucidated yet. Epidemiological studies point to different etiologies in the cleft lip and palate subgroups, isolated cleft lip (CL), isolated cleft palate (CP) and combined cleft lip...... and palate (CLP). In order to understand the biological basis in these cleft lip and palate subgroups better we studied the expression profiles in human tissue from patients with CL/P. In each of the CL/P subgroups, samples were obtained from three patients and gene expression analysis was performed....... Moreover, selected differentially expressed genes were analyzed by quantitative RT-PCR, and by immunohistochemical staining of craniofacial tissue from human embryos. Osteopontin (SPP1) and other immune related genes were significantly higher expressed in palate tissue from patients with CLP compared to CP...

  17. Cleft Lip Nasal Deformity After Mucormycosis Infection: Case Report

    Directory of Open Access Journals (Sweden)

    Abdullah Orhan

    2016-07-01

    Full Text Available Mucormycosis is an acute fulminant fungal infection. Mucormycosis usually accompanies uncontrolled diabetes [in particular, patients with ketoacidosis], malignancies like lymphoma or leukemia, renal failure, organ transplantations, long-term corticosteroid or immunosuppressant therapy, and conditions including burns, cirrhosis, protein-energy malnutrition or AIDS, though it also may be seen in healthy individuals. A 21-year-old male patient applied to our clinic with cleft lip and nasal deformity. It was understood from his medical history that he was diagnosed with lymphoma at age 10 and he developed an infection in his palate and nose during the treatment course. His cleft palate and nasal deformity was repaired by surgery in our clinic. Herein we reported a case of nasal deformity and incomplete cleft palate caused by mucormycosis infection.

  18. Periodontal plastic surgery for management of cleft alveolar ridge: a case report.

    Science.gov (United States)

    Agrawal, Amit A; Yeltiwar, Ramreddy K

    2012-02-01

    Cleft lips, alveoli, and palates are the most common congenital malformations of the head and neck region, all of which often can be managed successfully when presented at a young age. It is a common belief that clefts in the alveolar ridge should be treated with the help of bone grafting materials. This could be the best option when the cleft is to be treated in early age, when the patient is still developing and has high regenerative potential. However, in adults, the literature supports the fact that bone grafting in alveolar clefts has a higher chance for failure. The present case report exemplifies a periodontal plastic surgical procedure involving a combination of connective tissue and free gingival grafting to restore the form and function of a cleft alveolar ridge in an adult patient.

  19. Options for the nasal repair of non-syndromic unilateral Tessier no. 2 and 3 facial clefts

    Directory of Open Access Journals (Sweden)

    Srinivas Gosla Reddy

    2014-01-01

    Full Text Available Background: Non-syndromic Tessier no. 2 and 3 facial clefts primarily affect the nasal complex. The anatomy of such clefts is such that the ala of the nose has a cleft. Repairing the ala presents some challenges to the surgeon, especially to correct the shape and missing tissue. Various techniques have been considered to repair these cleft defects. Aim: We present two surgical options to repair such facial clefts. Materials and Methods: A nasal dorsum rotational flap was used to treat patients with Tessier no. 2 clefts. This is a local flap that uses tissue from the dorsal surface of the nose. The advantage of this flap design is that it helps move the displaced ala of a Tessier no. 2 cleft into its normal position. A forehead-eyelid-nasal transposition flap design was used to treat patients with Tessier no. 3 clefts. This flap design includes three prongs that are rotated downward. A forehead flap is rotated into the area above the eyelid, the flap from above the eyelid is rotated to infra-orbital area and the flap from the infraorbital area that includes the free nasal ala of the cleft is rotated into place. Results and Conclusions: These two flap designs show good results and can be used to augment the treatment options for repairing Tessier no. 2 and 3 facial clefts.

  20. Preferential associations between oral clefts and other major congenital anomalies

    NARCIS (Netherlands)

    Rittler, Monica; Lopez-Camelo, Jorge S.; Castilla, Eduardo E.; Bermejo, Eva; Cocchi, Guido; Correa, Adolfo; Csaky-Szunyogh, Melinda; Danderfer, Ron; De Vigan, Catherine; De Walle, Hermien; da Graca Dutra, Maria; Hirahara, Fumiki; Luisa Martinez-Frias, Maria; Merlob, Paul; Mutchinick, Osvaldo; Ritvanen, Annukka; Robert-Gnansia, Elisabeth; Scarano, Gioacchino; Siffel, Csaba; Stoll, Claude; Mastroiacovo, Pierpaolo

    2008-01-01

    Objectives: To identify preferential associations between oral clefts (CL = cleft lip only, CLP = cleft lip with cleft palate, CP = cleft palate) and nonoral cleft anomalies, to interpret them on clinical grounds, and, based on the patterns of associated defects, to establish whether CL and CLP are

  1. Early orthodontic intervention followed by fixed appliance therapy in a patient with a severe Class III malocclusion and cleft lip and palate.

    Science.gov (United States)

    Zhang, He; Deng, Feng; Wang, Huaqiao; Huang, Qianqian; Zhang, Yi

    2013-11-01

    This case report describes the treatment of a girl, age 11 years 10 months, with a cleft lip and palate and a postsurgical scar. The clinical examination showed a concave profile, a retrusive maxilla, an asymmetric face, severe dental crowding, a Class III dental relationship, and a complete dental crossbite. Maxillary expansion and distraction, chincap, and high-pull headgear were used to moderate the skeletal discrepancy. These approaches, combined with tooth extraction and fixed orthodontic appliances, finally established a functional and esthetic occlusal relationship, normal overjet and overbite, and a well-balanced facial appearance.

  2. Prophylaxis of migraine: general principles and patient acceptance

    Directory of Open Access Journals (Sweden)

    Domenico D’Amico

    2008-12-01

    Full Text Available Domenico D’Amico1, Stewart J Tepper21Headache Center, Department of Neurological Sciences, C Besta Neurological Institute, Milan, Italy; 2Center for Headache and Pain, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Migraine is a chronic neurological condition with episodic exacerbations. Migraine is highly prevalent, and associated with significant pain, disability, and diminished quality of life. Migraine management is an important health care issue. Migraine management includes avoidance of trigger factors, lifestyle modifications, non-pharmacological therapies, and medications. Pharmacological treatment is traditionally divided into acute or symptomatic treatment, and preventive treatment or prophylaxis. Many migraine patients can be treated using only acute treatment. Patients with severe and/or frequent migraines require long-term preventive therapy. Prophylaxis requires daily administration of anti-migraine compounds with potential adverse events or contraindications, and may also interfere with other concurrent conditions and treatments. These problems may induce patients to reject the idea of a preventive treatment, leading to poor patient adherence. This paper reviews the main factors influencing patient acceptance of anti-migraine prophylaxis, providing practical suggestions to enhance patient willingness to accept pharmacological anti-migraine preventive therapy. We also provide information about the main clinical characteristics of migraine, and their negative consequences. The circumstances warranting prophylaxis in migraine patients as well as the main characteristics of the compounds currently used in migraine prophylaxis will also be briefly discussed, focusing on those aspects which can enhance patient acceptance and adherence.Keywords: migraine, prophylaxis, preventive therapy, acceptance, adherence

  3. Bright Promise for Your Child with Cleft Lip and Cleft Palate. Revised Edition.

    Science.gov (United States)

    McDonald, Eugene T.; Berlin, Asa J.

    Intended for parents of children with cleft lip and cleft palate, the booklet provides an overview of the condition. Addressed are the following topics (sample subtopics in parentheses): prenatal development and birth defects (facial development); possible causes of cleft lip/cleft palate (common misconceptions, genetic factors, environmental…

  4. Oral health-related quality of life in children with orofacial clefts.

    Science.gov (United States)

    Ward, Jared A; Vig, Katherine W L; Firestone, Allen R; Mercado, Ana; da Fonseca, Marcio; Johnston, William

    2013-03-01

    Objectives : To determine the impact of orofacial clefts on the oral health-related quality of life of affected children and whether the oral health-related quality of life of children with orofacial clefts differs among different age groups. To assess whether the responses of children with orofacial clefts differ from the caregivers' perceptions of their child's oral health-related quality of life and compare with data from a control group. Design : Cross-sectional study. Patients/Setting : A total of 75 subjects with cleft lip and/or cleft palate (mean age, 13.0 years) from the Nationwide Children's Hospital Craniofacial Anomalies Clinic, as well as their caregivers, and 75 control subjects (mean age, 13.9 years). Main Outcome Measure : Self-reported oral health-related quality of life measured with the Child Oral Health Impact Profile, a reliable and valid questionnaire designed for use with children and teenagers. Results : Children with orofacial clefts had statistically significant lower quality of life scores than control subjects had for overall oral health-related quality of life, Functional Well-being, and Social Emotional Well-being. There was a statistically significant difference in the interaction of age group and Social-Emotional Well-being between children with orofacial clefts and control children. No statistically significant differences were found between the responses of children with orofacial clefts and their caregivers' reports. Conclusions : Presence of an orofacial cleft significantly decreases overall oral health-related quality of life, Functional Well-being, and Social-Emotional Well-being in children and adolescents. The negative impact of orofacial clefts on Social-Emotional Well-being is greater in 15- to 18-year-olds than in younger age groups. Children with orofacial clefts and their caregivers had very similar evaluations of the child's oral health-related quality of life.

  5. Dental caries in the primary dentition of german children with cleft lip, alveolus, and palate.

    Science.gov (United States)

    Kirchberg, Anja; Makuch, Almut; Hemprich, Alexander; Hirsch, Christian

    2014-05-01

    Objective : The purpose of this cross-sectional study was to assess the prevalence of dental caries in children with cleft lip, alveolus, and/or cleft palate living in central Germany between 1996 and 2010. Participants : A total of 295 children 1 to 6 years of age from three birth cohorts (BC) with clefts from central Germany were included in the study. They were compared with 548 1- to 6-year-old cleft-free children from the same region. Setting : Children with clefts underwent a dental examination in an outpatient dental clinic at the University of Leipzig. The first BC was examined between 1996 and 1998, the second between 2002 and 2004, and the third between 2008 and 2010. Controls were examined at day-care centers in Leipzig during the same periods. Main Outcome Measure : The standard dental caries index for the primary dentition (dmf/t3-4) was used for clinical assessment. Results : Over the entire study period, the mean prevalence of dental caries in deciduous teeth was significantly higher (1.32 dmf/t3-4) in children with clefts compared with cleft-free children. However, a decline in caries (approximately 1 dmf/t3-4) and an increase in the proportion of children with healthy primary dentition were observed in both groups. These results represent a caries decline of 61% in children with clefts. Conclusions : Caries rates for children 1 to 6 years of age with clefts from central Germany showed a considerable decline over the last years. The caries rates for clefts patients in the third BC (2008 to 2010) was similar to that of cleft-free children in the first BC (1996 to 1998).

  6. Risk of Oral Clefts in Twins

    DEFF Research Database (Denmark)

    Grosen, Dorthe; Bille, Camilla; Petersen, Inge

    2011-01-01

    BACKGROUND:: Small studies have indicated that twinning increases the risk of oral cleft. METHODS:: We used data from a Danish national population-based cohort study to investigate whether twinning was associated with isolated oral cleft, and to estimate the twin probandwise concordance rate...... and heritability. Twins (207 affected/130,710) and singletons (7766 affected/4,798,526) born from 1936 through 2004 in Denmark were ascertained by linkage among the Danish Facial Cleft Database, the Danish Twin Registry, and the Civil Registration System. We computed oral cleft prevalence and prevalence proportion...... ratio for twins versus singletons, stratified for 3 subphenotypes. Probandwise concordance rates and heritability for twins were estimated for 2 phenotypes-cleft lip with or without cleft palate (CL/P) and cleft palate (CP). RESULTS:: The prevalence of oral cleft was 15.8 per 10,000 twins and 16.6 per...

  7. Understanding Cleft and Craniofacial Team Care

    Science.gov (United States)

    ... Donor Spotlight Fundraising Ideas Vehicle Donation Volunteer Efforts Cleft Lip/Palate & Craniofacial Specialists in Your Area skip to submenu Parents & Individuals Cleft Lip/Palate & Craniofacial Specialists in Your Area Team Disclaimer States: ...

  8. 单侧完全性唇腭裂患者上颌前牵引后软组织的侧貌变化%Soft Tissue Profile Changes After Maxillary Protraction in Complete Unilateral Cleft Lip and Palate Patients

    Institute of Scientific and Technical Information of China (English)

    张桦; 朱敏; 陈建宇; 房兵

    2001-01-01

    Objective The purpose is to evaluate the soft tissue profilechanges in patients with complete unilateral cleft lip and palate treated after maxillary protraction. Method 12 patients with complete unilateral cleft lip and palate were treated using maxillary protraction. Lateral cephalometric films were taken before and after treatment. Soft tissue profile changes were evaluated by comparing the difference of soft tissue landmarks between two films. Results After maxillary protraction, the convex of nose (S-Ns-PRN) increased significantly (P<0.001), the convex of maxillary soft tissue was increased by 3.8 degree(P<0.01). The convex of middle face changed significantly (P<0.01). In mandible angle S-Ns-SM was decreased one degree (P>0.05).Vertically, there was no significant difference in upper face height (P>0.05).Total face height increased significantly (P<0.01). Conclusion After treatment of maxillary protraction, the soft tissue profile in patients with complete cleft lip and palate improved significantly.%目的 评价单侧完全性唇腭裂患者经上颌前牵引治疗后的软组织侧貌改变。方法 12例患者接受上颌前牵引治疗,根据X线头颅侧位定位片上软组织的测量标志点,对治疗前后软组织的侧貌改变进行比较分析。结果 上颌骨前牵引治疗后,患者鼻突度有明显改变,软组织上颌突度增加了3.8°(P<0.01),代表软组织面突度角也有明显改变(P<0.01)。而下颌软组织突度矢状方向S-Ns-SM角减少1°,无统计学意义。垂直方向,上面高无变化,而全面高度增加显著(P<0.01)。结论 上颌前牵引后,在矢状方向上软组织突度发生显著变化,主要包括轻度的鼻隆起,下颌及颏部的后缩也有一定改善。

  9. Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Kianifar

    2015-01-01

    Full Text Available Introduction: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P among live births in Mashhad, North-Eastern Iran.   Materials and Methods: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis.   Results: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP was the most prevalent type of cleft (50%, followed by isolated cleft lip         (35.2% and isolated cleft palate (14.8%. A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3. The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002–2011 (P=0.027. There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively. Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05.    Conclusion:  This study indicates a frequency of CL/P close to the findings

  10. Management of cleft lip and palate in adults

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2009-10-01

    Full Text Available Introduction: With advancement of medical services in developed countries and awareness among the patients, it is rare to find an adult with an unoperated cleft lip and palate. However, the scenario is totally different in developing countries. Working as a part of a team in developing country, where co-coordinated team work is primitive, resources to provide treatment are very thin, public awareness of availability of treatment for this anomaly is minimal, the age of patients reaching for primary treatment varies from few days to late forties. Though the aim and aspiration is to provide holistic multidisciplinary care, the priority is getting treatment for all cleft patients. In such situation, the management of cleft lip and palate demands changes of approach, techniques and philosophy. Aims and Objectives: The deformed anatomy especially the facial bones and dentition is described. Due to well established deformities, the approach for management is individualized. The procedures and modification of procedures has been described. Results and Outcome: The outcome of the primary repair is adults certainly have less than satisfactory outcome for obvious reasons. The expected outcome and expectation of patients and families following primary surgeries in cleft lip and palate has been discussed. Though all adult patients got some improvement in speech after palate repair, achieving normal speech was difficult. The naso-labial appearance was not perfect, but well accepted by the patients and families. There are many psychosocial problems in these patients, the objective evaluation could not be done due to too many variables. However, primary repair of cleft lip and palate is justified and beneficial for the patients.

  11. Surgical outcome and complications following cleft lip and palate repair in a teaching hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Taiwo O Abdurrazaq

    2013-01-01

    Full Text Available Background: Measurement of treatment outcome is important in estimating the success of cleft management. The aim of this study was to assess the surgical outcome of cleft lip and palate surgery. Patients and Methods: The surgical outcome of 131 consecutive patients with cleft lip and palate surgeries between October 2008 and December 2010 were prospectively evaluated at least 4 weeks postoperatively. Data collected included information about the age, sex, type of cleft defects, and type of surgery performed as well as postoperative complications. For cleft lip repair, the Pennsylvania lip and nose (PLAN score was used to assess the surgical outcome, while the integrity of the closure was used for cleft palate repair. Results: A total of 92 patients had cleft lip repair and 64 had palate repair. Overall, 68.8% cases of cleft lip and palate repair had good outcomes; 67.9% of lip repairs had good lip and nose scores, while 70.2% of palatal repair had a good surgical outcome. Oro-fistula was observed in 29.8% of cleft palate repairs Inter-rater reliability coefficient was substantially significant. Conclusions: The fact that 25.7% of those treated were aged >1 year suggests a continued need to enlighten the public on the availability of cleft lip and palate expertise and treatment. Although an overall good treatment outcome was demonstrated in this study, the nasal score was poorer than the lip score. Complication rate of about 14% following surgical repair is consistent with previous reports in the literature.

  12. Communication disorders in individuals with cleft lip and palate: An overview

    Directory of Open Access Journals (Sweden)

    Nagarajan Roopa

    2009-10-01

    Full Text Available The need for an interdisciplinary approach in the comprehensive management of individuals with cleft lip and palate is well recognized. This article provides an introduction to communication disorders in individuals with cleft lip and palate for members of cleft care teams. The speech pathologist is involved in identifying those infants who are at risk for communication disorders and also for initiating early intervention to prevent or mitigate communication disorders caused by the cleft. Even with early cleft repair, some children exhibit ′cleft palate speech′ characterized by atypical consonant productions, abnormal nasal resonance, abnormal nasal airflow, altered laryngeal voice quality, and nasal or facial grimaces. These manifestations are evaluated to identify those that (a are developmental, (b can be corrected through speech therapy alone, and, (c those that may require both surgery and speech therapy. Speech is evaluated perceptually using several types of stimuli. It is important to identify compensatory and obligatory errors in articulation. When velopharyngeal dysfunction is suspected, the assessment should include at least one direct measure such as nasoendoscopy or videofluoroscopy. This provides information about the adequacy of the velopharyngeal valve for speech production, and is useful for planning further management of velopharyngeal dysfunction. The basic principle of speech therapy in cleft lip and palate is to establish the correct placement of the articulators and appropriate air flow. Appropriate feedback is important during therapy for establishing the correct patterns of speech.

  13. Clinical photography among African cleft caregivers

    Directory of Open Access Journals (Sweden)

    Peter Babatunde Olaitan

    2011-01-01

    Full Text Available Objective: The aim of this paper is to document the practice of photography among clinicians whose daily work depends and is influenced so much by medical photography. Materials and Methods: Questionnaires documenting the bio data, place of practice, and experience of cleft caregivers with clinical photography were distributed. Knowledge of rules guiding clinical photography and adherence to them were also asked. Types of camera used were documented and knowledge of the value of clinical photographs were also inquired. Results: Plastic surgeons constitute the highest proportion of 27 (38.6%, followed by Oral and Maxillofacial surgeons with 14 (20.0%. Twenty one (30.0% of the respondents always, 21 (30.0% often, 12 (17.1% frequently, while 9 respondents sometimes took photographs of their patients. Suggested uses of clinical photographs included training, 52 (74.3%, education, 51 (72.9%, medicolegal, 44 (62.9% and advertisement, 44 (62.9% among others. Twenty two (31.4% did not know that there were standard guidelines for taking clinical photographs. Twenty three (32.9% of them did not seek the consent of the patients before taking clinical photographs. Conclusion: While the practice of clinical photography is high among African cleft caregivers, there is a need for further education on the issues of standard rules and obtaining consent from patients.

  14. Clinical photography among African cleft caregivers

    Science.gov (United States)

    Olaitan, Peter Babatunde; Oseni, Ganiyu Oladiran

    2011-01-01

    Objective: The aim of this paper is to document the practice of photography among clinicians whose daily work depends and is influenced so much by medical photography. Materials and Methods: Questionnaires documenting the bio data, place of practice, and experience of cleft caregivers with clinical photography were distributed. Knowledge of rules guiding clinical photography and adherence to them were also asked. Types of camera used were documented and knowledge of the value of clinical photographs were also inquired. Results: Plastic surgeons constitute the highest proportion of 27 (38.6%), followed by Oral and Maxillofacial surgeons with 14 (20.0%). Twenty one (30.0%) of the respondents always, 21 (30.0%) often, 12 (17.1%) frequently, while 9 respondents sometimes took photographs of their patients. Suggested uses of clinical photographs included training, 52 (74.3%), education, 51 (72.9%), medicolegal, 44 (62.9%) and advertisement, 44 (62.9%) among others. Twenty two (31.4%) did not know that there were standard guidelines for taking clinical photographs. Twenty three (32.9%) of them did not seek the consent of the patients before taking clinical photographs. Conclusion: While the practice of clinical photography is high among African cleft caregivers, there is a need for further education on the issues of standard rules and obtaining consent from patients. PMID:22279284

  15. CT appearances of unilateral cleft palate 20 years after bone graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kolbenstvedt, A.; Aaloekken, T.M. [Rikshospitalet, Oslo (Norway). Dept. of Radiology; Arctander, K. [Rikshospitalet, Oslo (Norway). Dept. of Plastic Surgery; Johannessen, S. [Inst. of Clinical Dentistry, Oslo (Norway)

    2002-11-01

    Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give satisfactory functional and cosmetic results, certain abnormalities persist. A knowledge of these is a prerequisite for a complete and final evaluation of the surgical and orthodontic regimen. Cleft palate nasal cavity abnormalities CT.

  16. Parent satisfaction with primary repair of paediatric cleft lip in Southwest China.

    Science.gov (United States)

    Ha, P; Li, C; Shi, B

    2017-03-01

    The purpose of this study was to investigate the key factors in relation to parent satisfaction with the primary repair of paediatric cleft lip. One hundred and ninety-five children born with cleft lip and/or palate aged between 3 months and 1 year were recruited, along with their caregivers. All patients underwent primary cleft lip repair, and a telephone interview was held with their main caregivers at 3 months postoperative. The level of satisfaction with each item included in a simplified Cleft Evaluation Profile was ascertained and recorded. Patient clinical data were obtained from the medical records. One hundred and thirty-eight (71%) parents reported satisfaction with the general outcome of surgery. Parents were satisfied with the appearance of the lip and profile of the face, but were dissatisfied with the appearance of the nose and teeth. Mothers of patients showed lower satisfaction levels than fathers and grandparents. Parental satisfaction with the appearance of the lip was lower for patients without a cleft palate than for those with a cleft palate. The results of this study suggest that most Chinese parents of children who undergo primary cleft lip repair express satisfaction with the surgical outcomes. Satisfaction with the appearance of the nose and teeth is low and this needs to be improved. Other factors are likely to influence expressions of satisfaction.

  17. 8~12岁唇腭裂患者的心理调查研究%Psychological research patients of 8-12 years with cleft of lip and/or palate*

    Institute of Scientific and Technical Information of China (English)

    郭世莉; 陈群

    2013-01-01

      目的探讨学龄期唇腭裂患者的心理状态和行为习惯。方法选取8~12岁一期手术前的唇腭裂患者及其家长50例作为观察组;选取8~12岁非唇腭裂患者及家长50例作为对照组,分别对其进行儿童社交焦虑量表、自尊量表、Achenbach儿童行为量表测定。结果家长用Achenbach儿童行为量表唇腭裂患者异常率为22%,高于对照组的8%(χ2=3.85,P<0.05);学龄期唇腭裂患者社交焦虑量表得分高于非唇腭裂患者( t=5.29,P<0.01);学龄期唇腭裂患者自尊量表得分低于非唇腭裂患者( t=4.25,P<0.01)。结论学龄期唇腭裂患者存在较为明显的心理和行为问题,应有针对性地采取相应的护理措施及健康教育。%Objective To investigate the pyschological states and behavior habits of school-age children with cleft of lip and /or palate .Methods 50 children at the age of 8-12 with cleft of lip before the first operation and their parents and 50 normal control children were tested with SAS (social anxiety scale) ,SEC(self esteem scale) ,and CBCL(children behavior checklist) .Results The rate of abnormal tested by CBCL (children behavior checklist)-parent in patients was 22% ,was higher than that in normal 8% (χ2 =3 .85 ,P<0 .05) .The scores of SAS in patients was higher than those in control (t=5 .29 ,P<0 .01) .Conclusion School-age chil-dren with cleft of lip and/or palate had obvious psychological and behavioral problems ,thus ,corresponding nursing and health edu-cation should be applied .

  18. Comparison of two different gingivectomy techniques for gingival cleft treatment.

    Science.gov (United States)

    Malkoc, Siddik; Buyukyilmaz, Tamer; Gelgor, Ibrahim; Gursel, Mihtikar

    2004-06-01

    Interdental clefts or invaginations contribute to orthodontic relapse and poor periodontal health in extraction cases. These clefts or invaginations can be removed both by electrosurgical or conventional surgical gingivectomy techniques. This study investigates and compares the efficacy of two different techniques to remove gingival clefts with respect to periodontal health and patient tolerance. Twenty-two patients (mean age, 15.7 years) with bilateral gingival clefts participated in this study. In each patient, the gingival invaginations were removed by gingivectomy using electrosurgery on one side and conventional surgery on the contralateral side. The length and depth of the invaginations, the gingival index of the adjacent teeth, and the changes in visual analogue scale scores were recorded before and after the operation for both groups. Mann-Whitney U-test and Wilcoxon tests were used to analyze the data statistically. The results showed significant improvement in invagination depth and length and gingival index scores for both techniques. There were no statistical differences between the two gingivectomy techniques with respect to gingival health and patient tolerance. Both techniques can be used to remove the gingival invaginations efficiently.

  19. Cleft lip: The historical perspective

    Directory of Open Access Journals (Sweden)

    Bhattacharya S

    2009-10-01

    Full Text Available The earliest documented history of cleft lip is based on a combination of religion, superstition, invention and charlatanism. While Greeks ignored their existence, Spartans and Romans would kill these children as they were considered to harbour evil spirits. When saner senses prevailed Fabricius ab Aquapendente (1537-1619 was the first to suggest the embryological basis of these clefts. The knowledge of cleft lip and the surgical correction received a big boost during the period between the Renaissance and the 19th century with the publication of Pierre Franco′s Petit Traite and Traite des Hernies in which he described the condition as "lievre fendu de nativite" (cleft lip present from birth. The first documented Cleft lip surgery is from China in 390 BC in an 18 year old would be soldier, Wey Young-Chi. Albucasis of Arabia and his fellow surgeons used the cautery instead of the scalpel and Yperman in 1854 recommended scarifying the margins with a scalpel before suturing them with a triangular needle dipped in wax. The repair was reinforced by passing a long needle through the two sides of the lip and fixing the shaft of the needle with a figure-of-eight thread over the lip. Germanicus Mirault can be credited to be the originator of the triangular flap which was later modified by C.W. Tennison in 1952 and Peter Randall in 1959. In the late 50s, Ralph Millard gave us his legendary ′cut as you go′ technique. The protruding premaxilla of a bilateral cleft lip too has seen many changes throughout the ages - from being discarded totally to being pushed back by wedge resection of vomer to finally being left to the orthodontists.

  20. Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 2. Lip Changes.

    LENUS (Irish Health Repository)

    Ayoub, Ashraf

    2010-09-08

    Abstract Objective: To evaluate 3D lip morphology, following primary reconstruction in children with unilateral cleft lip and palate (UCLP) relative to contemporaneous non-cleft data Design: Prospective, cross-sectional, controlled study Setting: Glasgow Dental Hospital & School, University of Glasgow, The UK. Patients and Participants: Two groups of 3-year old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a 3D vision based capture technique. Methods: 3D images of the face were reflected so the cleft was on the left side to create a homogenous group for statistical analysis. Three-dimensional co-ordinates of anthropometric landmarks were extracted from facial images. 3D generalised Procustes superimposition was employed and a set of linear measurements were utilised to compare between cleft and control subjects for right and left sides, adjusting for sex differences. Results: Christa philteri on both the cleft and non-cleft sides were displaced laterally and posteriorly; there was also a statistically significant increase in philtrum width. No significant differences between cleft and control regarding the cutaneous height of the upper lip. The lip in the cleft cases was flatter than in the non-cleft cases with less prominence of labialis superioris. Conclusions: Stereophotogrammetry allows detection of residual dysmorphology following cleft repair. There was significant increase of the philtrum width. The lip appeared flatter and more posterior displaced in Unilateral Cleft Lip and Palate (UCLP) cases compared with control. Keywords: child, cleft lip and palate, lip repair, three-dimensional imaging.

  1. Oral cleft prevention program (OCPP

    Directory of Open Access Journals (Sweden)

    Wehby George L

    2012-11-01

    Full Text Available Abstract Background Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P, on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg to that of a historical control group. The study has been approved by IRBs (ethics committees of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study

  2. Management of the Amniotic Band Syndrome with Cleft Palate: Literature Review and Report of a Case

    Science.gov (United States)

    Cortez-Ortega, Carolina; Flores-Velázquez, Joselín; Ruiz-Rodríguez, Socorro; Noyola-Frías, Miguel Ángel; Santos-Díaz, Miguel Ángel

    2017-01-01

    Amniotic Band Syndrome (ABS) is a group of congenital malformations that includes the majority of typical constriction rings and limb and digital amputations, together with major craniofacial, thoracic, and abdominal malformations. The syndrome is caused by early rupture of the amniotic sac. Some of the main oral manifestations include micrognathia, hyperdontia, and cleft lip with or without cleft palate, which is present in 14.6% of patients with this syndrome. The purpose of this report was to describe the clinical characteristics and the oral treatment provided to a 6-month-old male patient affected with ABS with cleft lip and palate. PMID:28246561

  3. The Effect of Cleft Palate Repair on Contractile Properties of Single Permeabilized Muscle Fibers From Congenitally Cleft Goats Palates

    Science.gov (United States)

    A cleft palate goat model was used to study the contractile properties of the levator veli palatini (LVP) muscle which is responsible for the movement of the soft palate. In 15-25% of patients that undergo palatoplasty, residual velopharyngeal insufficiency (VPI) remains a problem and often require...

  4. Bone grafting, corticotomy, and orthodontics: treatment of cleft alveolus in a chinese cohort.

    Science.gov (United States)

    Mao, Li-Xia; Shen, Guo-Fang; Fang, Bing; Xia, Yun-Hui; Ma, Xu-Hui; Wang, Bo

    2013-11-01

    Objective : A multimodal therapy was applied to solve a set of related problems including collapse of the posterior segment, high level gingival margin of canine, and resorption of grafted bone in a cohort of Chinese youngsters with cleft lip and palate. This study aimed to evaluate the benefits of this treatment procedure. Methods : Thirty patients with unilateral cleft lip and palate were included in this prospective study. All patients had previously undergone only cleft lip and palate repair and presented with alveolar cleft and an obvious step in the gingival margin between the canine tooth and the teeth beside it. A multimodal therapy that included bone grafting, corticotomy, and orthodontics was applied to solve these problems. Grafted bone volume, parallelism of the roots, root resorption, gingival margin, and mobility of the canine on the cleft side were established before surgery, 1 week after surgery, and after straightening of the canine. Results : Less than 25% of the grafted bone was reabsorbed in 25 of the 30 patients, while less than 50% was resorbed in the remaining five. The roots of the canines on the cleft side were mostly parallel to the adjacent teeth. Root resorption and mobility of the canines were slight. The difference in the gingival margin between the canines on the cleft side and the other side was small. Conclusions : Canines moved into the grafted bone safely and effectively, thus achieving a normal gingival margin and retaining grafted bone volume in one operation.

  5. Secondary alveolar bone grafting in combination with autologous iliac crest cortical plate and concellous bone for 19 adult cleft patients%自体髂骨皮质骨块与松质骨联合移植修复成人牙槽突裂19例分析

    Institute of Scientific and Technical Information of China (English)

    李增健; 卢利; 金山; 任媛媛; 刘强; 张斌; 张蕾; 吴楠; 杨鸣良; 王绪凯

    2012-01-01

    Objective To retrospectively study secondary alveolar bone grafting in combination with autologous iliac crest cortical bone and concellous bone for adult cleft patients. Methods Analveolar bone grafting procedure in combination with autologous illiac crest cortical bone and concellous bone has been applied in 19 adult cleft patients since 2008. A water-tight mucocusperiosteum pocket was formed around the alveolar cleft. The iliac concellous bone was put into the alveolar cleft with tender pressing. The carved iliac crest cortical bone was then covered on to the labial surface of alveolar cleft and pyriform aperture with titanium screws. Results Based on Bergland's criterion, the overall survival rate of bone grafting was 84.2% , clinical success rate was 73.7% , clinical failure rate was 26. 3%. Oral-nasal fistular recurred in 2 patients. Conclusion Secondary alveolar bone grafting in combination with autologous iliac crest cortical bone and concellous bone can effectively improve the grafting survival rate and keep a sufficient volume in regions of cleft and the pyriform aperture of adult cleft patients.%目的 观察自体髂骨块和松质骨联合移植修复成人牙槽突裂的效果.方法 对2008年以来在我院就诊的成人牙槽突裂患者19例采用自体髂骨块和松质骨联合移植修复.将髂松质骨填充牙槽突裂间隙内,用骨块恢复梨状孔边缘形态和鼻翼基底部高度后,采用微型钛板和单皮质钛钉固定.术后1年复查进行Bergland 分级评价.结果 植入骨成活率(Ⅰ~Ⅲ级)为84.2%,临床成功率(Ⅰ、Ⅱ级)为73.7%,临床失败率(Ⅲ、Ⅳ级)为26.3%.2例患者再次出现口鼻瘘孔.结论 自体髂骨块和松质骨联合移植修复成人牙槽突裂可以有效恢复牙槽突高度,增加患侧梨状孔周围骨量.

  6. A study on the cephalometric similarity between parents and offspring in cleft lip with or without palate

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Su Beom; Lee, Un Gyeong; Na, Seung Mog; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    1994-08-15

    The purpose of this study was to determine whether any similarity existed in craniofacial morphology between parents and offspring in cleft lip with or without cleft palate. Thirty three measurements of the various regions of cranium and face were obtained from lateral cephalometric radiograms in 28 families comprising 28 fathers, 28 mothers and 28 cleft patients. The measurements of cleft patients compared with those of their fathers, mothers and midparents. The obtained results were as follows: 1. There were similar measurements between the cleft patients and their fathers; ramal height (Ar-Go), mandibular angle (angle MP-RP). 2. There were similar measurements between the cleft patients and their mothers; cranial base angle (angle NSBa), relation of maxilla to the cranial base (angle SNA), relation of maxilla to the cranial base(soft tissue: ?BaN{sup S}n), angle of inferior border of mandible (angle SNL-MP) and convexity of nose apex (soft tissue: angle N'PrnPog'). 3. There were similar measurements between the cleft patients and their midparents; ramal height (Ar-Go), cranial base angle (angle NSBa), relation of maxilla to the cranial base (soft tissue: angle BaN{sup S}n), Y axis angle (angle NSGn) and mandibular angle (angle MP-RP). 4. There was no similar measurements between the cleft patients and their fathers and mothers simultaneously

  7. An evaluation of surgical outcome of bilateral cleft lip surgery using a modified Millard′s (Fork Flap technique

    Directory of Open Access Journals (Sweden)

    W L Adeyemo

    2013-01-01

    Full Text Available Background: The central third of the face is distorted by the bilateral cleft of the lip and palate and restoring the normal facial form is one of the primary goals for the reconstructive surgeons. The history of bilateral cleft lip repair has evolved from discarding the premaxilla and prolabium and approximating the lateral lip elements to a definitive lip and primary cleft nasal repair utilising the underlying musculature. The aim of this study was to review surgical outcome of bilateral cleft lip surgery (BCLS done at the Lagos University Teaching Hospital. Materials and Methods: A review of all cases of BCLS done between January 2007 and December 2012 at the Lagos University Teaching Hospital was done. Data analysis included age and sex of patients, type of cleft deformity and type of surgery (primary or secondary and whether the cleft deformity was syndromic and non-syndromic. Techniques of repair, surgical outcome and complications were also recorded. Results: A total of 39 cases of BCLS involving 21 males and 18 females were done during the period. This constituted 10% (39/390 of all cases of cleft surgery done during the period. There were 5 syndromic and 34 non-syndromic cases. Age of patients at time of surgery ranged between 3 months and 32 years. There were 24 bilateral cleft lip and palate deformities and 15 bilateral cleft lip deformities. Thirty-one of the cases were primary surgery, while 8 were secondary (revision surgery. The most common surgical technique employed was modified Fork flap (Millard technique, which was employed in 37 (95% cases. Conclusion: Bilateral cleft lip deformity is a common cleft deformity seen in clinical practice, surgical repair of which can be a challenge to an experienced surgeon. A modified Fork flap technique for repair of bilateral cleft lip is a reliable and versatile technique associated with excellent surgical outcome.

  8. Six years analysis of cleft palate in a university hospital center

    Directory of Open Access Journals (Sweden)

    Farahvash M

    1999-08-01

    Full Text Available Cleft palate is a congenital condition that occurs with the incidence rate of one out of 2000 births. This anomaly produces intraoral pressure changes (increase or decrease, can cause speech, sucking and feeding problems of involved patient. On the other hand, if cleft palate is associated with cleft of the lip or alveolar area, growth and alignment of teeth may change the appearance of the patient and affect the psychologic and occupational future of the patient. Eustatian tube malfunction in involved neonates increase. Many procedures are used to repair the cleft palate and correction of palatal muscles which are: 1 Von Langenbeck (18.5%. 2 Veau-Wardil-Kilner (72.5%. 3 Double opposing Z-Plasty (9%. In this research the demographic criteria of patients including age of the patient at operation rime (mean age 30.14 months, city of residence, family history of cleft palate (12.4%, familial relation of parents (15.2%, associated anomalies, complete or incomplete lesion, weight of patients at the time of surgery (mean 11.28 Kg, hemoglobin (11.3 mg/dl, complications, otitis media and the side of cleft palate are studied in 178 admitted patients to Imam General Hospital between 1989 and 1995.

  9. Simulating clefts in pumpkin balloons

    Science.gov (United States)

    Baginski, Frank; Brakke, Kenneth

    2010-02-01

    The geometry of a large axisymmetric balloon with positive differential pressure, such as a sphere, leads to very high film stresses. These stresses can be significantly reduced by using a tendon re-enforced lobed pumpkin-like shape. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin shape, including the constant bulge angle (CBA) design, the constant bulge radius (CBR) design, CBA/CBR hybrids, and NASA’s recent constant stress (CS) design. Utilizing a hybrid CBA/CBR pumpkin design, Flight 555-NT in June 2006 formed an S-cleft and was unable to fully deploy. In order to better understand the S-cleft phenomenon, a series of inflation tests involving four 27-m diameter 200-gore pumpkin balloons were conducted in 2007. One of the test vehicles was a 1/3-scale mockup of the Flight 555-NT balloon. Using an inflation procedure intended to mimic ascent, the 1/3-scale mockup developed an S-cleft feature strikingly similar to the one observed in Flight 555-NT. Our analysis of the 1/3-scale mockup found it to be unstable. We compute asymmetric equilibrium configurations of this balloon, including shapes with an S-cleft feature.

  10. Orthodontic tooth movement into the grafted alveolar bone: a clinical study in 10 cleft lip and palate patients%唇腭裂患者牙槽突裂植骨区牙移入的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨臣杰; 陈振琦; 杨育生; 钱玉芬

    2012-01-01

    PURPOSES: To explore the possibility of tooth movement into grafted alveolar bone in cleft lip and palate patients (CLP), and to evaluate the bone height of the grafted bone and alveolar bone support of the moved-in teeth. METHODS: Ten CLP patients were included in this study. Periapical radiographs were taken for the cleft-associated teeth 3 months later after bone grafting (Tl) and after tooth movement into the grafted bone (T2). Alveolar bone support of the moved teeth were measured at Tl and T2 stages. Paired t test were performed for statistical analysis with SPSS17.0 software package. The height of the grafted bone were evaluated serai -quantitatively using the Bergland system. RESULTS: All the cleft-associated teeth were bodily moved into the grafted area. The average alveolar bone support for the moved teeth was (89.85±2.51)% (Tl) and (90.22±2.44)% (T2), respectively. There was no significant difference between Tl and T2. No significant radiographic alteration was observed in the height of the grafted bone. CONCLUSIONS: Cleft-associated teeth could be bodily moved into the grafted bone. A successful level of alveolar bone support for the moved teeth was achieved. Moved-in teeth could reduce the resorption of grafted bone. Supported by Medical Research Fund of Science and Technology Commission of Shanghai Municipality(074119643).%目的:探讨牙槽突裂植骨区牙移入的可行性及牙移入的方式,评价移入牙的牙槽骨支持率和移植骨高度变化.方法:选取唇腭裂伴牙槽突裂患者10例,行牙槽突裂自体髂骨植骨术后,分别拍摄植骨后3个月(T1)及牙移入植骨区后(T2)的根尖片,观察牙移入植骨区的情况,测量T1和T2阶段移入牙的牙槽骨支持率,采用SPSS17.0软件包对测量数据进行配对t检验,并参照Bergaand四分法评价移植骨的高度变化.结果:①牙整体移入植骨区,牙槽骨支持率为(89.85±2.51)% (T1)和(90.22±2.44)%(T2),牙移入植骨区后的

  11. Unusual foreign body in the nasal cavity of an adult with repaired cleft lip and palate.

    Science.gov (United States)

    Ravikumar, Nagabhairava; GunaShekhar, M; Prasad, S Raghavendra; Lalitha, N; Raju, P Ramanjaneya; Natesh, Y A

    2015-03-01

    Intranasal foreign bodies arising from dental clinical practice, especially in patients with cleft lip and palate (CLP) occur rarely and are very scarce in the literature. This article reports an unusual case of a dental impression material presenting as a foreign body in the nasal cavity of an adult with repaired CLP who presented for dental prosthetic rehabilitation. To our knowledge, this is only the second report presenting nasal foreign body in a cleft patient arising due to a dental impression procedure.

  12. From principle to practice: bridging the gap in patient profiling.

    Directory of Open Access Journals (Sweden)

    Jonathan H Foley

    Full Text Available The standard clinical coagulation assays, activated partial thromboplastin time (aPTT and prothrombin time (PT cannot predict thrombotic or bleeding risk. Since thrombin generation is central to haemorrhage control and when unregulated, is the likely cause of thrombosis, thrombin generation assays (TGA have gained acceptance as "global assays" of haemostasis. These assays generate an enormous amount of data including four key thrombin parameters (lag time, maximum rate, peak and total thrombin that may change to varying degrees over time in longitudinal studies. Currently, each thrombin parameter is averaged and presented individually in a table, bar graph or box plot; no method exists to visualize comprehensive thrombin generation data over time. To address this need, we have created a method that visualizes all four thrombin parameters simultaneously and can be animated to evaluate how thrombin generation changes over time. This method uses all thrombin parameters to intrinsically rank individuals based on their haemostatic status. The thrombin generation parameters can be derived empirically using TGA or simulated using computational models (CM. To establish the utility and diverse applicability of our method we demonstrate how warfarin therapy (CM, factor VIII prophylaxis for haemophilia A (CM, and pregnancy (TGA affects thrombin generation over time. The method is especially suited to evaluate an individual's thrombotic and bleeding risk during "normal" processes (e.g pregnancy or aging or during therapeutic challenges to the haemostatic system. Ultimately, our method is designed to visualize individualized patient profiles which are becoming evermore important as personalized medicine strategies become routine clinical practice.

  13. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  14. Cyclodialysis Cleft Treatment Using a Minimally Invasive Technique

    Directory of Open Access Journals (Sweden)

    João Pinheiro-Costa

    2015-02-01

    Full Text Available Purpose: To report a case of a cyclodialysis cleft that was successfully managed with gas endotamponade and cyclocryotherapy. Methods: A 37-year-old male victim of a severe blunt ocular trauma was referred to our service for evaluation and treatment of a left eye hypotony. Clinical examination revealed an intraocular pressure of 2 mm Hg, a cyclodialysis cleft extending from the 11 to 1 o'clock positions and a hypotonic maculopathy. Left eye best corrected visual acuity (BCVA was 3/10. The patient failed to respond to conservative treatment with atropine 1%, so a single bubble of 16% C2F6 was injected into the vitreous cavity, followed by superior quadrant transconjunctival cyclocryotherapy. Results: After gas absorption, the intraocular pressure increased to 11 mm Hg and became steady during the 24 months of follow-up. His hypotonic maculopathy resolved, and the BCVA improved to 9/10. Complete closure of the cyclodialysis cleft was documented with ultrasound biomicroscopy. Conclusion: Cryotherapy associated with gas endotamponade is a minimally invasive technique that could be considered for patients with cyclodialysis clefts that fail to respond to medical therapy.

  15. Cleft lip and cleft palate relationship with familial marriage: a study in 136 cases

    Directory of Open Access Journals (Sweden)

    Azimi C

    2010-02-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Clefts of the lip and palate are one of the most common congenital birth anomalies. Genetic factors play a great role in the etiology of them and the high percentage of the consanguineous marriage of the parents of the affected persons is one of the reasons. These defects not only make abnormal changes on appearance of the neonate, but also make a lot of stress and psychological problems for the patients and their families. Study on the prevalence of clefts, their risk factors and also genetic counseling for affected persons and their families can be a guideline for general population and probably reduce these anomalies over the generations."n"nMethods: Patients referred to the Department of Genetics, Imam Khomeini Hospital, Tehran, Iran were studied. A total of 7374 pedigrees of all the patients admitted to the Department, were studied during 2002-2005 and 99 pedigrees with the patients with cleft lip± palate or isolated cleft palate were separated. The total number of cases among these 99 pedigrees was 136. The effects of consanguineous marriage, positive family history and sex were investigated among cases."n"nResults: 70.8% of patients with syndromic clefts and 58.7% of patients with nonsyndromic CL

  16. Communication and the Interpretive Principle of Charity in Nurse-Patient Interaction.

    Science.gov (United States)

    Nordby, Halvor

    2016-01-01

    A widespread view in nursing literature is that it is important for nurses to understand how patients experience states of disease and illness. To appear to patients as an empathetic practitioner involves more than identifying beliefs patients have about their conditions of ill health; it is also necessary to understand how illness experiences affect patients' well-being and quality of life. This article elucidates this condition of successful nurse-patient interaction by analyzing it in light of an influential theory of charitable interpretation from the philosophy of mind and language. According to this theoretical perspective, successful communication in caring practice presupposes that nurses apply a methodological principle of charity: They need to understand how patients think that they are entitled to their own idiosyncratic perspectives on their states of ill health. Setting the principle of charity aside can be legitimate but only when contextual limitations make it impossible to uncover patients' subjective horizons. Moreover, the methodological ideal of charitable interpretation is inconsistent with the idea that nurses and patients can understand each other even though they have incommensurable beliefs. Instead, the principle implies that primary understanding rests on interpersonal coherence and agreement about norms of rational reasoning. The last part of this article uses case studies to clarify these implications and show how they have striking applications in caring practice.

  17. 腭裂不同程度与腭裂语音关系的临床研究%The clinical study of cleft palate speech with different cleft palate

    Institute of Scientific and Technical Information of China (English)

    杨静; 李永生; 冯雁; 王瑜; 邹弘驹; 曹阳

    2013-01-01

    Objective: To investigate the influence of speech for different cleft palate. Methods: 45 cases include 15 cases of soft cleft palate and 15 cases of uncompleted cleft palate and 15 cases of complete cleft palate had been studied with speech evaluate. Results: The speech unclearness appeared positive relation with severe degree of cleft palate. The fact is speech of soft palate cleft is most mild than that of other two groups, the speech of two groups of uncompleted and completed cleft were most severe , and there is no obviously difference between both of them. Conclusion: The pronunciation of patients with every kind of cleft palate were not clear, cleft palate must be accepted palate plastic operation.%目的:探讨不同程度的腭裂对患者语音的影响。方法选取45例腭裂患者,包括软腭裂、不完全性腭裂及完全性腭裂患者各15例,行语音评估。结果腭裂程度越重,患者腭裂语音越明显。软腭裂患者腭裂语音较轻,不全腭裂和完全腭裂组最重。结论不同程度的腭裂均会影响患者发音,腭裂均应行手术修复。

  18. Demographics of orofacial clefts in Canada from 2002 to 2008.

    Science.gov (United States)

    Pavri, Sabrina; Forrest, Christopher R

    2013-03-01

    Objective : Orofacial clefts such as cleft lip, cleft palate, and cleft lip and palate are the most frequent congenital anomalies of the head and neck. The purpose of this study was to determine the current demographics for orofacial clefts in Canada. Methods : A request for data from all Canadian provinces (excluding Quebec due to incompatibilities with provincial coding systems) for the fiscal years 2002-2003 to 2007-2008 was submitted to the Canadian Institute for Health Information. Variables evaluated included gender, cleft type, gestational age, birth weight, income quintile, and institution health region. Results : Over the period studied, the prevalence of orofacial clefts ranged from 11.0 to 15.3 per 10,000 live births (1 in 654 to 1 in 909 live births). The distribution of cleft types for live births with orofacial clefts was 17% for cleft lip, 41% for cleft palate, and 42% for cleft lip and palate, of which cleft lip and cleft lip and palate were male dominant (62% and 66% male, respectively) and cleft palate was female dominant (56% female). Saskatchewan and Manitoba had significantly higher cleft birthrates (P orofacial clefting compared with those with no cleft. Conclusions : Canada has one of the highest orofacial cleft birthrates in the world (prevalence of 12.7 per 10,000 live births, approximately 1 in 790 live births). This study presents an updated demographic of orofacial clefts in Canadian newborns and may be useful in predicting the burden of anticipated health care.

  19. Incidence of Cleft Lip and Palate in Uganda

    NARCIS (Netherlands)

    Dreise, Marieke; Galiwango, George; Hodges, Andrew

    2011-01-01

    Objective: The purpose of the study was to estimate the need for resources for cleft repairs in Uganda by determining the overall incidence of oral-facial clefts and the ratio of isolated cleft lip to isolated cleft palate to cleft lip and palate. Design: A 1-year prospective study was implemented i

  20. Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

    NARCIS (Netherlands)

    Guo, J.; Li, C.; Zhang, Q.; Wu, G.; Deacon, S.A.; Chen, J.; Hu, H.; Zou, S.; Ye, Q.

    2011-01-01

    BACKGROUND: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy. OBJECTIVES: To compare the effectiveness and safety of different secondary bone grafting methods. SEARCH STRATEGY: The final electronic and handsearches were car

  1. Preliminary study of endocrine dysfunction in patients with Rathke's cleft cyst%单纯性Rathke囊肿患者内分泌功能改变的初步研究

    Institute of Scientific and Technical Information of China (English)

    魏广玉; 吕朝晖; 窦京涛; 母义明; 陆菊明

    2008-01-01

    A retrospective study of endocrine dysfunction in 65 patients with Rathke's cleft cyst (RCC) was conducted. Before surgical operation, most patients with RCC had various degrees of pituitary dysfunction.Impaired gonadotropin secretion and prolactinemia were the prevalent abnormalities. Erectile dysfunction or diminished libido in male and menstrual disorder or galactorrhea in female were frequently seen. The panhypopituitarism appeared in a few patients with RCC. The patients would benefit by surgical removal, however,attention should be paid to avoid new damage of the pituitary gland during operation.%回顾性分析65例单纯性Rathke囊肿患者手术前后内分泌功能改变,术前存在的垂体激素分泌异常以垂体-性腺激素分泌受损和高催乳素血症多见,最常见症状女性为月经紊乱及溢乳、男性为性欲减退及勃起功能障碍,严重者可发生全垂体功能减退甚至危象.手术可以有效改善受损的垂体功能,也可能导致新的损害.

  2. Presurgical management of unilateral cleft lip and palate in a neonate: a clinical report.

    Science.gov (United States)

    Avhad, Rajendra; Sar, Ranjukta; Tembhurne, Jyoti

    2014-09-01

    A cleft lip and palate consists of fissures of the upper lip and/or palate, and is the most commonly seen orofacial anomaly that involves the middle third of the face. Early treatment of patients with a cleft lip and palate is important because of esthetic, functional, and psychological concerns. Nasoalveolar molding provides excellent results when started immediately after birth. This clinical report describes the presurgical management of an infant with a complete unilateral cleft of the soft palate, hard palate, alveolar ridge, and lip.

  3. Surgically repaired cleft lips depicted in paintings of the late Gothic period and the Renaissance.

    Science.gov (United States)

    Pirsig, W; Haase, S; Palm, F

    2001-04-01

    Paintings and drawings by Lucas Moser, Leonardo da Vinci, Albrecht Dürer, and Jacob Cornelisz van Oostsanen suggest that they employed people who had had cleft lips operated on as models for their works of art. Created between 1431 and 1520, the portraits show diagnostic facial profiles with a curved nasal dorsum, short columella, maxillary retrusion, and pseudoprogenia. The first medical illustration of cleft lip surgery was published in 1564 by Ambroise Paré. It was therefore late Gothic and Renaissance artists who depicted the conspicuous signs of surgically treated patients with cleft lip more than 130 years before the surgeons.

  4. An integrative approach for comparing microcirculation between normal and alveolar cleft gingiva in children scheduled for secondary bone grafting procedures

    NARCIS (Netherlands)

    D.M.J. Milstein; Y.W. Cheung; L. Ziukaite; C. Ince; H.P. van den Akker; J.A.H. Lindeboom

    2013-01-01

    Objective The aim of this study was to compare microcirculatory parameters in normal versus alveolar cleft gingiva in children selected for secondary bone grafting procedures. Study Design This study included 11 consecutive patients with complete unilateral alveolar clefts who required secondary bon

  5. Olfactory cleft computed tomography analysis and olfaction in chronic rhinosinusitis

    Science.gov (United States)

    Kohli, Preeti; Schlosser, Rodney J.; Storck, Kristina

    2016-01-01

    Background: Volumetric analysis of the olfactory cleft by using computed tomography has been associated with olfaction in patients with chronic rhinosinusitis (CRS). However, existing studies have not comprehensively measured olfaction, and it thus remains unknown whether correlations differ across specific dimensions of odor perception. Objective: To use comprehensive measures of patient-reported and objective olfaction to evaluate the relationship between volumetric olfactory cleft opacification and olfaction. Methods: Olfaction in patients with CRS was evaluated by using “Sniffin' Sticks” tests and a modified version of the Questionnaire of Olfactory Disorders. Olfactory cleft opacification was quantified by using two- and three-dimensional, computerized volumetric analysis. Correlations between olfactory metrics and olfactory cleft opacification were then calculated. Results: The overall CRS cohort included 26 patients without nasal polyposis (CRSsNP) (68.4%) and 12 patients with nasal polyposis (CRSwNP) (31.6%). Across the entire cohort, total olfactory cleft opacification was 82.8%, with greater opacification in the CRSwNP subgroup compared with CRSsNP (92.3 versus 78.4%, p < 0.001). The percent total volume opacification correlated with the total Sniffin' Sticks score (r = −0.568, p < 0.001) as well as individual threshold, discrimination, and identification scores (p < 0.001 for all). Within the CRSwNP subgroup, threshold (r = −0.616, p = 0.033) and identification (r = −0.647, p = 0.023) remained highly correlated with total volume opacification. In patients with CRSsNP, the threshold correlated with total volume scores (r = −0.457, p = 0.019), with weaker and nonsignificant correlations for discrimination and identification. Correlations between total volume opacification and the Questionnaire of Olfactory Disorders were qualitatively similar to objective olfactory findings in both CRSwNP (r = −0.566, p = 0.070) and CRSsNP (r = −0.310, p

  6. EVALUATION OF THE EFFECT OF INTERVENTIONAL FEEDING PRACTICES ON GROWTH OF CLEFT LIP AND PALATE BABIES

    Directory of Open Access Journals (Sweden)

    Chandrashekar

    2015-01-01

    Full Text Available One year hospital based non - randomised trial to evaluate the effect of interventional feeding practices on the growth of cleft lip and palate patients was conducted at K.L.E.S’s Hospital, Belgaum, Karnataka state, India. This trial was planned to study the various feeding modalities, the feeding problems, the incidence of morbidities, and the effect of different types of clefts on the growth parameters in control group. At the same time, evaluation of the effect of interve ntional feeding practices in terms of difference in the incidence of morbidities and the growth parameters between the interventional and control groups was studied. 22 and 33 cleft patients, who satisfied the criteria for the interventional and the contro l groups respectively, were enrolled for the trial. The feeding problems were quite prevalent in both the groups, with nasal regurgitation being the commonest, followed by vomiting and chocking. Isolated cleft lip did not interfere with breast feeding as a ll the cases in both the groups practiced direct breast feeding. Cleft palate/lip interfered with the technique of direct breast feeding resulting in the practice of top feeds, commonly with cup and spoon modality even when the mother were eager to breast feed, indicating the less technical difficulties in the cup and spoon feeding modality. Isolated cleft lip did not have statistically significant over the growth parameters in contrast to the combined cleft palate and lip. There were no statistically signi ficant differences in the growth parameters between males and females among different types of clefts in both interventional and control groups. The interventional feeding practices in combined cleft palate and lip cases resulted in statistically significa nt decrease in various morbidities and also better growth parameters. The use of obturators was not associated with improved growth parameters secondary to small sample size and inherent disadvantages of its

  7. Argon laser photocoagulation of cyclodialysis clefts after cataract surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, B. [Univ. of Lund, Dept. of Ophthalmology, Lund (Sweden)

    1995-06-01

    Three patients with cyclodialysis clefts, hypotony and hypotonic retinopathy subsequent to cataract surgery were treated with argon laser photocoagulation. The hypotony was reversed in each patient and their visual acuity was normalized. Laser photocoagulation is a noninvasive treatment that can be repeated easily and safely. The complications of the treatment are minor. A hypertensive episode commonly occurs in the early postoperative period. (au) 8 refs.

  8. Prevalência de fissura de palato submucosa associada à fissura labial Prevalence of submucous cleft palate associated with cleft lip

    Directory of Open Access Journals (Sweden)

    Camila Queiroz de Moraes Silveira Di Ninno

    2011-09-01

    Full Text Available OBJETIVO: Investigar a prevalência de fissura de palato submucosa associada à fissura labial, sua correlação com o gênero, tipo de fissura labial, sinais e sintomas apresentados. MÉTODOS: Estudo baseado na coleta de dados de 132 pacientes com fissura labial consecutivos de um centro especializado em fissura labiopalatina, de ambos os gêneros, coletados pela mesma fonoaudióloga na primeira consulta do paciente no centro. Foram realizados palpação do palato duro, avaliação visual do palato mole e úvula e questionário aos pacientes ou responsáveis sobre a presença de sintomas associados. RESULTADOS: Da amostra total investigada, a maioria dos pacientes era do gênero masculino e apresentava fissura de lábio unilateral esquerda. Onze por cento dos casos apresentavam sinais de fissura submucosa. Dentre eles, a ocorrência de refluxo nasal foi encontrada em alguns casos (21%, histórico de otite em metade dos casos e nenhum deles apresentava fala com sinais de hipernasalidade. CONCLUSÃO: Onze por cento dos pacientes com fissura labial apresentam sinais de fissura de palato submucosa, sendo sua prevalência maior no gênero masculino e na fissura labial do tipo unilateral esquerda.PURPOSE: To investigate the prevalence of submucous cleft palate associated with cleft lip, and its correlation with gender, type of cleft lip, signs and symptoms. METHODS: Study based on the data of 132 consecutive patients with cleft lip at a specialized cleft lip and palate center, of both genders, collected by the same speech-language pathologist during the patients' first consultation at the center. Palpation of the hard palate, visual assessment of the soft palate and uvula, and an interview with patients or their parents regarding the presence of associated symptoms were performed. RESULTS: From the total sample, most patients were male and had left-sided cleft lip. Eleven percent of the cases presented signs of submucous cleft palate. Among them

  9. Nasolabial symmetry and aesthetics in children with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Fudalej, Piotr; Katsaros, Christos; Hozyasz, Kamil; Borstlap, Wilfred A; Kuijpers-Jagtman, Anne Marie

    2012-10-01

    The objective of this study was to evaluate the association between nasolabial symmetry and aesthetics in children with complete unilateral cleft lip and palate (CUCLP). Frontal and basal photographs of 60 consecutively treated children with CUCLP (cleft group: 41 boys and 19 girls, mean (SD) age 11 (2) years) and 44 children without clefts (control group: 16 boys and 28 girls, mean (SD) age 11(2) years), were used for evaluation of nasolabial symmetry and aesthetics. Nasal and labial measurements were made to calculate the coefficient of asymmetry (CA). The 5-grade aesthetic index described by Asher-McDade et al. was used to evaluate nasolabial appearance. Correlation and regression analysis were used to identify an association between aesthetics and CA, sex, and the presence of CUCLP. Ten measurements in the cleft, and 2 in the control, group differed significantly between the cleft and non-cleft (or right and left) sides, respectively. The significantly higher values of 9 of 11 CA in the children with CUCLP indicated that they had more asymmetrical nasolabial areas than children without clefts. However, the regression analyses showed that only a few CA were associated with nasolabial aesthetics. In conclusion, nasolabial aesthetics and nasolabial symmetry seem to be only weakly associated in patients with CUCLP.

  10. Evaluation and integration of disparate classification systems for clefts of the lip

    Directory of Open Access Journals (Sweden)

    Kathie H Wang

    2014-05-01

    Full Text Available Orofacial clefting is a common birth defect with wide phenotypic variability. Many systems have been developed to classify cleft patterns to facilitate diagnosis, management, surgical treatment, and research. In this review, we examine the rationale for different existing classification schemes and determine their inter-relationships, as well as strengths and deficiencies for subclassification of clefts of the lip. The various systems differ in how they describe and define attributes of cleft lip phenotypes. Application and analysis of the cleft lip classifications reveal discrepancies that may result in errors when comparing studies that use different systems. These inconsistencies in terminology, variable levels of subclassification, and ambiguity in some descriptions may confound analyses and impede further research aimed at understanding the genetics and etiology of clefts, development of effective treatment options for patients, as well as cross-institutional comparisons of outcome measures. Identification and reconciliation of discrepancies among existing systems is the first step towards creating a common standard to allow for a more explicit interpretation that will ultimately lead to a better understanding of the causes and manifestations of phenotypic variations in clefting.

  11. FOXE1 Association with both Isolated Cleft Lip with or without Cleft Palate; and Isolated Cleft Palate

    DEFF Research Database (Denmark)

    Moreno, Lina M; Mansilla, Maria Adela; Bullard, Steve A

    2009-01-01

    Nonsyndromic orofacial clefts are a common complex birth defect caused by genetic and environmental factors and/or their interactions. A previous genome-wide linkage scan discovered a novel locus for cleft lip with or without cleft palate (CL/P) at 9q22-q33. To identify the etiologic gene, we......) and rs4460498 (p=6.51E-12) were located inside a 70Kb high LD block containing FOXE1. Association signals for Caucasians and Asians clustered 5' and 3' of FOXE1, respectively. Isolated cleft palate (CP) was also associated indicating that FOXE1 plays a role in two phenotypes thought to be genetically...

  12. Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate. Planning and Management

    DEFF Research Database (Denmark)

    Semb, Gunvor; Enemark, Hans; Paulin, Gunnar

    2017-01-01

    Background and Aims This paper is an introduction to three concurrent, parallel group, randomised trials of primary surgery for patients born with complete unilateral cleft lip and palate (UCLP) outlining the development and performance of the project by ten North European cleft teams: Aarhus....../Copenhagen (Denmark), Bergen/Oslo (Norway), Gothenburg/Linköping/Stockholm (Sweden), Manchester/Belfast (UK) Method The three trials included patients born with complete unilateral cleft lip and palate (UCLP). One surgical protocol was defined to serve as a common method in each trial against which the established...... Words: Randomised control trials, Multicentre study, Scandcleft, Unilateral Cleft Lip and Palate, Palatal surgery. Running head: Scandcleft, planning and management....

  13. Dental Care for a Child with Cleft Lip and Palate

    Science.gov (United States)

    ... Volunteer Efforts Dental Care for a Child with Cleft Lip and Palate skip to submenu Parents & Individuals Information for Parents & ... version of this factsheet, click here How does cleft lip/palate affect the teeth? A cleft of the lip, ...

  14. Treatment for Adults (with Cleft Lip and Palate)

    Science.gov (United States)

    ... here What treatment is available for adults with cleft lip and palate? Treatments currently available to infants and children with cleft lip and palate are also available to adults with clefts. Although ...

  15. Puente adhesivo en paciente con labio leporino y fisura velopalatina: Una solución temporal con compromiso estético Adhesive bridge in a patient with cleft lip and palate: A temporary solution with esthetic commitment

    Directory of Open Access Journals (Sweden)

    N Leiva

    2013-04-01

    Full Text Available En la actualidad el aumento de la demanda estética y la necesidad de procedimientos mínimamente invasivos ha llevado a un aumento de la técnica adhesiva. Ribbond® es una marca de fibra de polietileno que permite un eficiente traspaso de fuerzas, es virtualmente plegable y se adapta fácilmente a la morfología dentaria y al contorno del arco dentario. Dentro de sus principales características podemos encontrar: Biocompatibilidad, inerte, translúcido y durable. Dentro de la odontología se le han dado distintos usos para esta fibra, ya sea como mantenedor de espacio, puente adhesivo, poste y núcleo endodóntico, ferulización, restauraciones tipo inlay y estabilización postortodóncica. En el caso de los pacientes fisurados se ha hecho relevante el uso de Ribbond® como puente adhesivo ya que permite mejorar la estética y rehabilitar temporalmente los espacios desdentados causados por la ausencia de un incisivo, principalmente una vez terminado el tratamiento de ortodoncia y en espera de una rehabilitación definitiva, aún más cuando el paciente no ha terminado su crecimiento y desarrollo. En este artículo se presenta un caso clínico de un paciente con labio leporino y fisura velopalatina operado demostrativo de la técnica de rehabilitación con Ribbond®.Today the increasing demand of aesthetic and minimally invasive procedures has led to a boom of the adhesive technique. Ribbond® is a polyethylene fiber that allows an efficient transfer of forces, is virtually foldable and is easily adapted to tooth morphology and dental arch contour. Among its main features we can find: Biocompatibility, inert, translucent and durable. In dentistry, different uses have been given to this fiber, whether as space maintainer, adhesive bridge, endodontic post and core, splinting, inlay type restorations and postorthodontic stabilization. In the case of cleft lip and palate patients the use of Ribbond® as an adhesive bridge has become relevant, as

  16. Face facts: Genes, environment, and clefts

    Energy Technology Data Exchange (ETDEWEB)

    Murray, J.C. [Univ. of Iowa, Iowa City IA (United States)

    1995-08-01

    Cleft lip and/or palate provides an ideal, albeit complex, model for the study of human developmental anomalies. Clefting disorders show a mix of well-defined syndromic causes (many with single-gene or environmental etiologies) coupled with their more common presentation in the nonsyndromic form. This summary presents some insight into the genetic causes of, etiology of and animal models for cleft lip and/or palate. 79 refs.

  17. Genetics Home Reference: ankyloblepharon-ectodermal defects-cleft lip/palate syndrome

    Science.gov (United States)

    ... Home Health Conditions AEC syndrome ankyloblepharon-ectodermal defects-cleft lip/palate syndrome Enable Javascript to view the expand/ ... mouth (a cleft palate ), a split in the lip (a cleft lip ), or both. Cleft lip or cleft palate ...

  18. Cleft Lip and Cleft Palate--What to Know and Who Can Help

    Science.gov (United States)

    Apel, Laura

    2008-01-01

    Craniofacial defects such as cleft lip and cleft palate are among the most common of all birth defects in the United States, with one in every 600 newborns affected. Cleft lip and/or palate can occur as an isolated condition or may be one component of an inherited disease or syndrome. Dealing with the condition is an extremely difficult and…

  19. Double-layered reconstruction of the nasal floor in complete cleft deformity of the primary palate using superfluous lip tissue.

    Science.gov (United States)

    Park, Young-Wook; Kwon, Kwang-Jun; Kim, Min-Keun

    2015-12-01

    After cleft lip repair, many patients suffer from nasolabial fistulas, asymmetrical nasal floor, or an indistinct nostril sill, as well as intraoral wound dehiscence and subsequent scar contracture of surgical wounds leading to vestibular stenosis. For successful primary nasolabial repair of complete cleft deformity of the primary palate, cleft surgeons need special care in reconstructing the sound nasal floor. Especially when the cleft gap is wide or when any type of nasoalveolar molding therapy was not performed, three-dimensional reconstruction of the nasal floor is critical for a balanced nasal shape. In this study, the author describes an effective method for reconstructing a double-layered nasal floor using two mucosal flaps from both sides of the fissured upper lip. This is a report of six patients with unilateral or bilateral complete cleft of the primary palate with a detailed description of the surgical technique and a literature review.

  20. Modified Activation Technique for Nasal Stent of Nasoalveolar Molding Appliance for Columellar Lengthening in Bilateral Cleft Lip/Palate.

    Science.gov (United States)

    Patil, Pravinkumar G; Nimbalkar-Patil, Smita P

    2016-03-22

    Bilateral cleft lip/cleft palate is associated with nasal deformities typified by a short columella. The presurgical nasoalveolar molding (NAM) therapy approach includes reduction of the size of the intraoral alveolar cleft as well as positioning of the surrounding deformed soft tissues and cartilages. In a bilateral cleft patient, NAM, along with columellar elongation, eliminates the need for columellar lengthening surgery. Thus the frequent surgical intervention to achieve the desired esthetic results can be avoided. This article proposes a modified activation technique of the nasal stent for a NAM appliance for columellar lengthening in bilateral cleft lip/palate patients. The design highlights relining of the columellar portion of the nasal stent and the wire-bending of the nasal stent to achieve desirable results within the limited span of plasticity of the nasal cartilages. With this technique the vertical taping of the premaxilla to the oral plate can be avoided.

  1. Maternal genes and facial clefts in offspring: a comprehensive search for genetic associations in two population-based cleft studies from Scandinavia.

    Directory of Open Access Journals (Sweden)

    Astanand Jugessur

    Full Text Available BACKGROUND: Fetal conditions can in principle be affected by the mother's genotype working through the prenatal environment. METHODOLOGY/PRINCIPAL FINDINGS: Genotypes for 1536 SNPs in 357 cleft candidate genes were available from a previous analysis in which we focused on fetal gene effects. After data-cleaning, genotypes for 1315 SNPs in 334 autosomal genes were available for the current analysis of maternal gene effects. Two complementary statistical methods, TRIMM and HAPLIN, were used to detect multi-marker effects in population-based samples from Norway (562 case-parent and 592 control-parent triads and Denmark (235 case-parent triads. We analyzed isolated cleft lip with or without cleft palate (iCL/P and isolated cleft palate only (iCP separately and assessed replication by looking for genes detected in both populations by both methods. In iCL/P, neither TRIMM nor HAPLIN detected more genes than expected by chance alone; furthermore, the selected genes were not replicated across the two methods. In iCP, however, FLNB was identified by both methods in both populations. Although HIC1 and ZNF189 did not fully satisfy our stringency criterion for replication, they were strongly associated with iCP in TRIMM analyses of the Norwegian triads. CONCLUSION/SIGNIFICANCE: Except for FLNB, HIC1 and ZNF189, maternal genes did not appear to influence the risk of clefting in our data. This is consistent with recent epidemiological findings showing no apparent difference between mother-to-offspring and father-to-offspring recurrence of clefts in these two populations. It is likely that fetal genes make the major genetic contribution to clefting risk in these populations, but we cannot rule out the possibility that maternal genes can affect risk through interactions with specific teratogens or fetal genes.

  2. Cone-Beam computed tomography evaluation of maxillary expansion in twins with cleft lip and palate

    OpenAIRE

    Luciane Macedo de Menezes; Fabiane Azeredo; André Weissheimer; Juliana Lindemann Rizzato; Susana Maria Deon Rizzatto

    2012-01-01

    OBJECTIVE: The establishment of normal occlusal relationships in patients with cleft lip and palate using rapid maxillary expansion may promote good conditions for future rehabilitation. OBJECTIVE: This study describes the clinical case of monozygotic twins with unilateral cleft lip and palate at the age of mixed dentition, who were treated using the same rapid maxillary expansion protocol, but with two different screws (conventional and fan-type expansion screw). Results were evaluated using...

  3. Análise do trato vocal em pacientes com nódulos, fendas e cisto de prega vocal Vocal tract analysis in patients with vocal fold nodules, clefts and cysts

    Directory of Open Access Journals (Sweden)

    Raquel Buzelin Nunes

    2009-04-01

    the frequency of supraglottic vocal tract adjustments in dysphonic women with nodules, clefts and cysts. METHODS: We assessed 31 dysphonic women, with age ranging between 18 and 45 years, with vocal alteration and a diagnosis of nodules, middle-posterior cleft and cyst, and we carried out a summarized evaluation of the sensory-motor and oral systems and the patients were submitted to video-laryngostroboscopy and nasal and laryngeal fibroscopy. Three distinct groups were selected: patients with bilateral nodules, clefts and cysts, with similar glottic configuration. Their vocal tracts were visually analyzed through exams of nasal and laryngeal fibroscopy, by speech and hearing therapists and otorhinolaryngologists, checking the following parameters: supraglottic constriction, larynx vertical mobility, pharyngeal constriction and tongue mobility. The data was statistically described and treated. RESULTS: during visual analysis we did not find statistically significant differences which would separate the glottic alterations groups. CONCLUSION: There was no correlation between supraglottic tract adjustments with any particular type of glottic alteration. These are individual behaviors that generate adjustments and justify the different vocal qualities in patients with the same type of laryngeal alteration.

  4. High Dosage Folic Acid Supplementation, Oral Cleft Recurrence and Fetal Growth

    Directory of Open Access Journals (Sweden)

    Carla Padovani

    2013-02-01

    Full Text Available Objectives: To evaluate the effects of folic acid supplementation on isolated oral cleft recurrence and fetal growth. Patients and Methods: The study included 2,508 women who were at-risk for oral cleft recurrence and randomized into two folic acid supplementation groups: 0.4 and 4 mg per day before pregnancy and throughout the first trimester. The infant outcome data were based on 234 live births. In addition to oral cleft recurrence, several secondary outcomes were compared between the two folic acid groups. Cleft recurrence rates were also compared to historic recurrence rates. Results: The oral cleft recurrence rates were 2.9% and 2.5% in the 0.4 and 4 mg groups, respectively. The recurrence rates in the two folic acid groups both separately and combined were significantly different from the 6.3% historic recurrence rate post the folic acid fortification program for this population (p = 0.0009 when combining the two folic acid groups. The rate of cleft lip with palate recurrence was 2.9% in the 0.4 mg group and 0.8% in the 4 mg group. There were no elevated fetal growth complications in the 4 mg group compared to the 0.4 mg group. Conclusions: The study is the first double-blinded randomized clinical trial (RCT to study the effect of high dosage folic acid supplementation on isolated oral cleft recurrence. The recurrence rates were similar between the two folic acid groups. However, the results are suggestive of a decrease in oral cleft recurrence compared to the historic recurrence rate. A RCT is still needed to identify the effect of folic acid on oral cleft recurrence given these suggestive results and the supportive results from previous interventional and observational studies, and the study offers suggestions for such future studies. The results also suggest that high dosage folic acid does not compromise fetal growth.

  5. [Cleft lip and palate in Campeche Mayas].

    Science.gov (United States)

    Weiss, K M; Georges, E; Levy, B; Aguirre, A; Portilla, R J; Gaitán, C L; Leyva, E; Rodríguez, T

    1988-07-01

    It has been suggested that among American Indians, as in some genetically-related Asiatic ethnic groups, incidence of cleft lip and/or cleft palate is higher than among people of Caucasian extraction. Such hypothesis, plus growing demand for services observed at a center for the surgery of cleft lip and cleft palate in Campeche state, led the authors to undertake research among the Maya residents of that region. However, neither careful review of case histories nor field research performed in several Indian communities could confirm the hypothesis of a higher incidence among this ethnic community.

  6. Improving Informed Consent for Cleft Palate Repair

    Science.gov (United States)

    2016-09-22

    Cleft Palate; Jaw Abnormalities; Maxillofacial Abnormalities; Mouth Abnormalities; Congenital Abnormalities; Jaw Diseases; Musculoskeletal Diseases; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Stomatognathic Diseases; Stomatognathic System Abnormalities

  7. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  8. Diagnosis of mitral valve cleft using real-time 3-dimensional echocardiography

    Science.gov (United States)

    Zhou, Aiyun; Chen, Li; Zhang, Cheng; Zhang, Yan; Xu, Pan

    2017-01-01

    Background Mitral valve cleft (MVC) is the most common cause of congenital mitral insufficiency, and MVC may occur alone or in association with other congenital heart lesions. Direct suture and valvuloplasty are the major and effective treatments for mitral regurgitation (MR) caused by MVC. Therefore, it is important to determine the location and magnitude of the pathological damage due to MVC when selecting a surgical procedure for treatment. This study explored the application value of transthoracic real-time 3-dimensional (3D) echocardiography (RT-3DE) in the diagnosis of MVC. Methods From October 2012 to June 2016, 19 consecutive patients with MVC diagnosed by 2-dimensional (2D) echocardiography in our hospital were selected for this study. Full-volume RT-3DE was performed on all patients. The 3D-imaging data were cropped and rotated in 3 views (horizontal, sagittal, and coronal) with 6 directions to observe the position and shape of the MVC and the spatial position between the cleft and its surrounding structures. The maximum longitudinal diameter and the maximum width of the cleft were measured. The origin of the mitral regurgitant jet and the severity of MR were evaluated, and these RT-3DE data were compared with the intraoperative findings. Results Of the 19 patients studied, 4 patients had isolated cleft mitral valve, and cleft mitral valves combined with other congenital heart lesions were detected in 15 patients. The clefts of 6 patients were located in the A2 segment, the clefts of 4 patients were located in the A1 segment, the clefts of 4 patients were located in the A3 segment, the clefts of 4 patients were located in the A2–A3 segment, and the cleft of 1 patient was located in the P2 segment. Regarding the shape of the cleft, 13 patients had V-shaped clefts, and the others had C- or S-shaped clefts. The severity of the MR at presentation was mild in 2 patients, moderate in 9 and severe in 8. Two of the patients with mild MR did not undergo surgery

  9. Preoperative evaluation of micro-organisms in non-operated cleft in soft palate: impact on use of antibiotics.

    Science.gov (United States)

    Roode, G J; Bütow, K-W; Naidoo, S

    2017-02-01

    To identify the pathogenic micro-organisms that had colonised preoperatively in clefts in the soft palate and oro-nasopharynx, we retrospectively studied the preoperative microbiological profiles of 200 infants who had had primary repair of all types of cleft in the soft palate. Data from a private practice that specialises in the repair of facial clefts were extracted randomly from patients' files. We analysed the results of the culture of preoperative swabs taken from clefts in the soft palate and oro-nasopharynx, and the resistance profile of organisms towards various antibiotics. A total of 23 different pathogenic micro-organisms were isolated from 115 (57%) of the sample. Klebsiella pneumoniae most commonly colonised clefts in the lip, alveolus, and palate. This was considerably higher than in other groups. The second most common micro-organism was Staphylococcus aureus, which was found most often in patients with isolated clefts in the hard palate. Those with complete cleft lip and palate presented with more pathogenic micro-organisms in preoperative cultures than those with other types of cleft. We need to find a way to control pathogenic micro-organisms in the oral and oro-nasopharyngeal region preoperatively to limit postoperative complications.

  10. Phonological process analysis of articulation disorders of patients with cleft palate after operation%腭裂术后构音障碍患者音韵历程的初步分析

    Institute of Scientific and Technical Information of China (English)

    何艳瑛; 张胜; 王铠; 吴汉江

    2016-01-01

    Objective:To explore the phonological process of articulation disorders of patients with cleft palate after operation and provide more evidence for speech therapy.Methods:Forty-six subjects with cleft palate after operation with ar-ticulation disorders were included.The patient ’ s velopharyngeal function, palatal fistula, percentage of consonant correct ( PCC) were retrospectively analyzed.The factors relating were analyzed by the correlation coefficient.Results:Thirty-seven subjects had initial consonant omission of construction process.Thirty-four subjects had backing of positional substitution process.Forty subjects had manner substitution process.The construction process and positional substitution process were re-lating to the PCC grade.Conclusion:Higher PCC grade were relating to patient’ s construction process and positional substi-tution process.%目的:分析腭裂术后构音障碍患者音韵历程,为语音治疗提供依据。方法:对46例腭裂术后构音障碍患者的语音资料进行回顾性分析,从腭咽闭合功能、腭瘘、辅音正确构音率( percentage of consonant correct,PCC)与音韵障碍的相关性方面进行统计研究。结果:46例构音障碍患者中37例出现结构历程,均为声母省略;34例出现位置替代历程,均为后置化;40例出现方法替代历程。患者音韵的结构历程、位置替代历程与PCC分级有相关性。结论:PCC分级高的患者与声母省略的结构历程和后置化的位置替代历程相关。

  11. Percutaneous balloon kyphoplasty of osteoporotic vertebral compression fractures with intravertebral cleft

    Directory of Open Access Journals (Sweden)

    Bao Chen

    2014-01-01

    Full Text Available Background: Intravertebral cleft is a structural change in osteoporotic vertebral compression fractures (OVCF, which is the manifestation of ischemic vertebral osteonecrosis complicated with fracture nonunion and pseudoarthrosis and appears in the late stage of OVCF. Despite numerous studies on OVCF, few aim to evaluate the clinicoradiological characteristics and clinical significance of intravertebral cleft in OVCF. This study investigates clinicoradiological characteristics of intravertebral cleft in OVCF and the effect on the efficacy of percutaneous balloon kyphoplasty (PKP. Materials and Methods: PKP was performed on 139 OVCF patients without intravertebral cleft (group A and 44 OVCF patients with intravertebral cleft (group B. The frequency distribution of the affected vertebral body, bone cement infusion volume, imaging manifestation, leakage rate and type, preoperative and postoperative height of the affected vertebral body, visual analog scale (VAS and Oswestry disability index (ODI score were evaluated. Results: Significant differences were found in the frequency distribution of the affected vertebral body and bone cement leakage type between the two groups ( P 0.05 were not detected. In both groups, the postoperative height of the affected vertebral body was significantly improved ( P 0.05. Conclusion: Intravertebral cleft exhibits specific clinical and imaging as well as bone cement formation characteristics. PKP can effectively restore the affected vertebral body height, alleviate pain, and improve daily activity function of patients.

  12. Evidence-based endocrinology: illustrating its principles in the management of patients with pituitary incidentalomas.

    Science.gov (United States)

    Bancos, I; Natt, N; Murad, M H; Montori, V M

    2012-02-01

    Incidentally discovered pituitary lesions are commonly encountered in the current era of ever-increasing imaging. Individualizing a particular approach implies a thorough analysis of existing evidence and balancing it against different patient expectations. We will illustrate the application of principles of Evidence-Based Medicine to a case of a pituitary incidentaloma by formulating questions that are important to patient care and finding related evidence. Our objective is to reflect the opportunities and the challenges that an evidence-based clinical approach offers to clinicians and patients.

  13. New neonatal classification of unilateral cleft lip and palate part 2: to predict permanent lateral incisor agenesis and maxillary growth.

    Science.gov (United States)

    Doucet, Jean-Charles; Delestan, Christian; Montoya, Pedro; Matei, Lucia; Bigorre, Michèle; Herlin, Christian; Baümler, Caroline; Daures, Jean-Pierre; Captier, Guillaume

    2014-09-01

    Objectives : To bring a neonatal classification system of unilateral cleft lip and palate and to correlate this classification with the distribution of the permanent lateral incisor and maxillary growth. Design : Retrospective with longitudinal follow-up. Setting : Tertiary. Patients : A total of 112 individuals with treated unilateral cleft lip and palate and 30 controls. Main Outcome Measures : Unilateral cleft lip and palate neonatal casts were classified anatomically in four categories, in which Class 1 corresponds to a maxillary arch with a narrow alveolar cleft; Class 2 corresponds to a balanced form; Class 3 corresponds to a wide cleft and short maxilla; and Class 4 corresponds to a wide cleft and long maxilla. The classification was correlated with the distribution of the permanent lateral incisor. Maxillary growth was evaluated using a cephalometric analysis after the age of 10 years. Results : Clinical classification of unilateral cleft lip and palate found 10 cases of Class 1 (8.9%), 34 cases of Class 2 (30.4%), 46 cases of Class 3 (41.1%), and 22 cases of Class 4 (19.6%). The permanent lateral incisor was most often present in narrower clefts (Classes 1 and 2); whereas, large clefts (Classes 3 and 4) were relatively more frequently associated with an agenesis of the permanent lateral incisor (P = .019). Maxillary growth impairment was most severe in Class 3, with a mean sella-nasion-A point angle at 71.9° ± 4.6° (P cleft width, arch form, and shape of the nasal septum, unilateral cleft lip and palate can be classified into four different classes at birth, which can all give information about permanent lateral incisor agenesis and maxillary growth.

  14. [General principles of effective communication between physician and patient with selected mental disorders].

    Science.gov (United States)

    Błaszczyk, Justyna; Bobińska, Kinga; Filip, Maria; Gałecki, Piotr

    2015-04-01

    Faced with the growing frequency of mental disorders occurrence and considering the necessity of improving the patient care, it is particularly important that physicians of different specialties knew the general principles of effective communication with patients who are mentally ill. Equally important is to spread the knowledge of the symptomatology of various mental illnesses. Studies published by the Institute of Psychiatry and Neurology involving persons between 18 and 64 years old, show that 8 millions Poles suffers or suffered from mental disorders. This represents almost 25% of Polish society. The above data confirm, that basic knowledge of criteria for diagnosing mental disorders and their treatment by primary care physicians, determines the success of the entire health care system. It must be taken into consideration that frequently patients seeing general practitioner (GP) are suffering from more than one mental illness or it is accompanied by somatic disease. Adequate communication determines effective treatment. Simple yet exact message, ability to adapt it to patient and problems reported by him, is a valuable means in daily medical practice. It reduces the risk of iatrogenic disorder, encourages the efficiency of the entire therapeutic process. Good cooperation with the patient is also determined by patience, empathy, understanding, and competence. The aim of this study is to present the principles of effective communication between doctor and patient suffering from selected mental disorders. The article defines the concept of communication. It shows symptomatology of primary psychiatric disorders. Moreover, the most common difficulties in relationship between the doctor and the patient had been pointed.

  15. The relevance of Rawls' principle of justice for research on cognitively impaired patients.

    Science.gov (United States)

    Maio, Giovanni

    2002-01-01

    An ethical conflict arises when we must perform research in the interest of future patients, but that this may occasionally injure the interests of today's patients. In the case of cognitively impaired persons, the question arises whether it is compatible with humane healthcare not only to treat, but also to use these patients for research purposes. Some bioethicists and theologians have formulated a general duty of solidarity, also pertaining to cognitively impaired persons, as a justification for research on these persons. If one examines this thesis from the theory of justice according to John Rawls, it is revealed that such a duty of solidarity cannot necessarily be extrapolated from Rawls' conception of justice. This is at least true of Rawls' difference principle, because according to the difference principle only those measures are justifiable which serve the interest of the respective least well off. Those measures which would engender additional injury for the least well off could not be balanced by any utility according to Rawls. However, John Rawls' difference principle is subordinate to the first principle, which is that each person has an equal right to the most extensive basic liberty compatible with the same liberty for others. These "primary goods" are determined by the freedom and integrity of the person. This integrity of decisionally impaired persons would be in danger if one would abstain from research and thus forego the increase in knowledge related to their disease. Thus one could conclude, at least from Rawls' first principle, that society must take on a duty to guarantee the degrees of freedom for cognitively impaired persons and thus also support the efforts for their healing.

  16. Three-dimensional analysis of naso-maxillary complex symmetry in patients with unilateral complete cleft lip and palate%单侧完全性唇腭裂患者鼻上颌复合体对称性的三维分析

    Institute of Scientific and Technical Information of China (English)

    倪初蕾; 贾绮林

    2014-01-01

    Objective To evaluate the symmetry of naso-maxillary complex in patients with unilateral complete cleft lip and palate with no palatoplasty history before 17 years old.Methods 9 patients (4 males and 5 females) with unilateral complete cleft lip and palate (UCLP) were selected.They all underwent lip repair before 2.5 years old and had no history of palatoplasty before 17 years.They received spiral CT scan and 3D reconstruction of their naso-maxillary complex.22 variables were measured in the reconstructed images and the symmetry of the complex were analyzed.Results The distances of NC-HP and PF-MSP in cleft side were 18.01 mm and 19.72 mm,which were 13.35 mm and 17.31 mm bigger than that in the noncleft side(P<0.05).The distances of NC-CP and U3-HP in cleft side were 59.64 mm and 39.55 mm,which were 64.13 mm and 39.70 mm shorter than that in the non-cleft side (P<0.05).The measurements showed a collapsed and sunken nasal cavity,a wider posterior hard palate and elevated canine in cleft side.There were also deviations of the middle structures.Crista galli,nasal septum,and the mid-point of upper central incisors deviated to cleft side,while skeletal anterior nasal spine deviated to noncleft side.Conclusions Most asymmetries are found in nasal cavity and the dentoalveolar area near the cleft.No significant asymmetry is found in upper cranialfacial strutures,nor in regions not in the adjacency of the cleft.%目的 三维分析成年期前未行腭裂修复术的单侧完全性唇腭裂(UCLP)患者的鼻上颌复合体形态对称性.方法 对9例2.5岁前完成唇裂修复术、成年前未行腭裂修复术的UCLP患者进行螺旋CT扫描、三维重建,选择22个头颅标志点进行定点测量,分析鼻上颌复合体的三维形态.结果 成年前未行腭裂修复术UCLP患者裂侧NC-HP、PF-MSP距离分别为18.01mm、19.72mm,大于健侧13.35mm、17.31mm(P<0.05);裂侧NC-CP、U3-HP距离分别为59.64mm、39.55mm,小于健侧64.13mm、39.70mm(P<0

  17. Hypertrophic scarring in cleft lip repair: a comparison of incidence among ethnic groups

    Directory of Open Access Journals (Sweden)

    Soltani AM

    2012-07-01

    Full Text Available Ali M Soltani, Cameron S Francis, Arash Motamed, Ashley L Karatsonyi, Jeffrey A Hammoudeh, Pedro A Sanchez-Lara, John F Reinisch, Mark M UrataDivision of Plastic and Maxillofacial Surgery at Children's Hospital Los Angeles, CA, USA; The Division of Plastic and Reconstructive Surgery at the Keck School of Medicine of the University of Southern California, Los Angeles, CA, USABackground: Although hypertrophic scar (HTS formation following cleft lip repair is relatively common, published rates vary widely, from 1% to nearly 50%. The risk factors associated with HTS formation in cleft patients are not well characterized. The primary aim of this retrospective study of 180 cleft lip repairs is to evaluate the frequency of postoperative HTS among various ethnic groups following cleft lip repair.Methods: A retrospective chart view of patients undergoing primary cleft lip repair over a 16-year period (1990–2005 by the senior surgeon was performed. The primary outcome was the presence of HTS at 1 year postoperatively. Bivariate analysis and multivariable logistic regression were used to evaluate potential risk factors for HTS, including ethnicity, type and laterality of cleft, and gender.Results: One hundred and eighty patients who underwent cleft lip repair were included in the study. The overall rate of postoperative HTS formation was 25%. Ethnicity alone was found to be an independent predictor of HTS formation. Caucasian patients had the lowest rate of HTS formation (11.8% and were used as the reference group. HTS rates were significantly higher in the other ethnicities, 32.2% in Hispanic patients (odds ratio [OR]: 3.51; 95% confidence interval [CI]: 1.53–8.85, and 36.3% for Asian patients (OR 4.27; 95% CI: 1.36–13.70. Sex, cleft type, and cleft laterality were not associated with increased rates of HTS.Conclusions: Differences in ethnic makeup of respective patient populations may be a major factor influencing the wide variability of reported

  18. Classification and operation in the treatment of maxillary retrusion of adult patients with cleft lip and palate%成人唇腭裂上颌后缩的分类和治疗方法

    Institute of Scientific and Technical Information of China (English)

    郑益略; 尹宁北; 赵振民; 孙晓梅; 姜婵媛; 童海洲; 麻恒源; 宋涛

    2016-01-01

    Objective To classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.Methods From January 2005 to May 2015,121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery.Inclusion criteria:①male aged over 16,female aged over 14;②diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases;③without previous orthodontic and orthognathic treatment;④having no other craniofacial malformation.Maxillary features and repaired types were recorded.Results 93 patients were included and divided into two categories depended on the dental crowding.Class Ⅰ:the teeth quantity and bone quantity is coordinated,space analysis ≤4 mm (mild dental crowding).The forward distance of maxillary less than 6 mm was defined as Class Ⅰ a (36 cases),more than 6 mm as Class Ⅰ b (28 cases).Class Ⅱ:the teeth quantity and bone quantity is not coordinated,space analysis > 4 mm (moderate or severe dental crowding).After the simulation of distraction osteogenesis,the anterior crossbite was corrected defined as Class Ⅱ a (23 cases),not corrected defined as Class Ⅱb (6 cases).Class Ⅰ a were corrected by conventional orthognathic surgery.While Class Ⅰ b were corrected by Le Fort Ⅰ maxillary advancement using distraction osteogenesis.Class Ⅱ a were repaired just by anterior maxillary distraction.While Class Ⅱb need to combine conventional orthognathic surgery with anterior maxillary distraction.All the patients were satisfied with the treatment effect.Conclusions The patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above,and then choose the appropriate operations.%目的 对需要正颌外科治疗的唇腭裂上颌后缩的患者进行分类,并提出相应的手术方法.方法 2005年1月至2015年5月,共收治唇腭裂上颌后缩患者121

  19. Presurgical nasoalveolar molding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Rahul J Hegde

    2015-01-01

    Full Text Available Unilateral cleft lip and palate (UCLP patients have an esthetic and functional compromise of the middle third of the face and nasal structures. To improve the esthetic result of lip repair, the concept of presurgical nasoalveolar molding (PNAM was brought into conception. PNAM is an easy and passive method of bringing the alveolus and lips together by redirecting the forces of natural growth. This case report documents a 2-year follow-up of PNAM in UCLP.

  20. Chemical meningitis: a rare presentation of Rathke's cleft cyst.

    Science.gov (United States)

    Mrelashvili, Anna; Braksick, Sherri A; Murphy, Lauren L; Morparia, Neha P; Natt, Neena; Kumar, Neeraj

    2014-04-01

    Rathke's cleft cysts (RCC) are usually benign, sellar and/or suprasellar lesions originating from the remnants of Rathke's pouch. Rarely, RCC can present with chemical meningitis, sellar abscess, lymphocytic hypophysitis, or intracystic hemorrhage. We describe an unusual presentation of RCC in which the patient presented with a clinical picture of chemical meningitis consisting of meningeal irritation, inflammatory cerebrospinal fluid profile, and enhancing pituitary and hypothalamic lesions, in addition to involvement of the optic tracts and optic nerve.

  1. Association between alleles of the transforming growth factor alpha locus and cleft lip and palate in the Chilean population

    Energy Technology Data Exchange (ETDEWEB)

    Jara, L.; Blanco, R.; Chiffelle, I. [Univ. of Chile, Santiago (Chile)] [and others

    1995-07-17

    Two RFLPs at the TGFA locus were studied in 39 unrelated Chilean (Caucasoid-Mongoloid) patients with non-syndromic cleft lip/palate [CL(P)] and 51 control individuals. A highly significant association between BamHI A2 allele and CL(P) was detected ({chi}{sub 2} = 6.00; P = 0.014), while no association was found between TaqI RFLPs and clefting. No significant differences were found when comparing genotypes by type of cleft and a positive or negative family history of clefting. Our results seem to support rather definitively the association between TGFA and clefting but not support the hypothesis that TGFA is a major causal gene of CL(P). 29 refs., 5 tabs.

  2. Current principles in the management of patients with chronic nonspecific lumbago

    Directory of Open Access Journals (Sweden)

    E.Yu. Suslova

    2014-01-01

    Full Text Available To manage patients with low back pain is an urgent problem of modern medicine. The paper covers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. A multidisciplinary treatment approach involving drug therapy with analgesics (nonsteroidal anti-inflammatory drugs, antidepressants, myorelaxants, therapeutic exercises, and cognitive-behavioral therapy is noted to be highly effective.

  3. Dental materials for cleft palate repair.

    Science.gov (United States)

    Sharif, Faiza; Ur Rehman, Ihtesham; Muhammad, Nawshad; MacNeil, Sheila

    2016-04-01

    Numerous bone and soft tissue grafting techniques are followed to repair cleft of lip and palate (CLP) defects. In addition to the gold standard surgical interventions involving the use of autogenous grafts, various allogenic and xenogenic graft materials are available for bone regeneration. In an attempt to discover minimally invasive and cost effective treatments for cleft repair, an exceptional growth in synthetic biomedical graft materials have occurred. This study gives an overview of the use of dental materials to repair cleft of lip and palate (CLP). The eligibility criteria for this review were case studies, clinical trials and retrospective studies on the use of various types of dental materials in surgical repair of cleft palate defects. Any data available on the surgical interventions to repair alveolar or palatal cleft, with natural or synthetic graft materials was included in this review. Those datasets with long term clinical follow-up results were referred to as particularly relevant. The results provide encouraging evidence in favor of dental and other related biomedical materials to fill the gaps in clefts of lip and palate. The review presents the various bones and soft tissue replacement strategies currently used, tested or explored for the repair of cleft defects. There was little available data on the use of synthetic materials in cleft repair which was a limitation of this study. In conclusion although clinical trials on the use of synthetic materials are currently underway the uses of autologous implants are the preferred treatment methods to date.

  4. Invariant properties of representations under cleft extensions

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The main aim of this paper is to give the invariant properties of representations of algebras under cleft extensions over a semisimple Hopf algebra. Firstly, we explain the concept of the cleft extension and give a relation between the cleft extension and the crossed product which is the approach we depend upon. Then, by making use of them, we prove that over an algebraically closed field k, for a finite dimensional Hopf algebra H which is semisimple as well as its dual H*, the representation type of an algebra is an invariant property under a finite dimensional H-cleft extension . In the other part, we still show that over an arbitrary field k, the Nakayama property of a k-algebra is also an invariant property under an H -cleft extension when the radical of the algebra is H-stable.

  5. Cleft deformities in adults and children aged over six years in Nigeria: Reasons for late presentation and management challenges

    Directory of Open Access Journals (Sweden)

    Wasiu L Adeyemo

    2009-11-01

    Full Text Available Wasiu L Adeyemo1, Mobolanle O Ogunlewe1, Ibironke Desalu2, Akinola L Ladeinde1, Bolaji O Mofikoya3, Michael O Adeyemi4, Adegbenga A Adepoju4, Olufemi O Hassan41Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, 2Department of Anaesthesia, 3Department of Surgery, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria; 4Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, NigeriaAbstract: In developing countries, untreated cleft lips and palates are found with increasing frequency and patients often present to the surgeon far past the optimal time for closure of the cleft deformities. A prospective study was conducted between March 2007 and September 2009, to identify the reasons and treatment challenges of delayed presentation of cleft lip and palate deformities at the Lagos University Teaching Hospital, Nigeria. Out of a total of 150 patients with cleft defects during the period, 43 (28.7% were adults and children aged over six years. The mean age of these patients at the time of presentation was 17.3 years. The most common reasons for late presentation were lack of money (56.7%, lack of health care services nearby (18.4%, and lack of awareness of treatment availability (13.3%. Common challenges in these patients included surgical, orthodontic, speech, anesthetic, and psychological. Although adult clefts were significantly enlarged in three dimensions the anatomic landmarks were easier to discern than in an infant. However, extensive soft tissue dissection in adult cleft lip repair resulted in significant postoperative edema. Closure of wide palatal cleft often required the use of adjunct intraoral flaps. Despite late presentation, surgical outcome of these patients was satisfactory and comparable to cleft repair in infants.Keywords: cleft deformities, adults, adolescents, late presentation, management, challenges

  6. X-linked genes and risk of orofacial clefts

    DEFF Research Database (Denmark)

    Jugessur, Astanand; Skare, Øivind; Lie, Rolv T

    2012-01-01

    Orofacial clefts are common birth defects of complex etiology, with an excess of males among babies with cleft lip and palate, and an excess of females among those with cleft palate only. Although genes on the X chromosome have been implicated in clefting, there has been no association analysis...

  7. Velopharyngeal sphincter pathophysiologic aspects in the in cleft palat

    Directory of Open Access Journals (Sweden)

    Collares, Marcus Vinicius Martins

    2008-09-01

    Full Text Available Introduction: Cleft lip and palate are common congenital abnormalities with typical functional disorders on speech, deglutition and middle ear function. Objective: This article reviews functional labiopalatine disorders through a pathophysiological view. Method: We performed a literature search on line, as well as books and periodicals related to velopharyngeal sphincter. Our sources were LILACS, MEDLINE and SciELO databases, and we applied to the research Keywords of interest on the velopharyngeal pathophysiology, for articles published between 1965 and 2007. Conclusion: Velopharyngeal sphincter plays a central role in speech, swallowing and middle ear physiology in patients with labiopalatine cleft. At the end of our bibliographic review, pursuant to the velopharyngeal physiology in individuals with this disorder in the functional speech, deglutition and otologic function, we observed that although there is a great number of published data discussing this issue, further studies are necessary to completely understand the pathophysiology, due to the fact they have been exploited superficially.

  8. Parents' age and the risk of oral clefts

    DEFF Research Database (Denmark)

    Bille, C.; Skytthe, A.; Vach, W.

    2005-01-01

    . METHODS: Among the 1,489,014 live births in Denmark during 1973-1996, there were 1920 children with nonsyndromic cleft lip with or without cleft palate and 956 children with nonsyndromic cleft palate. We used logistic regression to assess the impact of parental age on the occurrence of cleft lip....... In a joint analysis, both maternal and paternal ages were associated with the risk of cleft lip with or without cleft palate, but the contribution of each was dependent on the age of the other parent. In the analysis of cleft palate only, the effect of maternal age disappeared, leaving only paternal age...

  9. Division of flap in cleft palate patients after posterior pharyngeal flap surgery%咽后壁瓣断蒂对腭咽闭合影响的探讨

    Institute of Scientific and Technical Information of China (English)

    周治波; 罗奕; 马莲

    2010-01-01

    Objective To investigate the reasons of flap division in patients with posterior pharyngeal flap and the outcome of the flap division for treating secondary velopharyngeal insufficiency (VPI) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Twenty patients who underwent flap division after posterior pharyngeal flap surgery were included in this study, including 11 uncomplete cleft palate and 9 complete cleft palate).Nasal endoscopy and lateral cephalometric radiographs were performed for all the patients preoperatively. Speech recordings were made pre- and postoperatively.The respiratory status of patients who hadOSAHS manifestations was monitored by polysomnography. Simple division of the flap was carried out in 14 cases, and additional pharyngoplasty combined the division of posterior pharyngeal flap was performed in six cases. ResultsThe speech did not show significant improvement in 14 cases after posterior pharyngeal flap surgery but improved after flap division. Three cases got speech improvement, but developed the respiratory obstruction causing sleep apnea. After the division of flap, the respiratory status got improved. Three cases required orthognathic surgery under general anesthesia, which demanded the division of flap simultaneously. The speech did not change after the division. ConclusionsIf OSAHS occurred or VPI remained after posterior pharyngeal flap surgery, the division of the flap or additional pharyngoplasty should be performed. It is suggested that the operation of the flap division be done six months after posterior pharyngeal flap surgery.%目的 探讨咽后壁瓣成形术后腭咽闭合功能不全(velopharyngeal insufficiency,VPI)及其并发症阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗中咽后壁瓣断蒂的作用.方法 1993至2008年于北京大学口腔医学院·口腔医院唇腭裂治疗中心接受咽后壁瓣断蒂术患者20例(不完全腭裂11例、完全性唇腭裂9例),20例断蒂术前均行

  10. Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique

    Directory of Open Access Journals (Sweden)

    Cassio Eduardo Raposo-Amaral

    2012-01-01

    Full Text Available Objective. To compare the cutaneous lip height at early and late postoperative periods and to objectively determine the average amount of lip height improvement during the first year of unilateral complete cleft lip repair using Cutting extended Mohler technique. Methods. In this prospective cohort study, 26 unilateral complete cleft patients and 50 noncleft subjects were included. Photographs were taken between 12 and 16 weeks (T1 and also taken between 12 and 13 months after surgery (T2. The cutaneous lip height distance (photogrammetric lip analysis obtained in these two periods of time were measured and statistically analyzed. Results. The average lip heights were in T1 and in T2 (. The average lip height asymmetry in the noncleft individuals was . Conclusion. Since all principles to obtain a symmetrical Cupid’s bow were performed, the postoperative pull-up of Cupid’s bow is probably owed to the scar contracture, which improves by 2 times during the first year after surgery.

  11. Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique.

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Giancolli, André Pecci; Denadai, Rafael; Marques, Frederico Figueiredo; Somensi, Renato Salazar; Raposo-Amaral, Cesar Augusto; Alonso, Nivaldo

    2012-01-01

    Objective. To compare the cutaneous lip height at early and late postoperative periods and to objectively determine the average amount of lip height improvement during the first year of unilateral complete cleft lip repair using Cutting extended Mohler technique. Methods. In this prospective cohort study, 26 unilateral complete cleft patients and 50 noncleft subjects were included. Photographs were taken between 12 and 16 weeks (T1) and also taken between 12 and 13 months after surgery (T2). The cutaneous lip height distance (photogrammetric lip analysis) obtained in these two periods of time were measured and statistically analyzed. Results. The average lip heights were 24% ± 9% in T1 and 8% ± 6% in T2 (P < 0.01). The average lip height asymmetry in the noncleft individuals was 4.52% ± 1.89%. Conclusion. Since all principles to obtain a symmetrical Cupid's bow were performed, the postoperative pull-up of Cupid's bow is probably owed to the scar contracture, which improves by 2 times during the first year after surgery.

  12. [Clinical nutrition therapy in patients with short bowel syndrome in line with principles of personalized medicine].

    Science.gov (United States)

    Sahin, Péter; Molnár, Andrea; Varga, Mária; Bíró, Ilona; Kőmíves, Csilla; Fejér, Csaba; Futó, Judit; Tomsits, Erika; Topa, Lajos

    2014-12-21

    Home parenteral nutrition administered in selected care centres has been financed in Hungary since January, 2013. The authors discuss diagnostic issues, treatment and nutrition therapy of short bowel syndrome patients in line with the principles of personalised medicine. The most severe form of short bowel syndrome occurs in patients having jejunostomy, whose treatment is discussed separately. The authors give a detailed overview of home parenteral feeding, its possible complications, outcomes and adaptation of the remaining bowel. They describe how their own care centre operates where they administer home parenteral nutrition to 12 patients with short bowel syndrome (5 females and 7 males aged 51.25±14.4 years). The body mass index was 19.07±5.08 kg/m2 and 20.87±3.3 kg/m2, skeletal muscle mass was 25.7±6.3 kg and 26.45±5.38 kg, and body fat mass was 14.25±8.55 kg and 11.77±2.71 kg at the start of home parenteral nutrition and presently, respectively. The underlying conditions of short bowel syndrome were tumours in 4 patients, bowel ischaemia in four patients, surgical complications in three patients, Crohn's disease in one patient, and Crohn's disease plus tumour in one patient.

  13. Short mandible - a possible risk factor for cleft palate with/without a cleft lip

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Darvann, Tron Andre; Ersbøll, Bjarne Kjær

    2014-01-01

    Structured Abstract Objectives To estimate the influence of a short mandible on the risk of developing a cleft palate with/without a cleft lip (CP). Setting and sample population The retrospective sample consisted of 115 2-month-old Danish infants with CP, and 70 control infants with unilateral...... incomplete cleft lip (UICL). Material and Methods Cephalometric X-rays were obtained. Mandibular length (L-m) was measured and corrected for body length (L-b) to remove influence of varying body length in the sample. Logistic regression was applied to the corrected mandibular length (L-mc) to calculate...... the risk of having a cleft palate. Results The mean mandibular length in the group with CP was about 4mm shorter than in the control group. Odds ratio (OR) was calculated to be 0.58 (95% confidence interval 0.48-0.68), implying that an individual's risk of cleft palate with/without a cleft lip increases...

  14. Quality of life as patient-reported outcomes: principles of assessment.

    Science.gov (United States)

    Bullinger, Monika; Quitmann, Julia

    2014-06-01

    Assessing quality of life (QoL) as a patient-reported outcome in adult psychiatry poses challenges in terms of concepts, methods, and applications in research and practice. This review will outline conceptually the construct of QoL, its dimensionality, and its representation across patient groups. Methodological challenges are examined, along with principles of QoL instrument development and testing, as well as across cultures. Application of instruments in epidemiological, clinical health economics, and health services research is reviewed based on pertinent literature. Validated measures for depression, psychosis, and anxiety disorders are available in adult psychiatry, and are increasingly used in research. Still, targeted measures are lacking for many mental health conditions and only rarely are tools applied in the practice context. Progress has been made in the development of instruments that are now ready for implementation. The information to be gained is valuable for identifying patient-reported needs for and benefits of treatment.

  15. Association between FOXE1 and non-syndromic orofacial clefts in a northeastern Chinese population.

    Science.gov (United States)

    Liu, Kun; Lu, Yongping; Ai, Lisi; Jiao, Boqiang; Yu, Jiantao; Zhang, Bin; Liu, Qiang

    2015-10-01

    Non-syndromic orofacial clefts are among the most common congenital defects, and several reports have shown that the FOXE1 gene has strong associations with them. To find out if the gene was a risk factor we used a case-control and family-based analysis, and recruited 230 patients with non-syndromic oral clefts including 179 with non-syndromic cleft lip with or without cleft palate, and 51 with non-syndromic cleft palate alone, their parents (166 mothers and 161 fathers, including 135 complete trios), and 180 healthy controls. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used to genotype the 2 most strongly associated markers (rs4460498 and rs3758249) in FOXE1, and case-control and family-based associations were analysed. In the case-control analyses we found a significant association with non-syndromic cleft lip and palate in rs4460498 (p=0.009) and rs3758249 (p=0.014), but no association in patients with cleft palate alone. For rs4460498 in FOXE1, the odds ratio (OR) for cases with CC homozygotes compared with TC+CC genotypes was 1.813 (95% CI 1.176 to 2.796), and for rs3758249 in FOXE1, the OR for cases with GG homozygotes compared with those with AG+AA genotypes was 0.561 (95%CI 0.371 to 0.848). The results of transmission-disequilibrium tests for rs4460698 and rs3758249 for non-syndromic orofacial clefts were p=0.003, OR=2.781 (95% CI 1.414 to 5.469) and p=0.001, OR=2.552 (95%CI 1.574 to 4.138), respectively. This suggests that FOXE1 (rs4460498 and rs3758249) is strongly associated with non-syndromic cleft lip and palate in populations in northeast China, and further study between FOXE1 and non-syndromic orofacial clefts is necessary.

  16. MRI of brain disease in veterinary patients part 1: Basic principles and congenital brain disorders.

    Science.gov (United States)

    Hecht, Silke; Adams, William H

    2010-01-01

    Magnetic resonance imaging (MRI) is increasingly being used in the diagnosis of central nervous system disorders in veterinary patients and is quickly becoming the imaging modality of choice in evaluation of brain and intracranial disease. This article provides an overview of the basic principles of MRI, a description of sequences and their applications in brain imaging, and an approach to interpretation of brain MRI. A detailed discussion of imaging findings in general intracranial disorders including hydrocephalus, vasogenic edema, brain herniation, and seizure-associated changes, and the MR diagnosis of congenital brain disorders is provided. MRI evaluation of acquired brain disorders is described in a second companion article.

  17. Advances in Liposuction: Five Key Principles with Emphasis on Patient Safety and Outcomes

    Directory of Open Access Journals (Sweden)

    Geo N. Tabbal, MD

    2013-11-01

    Full Text Available Summary: Since Illouz’s presentation of a technique for lipoplasty at the 1982 Annual Meeting of the American Society of Plastic and Reconstructive Surgeons, liposuction has become one of the most commonly performed aesthetic surgery procedures. The evolution of liposuction has seen refinements in technique and improvement of patient safety-related standards of care. Based on long-term experience with body contouring surgery, 5 principles of advanced liposuction are presented: preoperative evaluation and planning, intraoperative monitoring—safety measures, the role of wetting solutions and fluid resuscitation, circumferential contouring and complication prevention, and outcomes measurement.

  18. Use of Biphasic Continuous Positive Airway Pressure in Premature Infant with Cleft Lip–Cleft Palate

    Directory of Open Access Journals (Sweden)

    Lovya George

    2015-10-01

    Full Text Available Preterm infants (PIs often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure ventilation. PI with a cleft lip and palate often fail noninvasive respiratory support and require continued intubation and mechanical ventilation. We are presenting the first case report of a PI with cleft lip and palate who was managed by biphasic nasal continuous positive airway pressure.

  19. 布比卡因、吗啡复合液对小儿唇裂术后疼痛的影响%Effects of bupivacaine and morphine combination on postoperative pain after cleft lip repair operation in paediatric patients

    Institute of Scientific and Technical Information of China (English)

    闵振兴; 顾文彤

    2013-01-01

    目的 观察布比卡因复合吗啡注射液应用于眶下神经阻滞对小儿唇裂术后镇痛的临床效果.方法 选择95例确诊为唇裂并行手术治疗的患儿,随机双盲分为布比卡因组(B组)47例和布比卡因、吗啡复合组(BM组)48例.常规诱导气管插管后,B组取0.25%布比卡因2 ml;BM组取0.25%布比卡因2 ml+1μg/kg吗啡注射液;两组均行双侧眶下神经阻滞,每侧1 ml.观察两组术后FLACC疼痛评分及不良反应.结果 两组患儿术后3、6小时FLACC评分差异无显著性(P>0.05),术后12、24小时差异有显著性(P<0.05),术后48小时差异有极显著性(P<0.01).B组总不良反应发生率为14.89%,BM组16.67%.结论 采用布比卡因、吗啡复合液行眶下神经阻滞对小儿唇裂术后具有良好的镇痛效果,且不良反应少,麻醉安全性高.%Objective To study effects of bupivacaine and morphine combination with infraorbital nerve block on postoperative pain after cleft lip repair operation in paediatric patients.Methods 50 paediatric patients (ASA I) aged from 12 to 60 months undergoing cleft lip repair were randomly divided into two groups,25 cases for each group.After tracheal intubation,group B (using bupivacaine) received bilateral infraorbital nerve block with 1 ml of 0.25% hupivacaine on each side and group BM (using bupivacaine and morphine combination) received 1 ml of 0.25% bupivacaine along with 1 μ g/kg body weight morphine.Pain after recovery from anaesthesia was assessed postoperatively using the FLACC scale.Results Physical characteristics of the children studied had no significant differences.The duration of analgesia from the time of administration of block in group B was (20.2 ± 2.6) h compared to (36.8 ± 3.4) h in group BM (P<0.01).Between two groups,the FLACC scale in group B was higher at 12,24 and 48 h postoperatively than those in group BM (P<0.01).Conclusion Addition of morphine as an adjunct to local anaesthetic significantly

  20. Implementation of standardized medical photography for cleft lip and palate audit.

    Science.gov (United States)

    Jones, Marie; Cadier, Michael

    2004-12-01

    Much has been published relating to the treatment and surgical outcome of cleft lip and palate disorders. Clinical audit is one of the most important tools for assessing the quality of care provided, with medical photography an invaluable component of this process. The Clinical Standards Advisory Group Report 1998 recommended that cleft lip and palate patients should be audited when 0 (under 1 year of age), and then at the ages of 5, 10, 15 and 20 years. For both audit and research purposes, medical photographs need to be accurate and of a consistently high standard. This paper describes the development of a standardized photographic protocol for cleft patients of audit age, to the benefit of both the multidisciplinary team and the patients.

  1. FRONTAL COLUMELLAR FLAP IN UNILATERAL CLEFT LIP REPAIR

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The authors modified the design of Mohler's method of cleft lip repair, and attempted to make this method more reasonable, standard and surgically applicable, yield better outcome and to broaden the indications. In the modified Mohler technique, wherein designing and dissecting of the flap and the orbicular oris muscle are done separately, the author created an equilateral triangle flap (side≤6mm) from the frontal part of the columella.The flap is rotated and displaced downwards so that the atrophic philtral dimple is lengthened, the philtral column is reconstructed in such a way that the involved side of the Cupid's bow peak is restored to the normal position. From 1998 to 2000, the authors used this modified method to correct unilateral cleft lips in 38 patients. The results showed that the skin of the frontal columella and that of the philtral dimple were structurely similar, and so is ideal material for repairing the atrophied philtral dimple. The modified Mohler method for unilateral cleft lips can produce a better lip contour and broaden the indications.

  2. MAXILLARY GROWTH PATTERNS IN ROMANIAN CHILDREN WITH CLEFT PALATE DURING THE FIRST 6 YEARS OF LIFE

    Directory of Open Access Journals (Sweden)

    Liliana-Gabriela Halitchi

    2012-12-01

    Full Text Available In order to visualize, evaluate and measure the maxillary growth in patients with cleft palate and to identify the reactive morphological pattern that could be identified from the dimensional changes produced along the first six years of life, maxillary impressions were made in two groups of study, by means of standard trays and silicone impression materials. The maxillary casts resulted had been 3D scanned at Multinr, in Sf. Gheorghe. The study was carried on a number of 34 patients with cleft palate, 16 boys and 18 girls, with ages between 2 months and 6 years, operated by the same surgical team in “St. Mary” University Children Hospital of Iaşi, as well as on 60 normal children. Bivariate Student’s t test established statistically significant negative differences between the mean values of the anterior and posterior width of the maxillary alveolar arch, positive non significant differences for the length and positive differences for the depth of the dehiscent palate in the experimental group, comparatively with normal children. Cleft palate patients have narrowed and shorter maxillary alveolar arch and flattened palate. At least therapeutically, the cleft palate group, operated at different ages, from 2 to 4 years, could not react like other groups of study from important European Cleft Centers and benefit from a good residual growth.

  3. 河南省部分地区唇腭裂患者术后继发畸形调查分析%The Secondary Deformity Distribution of Cleft lip and Cleft Palate in Henan Province

    Institute of Scientific and Technical Information of China (English)

    马敬斋; 张景霞

    2012-01-01

    Objective: To explore the relationships between secondary deformities of Cleft lip and cleft palate and selection of mode of initial operation. Methods; To survey and to take photos for the patients of cleft lip and cleft palate in henan province,to study the photos and to record the Operation mode and the secondary deformities. Re-sults: There were 2046 cases of Cleft lip and cleft palate . Of the 1514 cases of unilateral Cleft Up with or without cleft palate, 1268 were diagnosed as the patients of the secondary defortuities,Of the 488 cases of bilateral Cleft lip with or without cleft palate,464 were diagnosed as the patients of the secondary defortuities. Conclusion: Initially a-dopted operation mode for Cleft lip with or without cleft palate has remarkably affected the risk of secondary defortuities.%目的:了解唇裂、腭裂一期手术后继发畸形的情况,并探讨其影响因素及有效的解决方法.方法:采用普查法对河南省部分地区人群进行随访,对唇腭裂患者进行术区照相,根据照片记录手术类型、术后继发畸形情况,将结果进行统计学分析.结果:共随访唇腭裂术后患者2046例.单侧唇裂患者1514例,术后继发畸形1268例,,双侧唇裂患者488例,术后继发畸形466例,腭裂患者446例,术后继发硬腭穿孔及软腭复裂26例.结论:适当选择唇腭裂手术类型,对唇腭裂术后患者进行定期随诊及普查,及时发现、治疗术后继发畸形,对提高唇腭裂手术的治疗效果具有极为重要的意义.

  4. Comparison of the Pharyngeal Airway Volume between Non-Syndromic Unilateral Cleft Palate and Normal Individuals Using Cone Beam Computed Tomography

    Science.gov (United States)

    Shahidi, Shoaleh; Momeni Danaie, Shahla; Omidi, Mahsa

    2016-01-01

    Statement of the Problem: Individuals with cleft lip and cleft palate mostly have airway problems. Introduction of cone beam computed tomography (CBCT) and imaging software has provided the opportunity for a more precisely evaluating 3D volume of the airway. Purpose: The purpose of this study was to analyze and compare 3D the pharyngeal airway volumes of cleft palate patients with normal individuals using CBCT. Materials and Method: 30 complete cleft palate patients were selected from the Department of Orthodontics; Dental University (Shiraz, Iran) who had CBCT scans of the head. The control group included 30 individuals with Class I angle occlusion who were matched for age and gender with the experimental group. ITK-SNAP 2.4.0 PC software was used to build 3D models of the airways for the subjects and measuring airway volumes. The statistical analyses were performed using SPSS software (version 19). Mann-Whitney test was adopted with p< 0.05 as statistical significance. Results: The average volume of the pharyngeal airway of cleft group was 18.6 cm3, with mean volumes of 6.8 cm3 for the superior component and 11.3 cm3 for the inferior component. The total and superior airway volume of cleft group were significantly lower than non-cleft groups (p= 0.008, p= 0.00, respectively) but the inferior airway volumes were not significantly different between the cleft and non-cleft groups. There was a significant and positive correlation between superior airway volume and inferior airway volume in cleft palate patients (r=+0.786, p< 0.001) and control group (r=+0.575, p= 0.001). Conclusion: 3D analysis showed that the nasal and total airway was restricted in individuals with cleft palate but the inferior airway was not compromised in these individuals. This would be a crucial data to be considered for surgeons during surgical planning. PMID:27840840

  5. Comparison of the Pharyngeal Airway Volume between Non-Syndromic Unilateral Cleft Palate and Normal Individuals Using Cone Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Shoaleh Shahidi

    2016-09-01

    Full Text Available Statement of the Problem: Individuals with cleft lip and cleft palate mostly have airway problems. Introduction of cone beam computed tomography (CBCT and imaging software has provided the opportunity for a more precisely evaluating 3D volume of the airway. Purpose: The purpose of this study was to analyze and compare 3D the pharyngeal airway volumes of cleft palate patients with normal individuals using CBCT. Materials and Method: 30 complete cleft palate patients were selected from the Department of Orthodontics; Dental University (Shiraz, Iran who had CBCT scans of the head. The control group included 30 individuals with Class I angle occlusion who were matched for age and gender with the experimental group. ITK-SNAP 2.4.0 PC software was used to build 3D models of the airways for the subjects and measuring airway volumes. The statistical analyses were performed using SPSS software (version 19. Mann-Whitney test was adopted with p< 0.05 as statistical significance. Results: The average volume of the pharyngeal airway of cleft group was 18.6 cm3, with mean volumes of 6.8 cm3 for the superior component and 11.3 cm3 for the inferior component. The total and superior airway volume of cleft group were significantly lower than non-cleft groups (p= 0.008, p= 0.00, respectively but the inferior airway volumes were not significantly different between the cleft and non-cleft groups. There was a significant and positive correlation between superior airway volume and inferior airway volume in cleft palate patients (r=+0.786, p< 0.001 and control group (r=+0.575, p= 0.001. Conclusion: 3D analysis showed that the nasal and total airway was restricted in individuals with cleft palate but the inferior airway was not compromised in these individuals. This would be a crucial data to be considered for surgeons during surgical planning.

  6. BILATERAL TESSIER CLEFT 3: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Utpal

    2014-06-01

    Full Text Available Tessier cleft 3 is a very rare congenital anomaly, (2 especially the bilateral form. Very few cases have been reported worldwide. (1,2 I report a case of bilateral Tessier cleft 3 presenting at the age of three months with clefts extending from philtral regions, undermining the nasal alar bases to the medial canthal areas bilaterally. There were bilateral complete alveolar clefts with mild protrusion of the pre-maxilla, but the rest of the maxilla including the palate was not involved. Surgical correction was started at the age of three months and completed at the age of one and half years in three stages. There was no intra-operative or postoperative complications and the final result was satisfactory.

  7. Effect of cleft palate repair on the susceptibility to contraction-induced injury of single permeabilized muscle fibers from congenitally-clefted goat palates.

    Science.gov (United States)

    Despite cleft palate repair, velopharyngeal competence is not achieved in ~ 15% of patients, often necessitating secondary surgical correction. Velopharyngeal competence postrepair may require the conversion of levator veli palatini muscle fibers from injury-susceptible type 2 fibers to injury-resi...

  8. Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 1. Nasal changes.

    LENUS (Irish Health Repository)

    Ayoub, Ashraf

    2010-08-11

    Abstract Objective: To evaluate 3D nasal morphology following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous non-cleft data Design: Prospective, cross-sectional, controlled study. Setting: Glasgow Dental Hospital & School, Faculty of Medicine, Glasgow University Patients and Participants: Two groups of 3-year old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a 3D vision based capture technique. Methods: 3D images of the face were reflected so the cleft was on the left side to create a homogenous group for statistical analysis. Three-dimensional co-ordinates of anthropometric landmarks were extracted from facial images by a single operator. A set of linear measurements was utilised to compare cleft and control subjects on right and left sides, adjusting for sex differences Results: the mean nasal base width and the width of the nostril floor on right and left sides differed significantly between control and Unilateral Cleft Lip and Palate (UCLP) groups. The measurements were greater in UCLP children. The difference in the mean nasal height and mean nasal projection between the groups were not statistically significant. Mean columellar lengths were different between the left and right sides in UCLP cases. Conclusions: There were significant nasal deformities following the surgical repair of UCLP. Keywords: child, cleft lip and palate, three-dimensional imaging.

  9. Presurgical nasoalveolar molding: A boon to facilitate the surgical repair in infants with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Prabhakar Ramasetty Attiguppe

    2016-01-01

    Full Text Available Cleft lip and palate (CLP is the most common congenital craniofacial anomaly. Rehabilitation of CLP generally requires a team approach. Alveolar and nasal reconstruction for these patients is a challenge for the reconstructive surgeon. Various procedures have been attempted to reduce the cleft gap, so as to obtain esthetic results postsurgically. The presurgical nasoalveolar molding (PNAM technique, developed by Grayson, is a new approach to presurgical infant orthopedics. PNAM reduces the severity of the initial cleft alveolar and nasal deformity. Thus, it enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This article presents a brief insight into PNAM with a case series of three different cases (one unilateral and two bilateral which underwent PNAM treatment and gave an excellent surgical prognosis.

  10. Retrospective subjective evaluation of aesthetic outcome in secondary cleft lip deformities operated with Abbe's flap

    Directory of Open Access Journals (Sweden)

    Kamal M. Kumar

    2015-01-01

    Full Text Available Background: The Abbe's flap is most commonly used to repair the full thickness defects of the lip that do not involve the commissure. The Abbe flap was first introduced to correct the secondary deformity of bilateral cleft lip. By this pedicled flap, we are able to equalize the disparity which existed between the tight upper lip and excessive lower lip. Aims to study retrospective subjective evaluation of aesthetic outcome in secondary cleft lip deformities operated with Abbe's flap. Methods: 29 patients operated during the period of January 2007 - December 2011 for correction of secondary cleft lip and nasal deformity with Abbe's flap with or without rhinoplasty were included in our retrospective study. The secondary corrective surgeries were performed by a single surgeon. The photographs of the patients were retrospectively assessed by two plastic surgeons and one oral and maxillofacial surgeon, other than the one who performed the surgery. 29 patients operated during the period of January 2007 - December 2011 for correction of secondary cleft lip and nasal deformity with Abbe's flap with or without rhinoplasty were included in our retrospective study. The secondary corrective surgeries were performed by a single surgeon. The photographs of the patients were retrospectively assessed by two plastic surgeons and one oral and maxillofacial surgeon, other than the one who performed the surgery. Results: Out of 29 patients with secondary cleft deformities 12 were male and 17 were female. Average follow up period was 3 years. Multiple variables of the nose and the lips were used to assess the aesthetic outcome of Abbe's flap. Conclusion: As per the subjective retrospective analysis of our study we have come to the conclusion that Abbe's flap is a work horse for correction of shortage of tissue for the secondary cleft lip deformities. Uniform satisfactory outcome was obtained with a more natural contour and more satisfactory proportion of both lips

  11. Novel homozygous mutation, c.400C>T (p.Arg134*), in the PVRL1 gene underlies cleft lip/palate-ectodermal dysplasia syndrome in an Asian patient.

    Science.gov (United States)

    Yoshida, Kazue; Hayashi, Ryota; Fujita, Hideki; Kubota, Masaya; Kondo, Mai; Shimomura, Yutaka; Niizeki, Hironori

    2015-07-01

    Cleft lip/palate-ectodermal dysplasia syndrome is a rare, autosomal recessive disorder caused by homozygous loss-of-function mutations of the poliovirus receptor-like 1 (PVRL1) gene encoding nectin-1. Nectin-1 is a cell-cell adhesion molecule that is important for the initial step in the formation of adherens junctions and tight junctions; it is expressed in keratinocytes, neurons, and the developing face and palate. Clinical manifestations comprise a unique facial appearance with cleft lip/palate, ectodermal dysplasia, cutaneous syndactyly of the fingers and/or toes, and in some cases, mental retardation. We present the first report, to our knowledge, of an Asian individual with cleft lip/palate-ectodermal dysplasia syndrome with a novel PVRL1 mutation. A 7-year-old Japanese boy, the first child of a consanguineous marriage, showed hypohidrotic ectodermal dysplasia with sparse, brittle, fine, dry hair and hypodontia, the unique facial appearance with cleft lip/palate, cutaneous syndactyly of the fingers and mild mental retardation. Scanning electron microscopic examination of the hair demonstrated pili torti and pili trianguli et canaliculi. Mutation analysis of exon 2 of PVRL1 revealed a novel homozygous nonsense mutation, c.400C>T (p.Arg134*). His parents were heterozygous for the mutant alleles. All four PVRL1 mutations identified in cleft lip/palate-ectodermal dysplasia syndrome to date, including this study, resulted in truncated proteins that lack the transmembrane domain and intracellular domain of nectin-1, which is necessary to initiate the cell-cell adhesion process.

  12. New trends in the complex treatment in the Cleft Centre in Bratislava.

    Science.gov (United States)

    Kokavec, R; Hedera, J; Fedeles, J; Janovic, J; Kratka, E; Klimova, I

    2001-01-01

    The last decade of the second millennium has brought some major changes into the concept of comprehensive treatment of the cleft lip and palate patients commonly accepted by the cleft center in Bratislava. Important events occurred, which surely had and in future they probably still would have an important impact on the comprehensive medical care of children with cleft lip and palate. There is beyond any doubt that an ongoing application of new trends in such fields as plastic surgery, anesthesiology, maxillofacial surgery, orthodontics, phonetics, speech therapy, paediatrics, human genetics or teratology will contribute to the progress and improvement of functional and aesthetic results and to better social adaptation of the cleft lip and palate patients. The study focuses on the following issues: cleft incidence, timing of the primary surgical repair, as well as the need of secondary operations (closures of communications, bone grafts, pharyngeal flaps, corrections of the lip and nose) and the achieved standard of speech quality and articulation, as well as on the early and late otological states and phonation. (Tab. 7, Fig. 3, Ref. 8.)

  13. An Extraoral Nasoalveolar Molding Technique in Complete Unilateral Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Qi Wang, PhD, DDS

    2013-07-01

    Full Text Available Summary: Although nasoalveolar molding is commonly performed before cleft lip surgery, customized palatal plate availability is limited for patients far from a hospital. This case report describes a preformed extraoral nasoalveolar molding (PENAM appliance and treatment approach for presurgical nasoalveolar molding in newborns with complete unilateral cleft lip and palate. A 12-day-old boy presented with complete unilateral cleft lip and palate. The PENAM device was supported by an adhesive-taped upper lip, which consisted of a lip nasal stent made from a 0.5-mm stainless steel wire. The spring was activated monthly. The shape of the cartilaginous septum, alar cartilage tip, medial crus, lateral crus, and alveolar segments was molded to resemble the normal shape of these structures. The 9.3-mm alveolar gaps were reduced and approximated. The approximation mostly came from the major alveolus segment with approximately 6.4-mm movement. Cleft side nostril height increased 5.5 mm and deviation of the columella was corrected by 42°. PENAM can be helpful in infants with unilateral cleft lip and palate because it has benefits for long-term forced delivery, requires less frequent activations, and is suitable for patients who live far from a hospital.

  14. Nostril Morphometry Evaluation before and after Cleft Lip Surgical Correction: Clinical Evidence

    Directory of Open Access Journals (Sweden)

    Feijo, Mario Jorge Frassy

    2014-01-01

    Full Text Available Introduction The purpose to this work is to review systematically the morphological changes of the nostrils of patients undergoing surgery for correction of cleft lip and identify in the literature the issues involved in the evaluation of surgical results in this population. Review of Literature A review was conducted, searching for clinical evidence from MEDLINE. The search occurred in January 2012. Selection criteria included original articles and research articles on individual subjects with cleft lip or cleft palate with unilateral nostril anthropometric measurements before and after surgical correction of cleft lip and measurements of soft tissues. There were 1,343 articles from the search descriptors and free terms. Of these, five articles were selected. Discussion Most studies in this review evaluated children in Eastern countries, using different measurement techniques but with the aid of computers, and showed improved nostril asymmetry postoperatively compared with preoperatively. Conclusion There is a reduction of the total nasal width postoperatively compared with preoperative measurements in patients with cleft lip.

  15. Analysis on the curative effect of orthodontic and orthognathic treatment for patients with dento-maxillofacial defor-mities after cleft lip and palate operation%关于正畸正颌联合治疗唇腭裂术后牙颌面畸形的疗效分析

    Institute of Scientific and Technical Information of China (English)

    倪国宇

    2016-01-01

    Objective:To observe and investigate the application effect of orthodontic and orthognathic treatment for patients with dento-maxillofacial deformities after cleft lip and palate operation.Methods:80 patients with dento-maxillofacial deformities after cleft lip and palate operation were selected.They were randomly divided into the two groups.The experimental group was treated with orthodontic and orthognathic treatment,while the control group was treated with orthodontic treatment.We observed the effect of the two groups.Results:In the experimental group,the restoration of dento-maxillofacial deformities was good;the teeth occlusal relationship improved;chewing function was also improved;deformity recurrence rate was significantly decreased.Conclusion:The effect of orthodontic and orthognathic treatment for patients with maxillofacial deformities after cleft lip and palate operation is significant.%目的:观察和探讨正畸正颌联合手术在唇腭裂术后的牙颌面畸形治疗中的应用效果。方法:收治唇腭裂术后牙颌面畸形的患者80例,随机平分为两组,试验组采取正畸正颌联合治疗,对照组采用正颌手术行矫正治疗,观察两组效果。结果:试验组的牙颌面畸形恢复状况良好,牙齿咬合关系改善,咀嚼功能提升,畸形复发率明显降低。结论:正畸正颌联合手术在治疗唇腭裂术后牙颌面畸形中效果显著。

  16. Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique

    OpenAIRE

    2012-01-01

    Objective. To compare the cutaneous lip height at early and late postoperative periods and to objectively determine the average amount of lip height improvement during the first year of unilateral complete cleft lip repair using Cutting extended Mohler technique. Methods. In this prospective cohort study, 26 unilateral complete cleft patients and 50 noncleft subjects were included. Photographs were taken between 12 and 16 weeks (T1) and also taken between 12 and 13 months after surgery (T2). ...

  17. Intraoperative and early postoperative complications using the buccal fat pad during cleft palate surgery in East Indonesia

    Directory of Open Access Journals (Sweden)

    Eveline Vere Konijnendijk

    2016-06-01

    Full Text Available Six baby’s with cleft are born in Indonesia every hour. There is no standardized treatment of cleft in East Indonesia. Closure is an important aspect during cleft lip and palate surgery. Various techniques have been advocated to gain tissue for closure of cleft area. Mostly these techniques may only provide a small amount of additional length. For lager defects they may be use the local flaps or the buccal fat pad flap. The aim of this study is gain more information about intraoperative and early postoperative complications using the buccal fat pat during cleft palate surgery in East Indonesia. The mouth can be divided in six parts therefor the LAHSAL index will be used. This LAHSAL system is a diagrammatic classification of cleft lip and palate. The LAHSAL system is being used for this study as this system classifies the cleft primarily on location and also on the cleft being complete or incomplete, which can be significant for the research. After diagnosis and classification, the following patient data was obtained: patient age, weight, gender, type of surgery (primary or following, i.e. when the surgery is a correction of a previous treatment, if a bone graft is needed for closure, history of maxillofacial surgery or orthodontics, operation technique, operation duration, type of an aesthesia (local or general, radiographical records and light photos. These data were collected during the pre-operative consultation, about 24 hours before surgery. It was the policy of the team to admit and see all patients one day prior to surgery for counselling, postoperative instructions and evaluating the patient's facial defect.

  18. A retrospective analysis of applications on protraction facemask for maxillary hypoplasia in cleft lip and palate patients%应用上颌前牵引治疗唇腭裂患者术后上颌发育不足的回顾分析

    Institute of Scientific and Technical Information of China (English)

    陈铮晰

    2012-01-01

    唇腭裂畸形是人类最常见的先天发育性缺陷之一.目前,唇腭裂手术是治疗畸形的主要手段,但术后患者常出现上颌发育不足,通常表现为面中部发育不足、凹陷,前牙反,严重影响了患者的面容美观和心理健康.上颌前牵引是通过牵引装置作用于上颌牙齿来刺激上颌骨周围4 个骨缝的改建,进而促进上颌骨向前移位,抑制下颌骨向前生长,改善凹陷的面型.本文就前方牵引治疗唇腭裂患者术后前牙反的报道作一综述.%Cleft lip and palate is one of the most common congenital craniofacial defects. At present, the optimal approach to treat it is operation. Maxillary retrusion which could be seen in cleft lip and palate patients after palate repair is characterized by the presence of concave profile, anterior crossbite and even psychological problems. Maxillary protraction can cause maxilla to move forward, inhibit mandible to move forward and improve the concave profile by stimulating 4 sutures in maxilla through a facemask. This article is to provide an overview of maxillary protraction in cleft lip and palate patients.

  19. 2012 American Board of Pediatric Dentistry College of Diplomates annual meeting: the role of pediatric dentists in the presurgical treatment of infants with cleft lip/cleft palate utilizing nasoalveolar molding.

    Science.gov (United States)

    Ahmed, Mohammad M; Brecht, Lawrence E; Cutting, Court B; Grayson, Barry H

    2012-01-01

    The pediatric dentist plays a crucial role in the treatment and management of infants born with cleft deformities of the lip, alveolus, and palate. At New York University Langone Medical Center in New York City, 70% of infants with cleft lip/cleft palate (CLCP) are detected on prenatal ultrasound analysis. Thus, the role of the pediatric dentist can start as early as prenatal counseling. Nasoalveolar molding (NAM) is delivered during the first 3 to 5 months of life. During this stage of treatment, the pediatric dentist establishes the foundation of the “cleft dental” home and initiates the first stage of anticipatory guidance. Consequently, parents are educated and motivated to initiate oral hygiene care upon eruption of the first primary teeth. The purpose of this paper was to describe the role of the pediatric dentist in performing nasoalveolar molding and also describe its indications, appliance design, fabrication, biomechanics, complications, and patient management.

  20. Evaluation of the lesions of synovial-lined clefts in the Hoffa's infrapatella fat pad with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Min Sun; Park, Jin Gyoon; Kim, Young Cheol; Hwang, Eai Hong; Joo, Jung Hyun; Chung, Tae Woong; Kang, Heoung Keun [Chonnam Univ., College of Medicine, Kwangju (Korea, Republic of); Oh, Hee Yeon [Namkwang Hospital, Kwangju (Korea, Republic of)

    1998-09-01

    Within Hoffa's infrapatellar fat pad there are two synovial clefts, horizontal and vertical, which communicate with the intra-articular space. Intra-articular lesions can also occur in these clefts, and are often difficult to differentiate from extra-articular lesions. The purpose of this study is to evaluate, using MR imaging, the lesions occurring in these synovial lined clefts, as well as associated abnormalities. Thirty-one knees of 31 patients with lesions in horizontal and vertical clefts in Hoffa's infrapatellar fat pad were retrospectively evaluated. Using a 1.5T MR imager, axial, sagittal, and coronal MR images of knees were obtained. Lesions in clefts, degree of joint effusion and associated knee abnormalities were analyzed. Horizontal cleft lesions were noted in 21 cases; there were 17 cystic dilatations, two loose bodies, one synovial chondroma, and one case of pigmented villonodular synovitis(PVNS). Vertical cleft lesions were noted in 15 cases; these comprised 11 cystic dilatations, two loose bodies, one synovial osteochondromatosis, and one PVNS. Among all cases, three cystic dilatations, one loose body, and one PVNS occurred in both horizontal and vertical clefts. Among 25 knees with cystic dilatations of clefts, five showed grade 1, joint effusion, ten grade 2, and ten grade 3, Associated abnormalities were meniscal tear in 16 cases, osteoarthritis in 13, cruciate ligament tear in five, osteochondritis dissecans in three, osteochondral fracture in two, osteonecrosis in one, loose body in one, and synovitis in one. Among synovial-lined clefts in Hoffa's fat pad, the most common lesion was cystic dilatation;there were various associated abnormalities and a close relationship to joint effusion. An awareness of the types of lesions found in clefts is helpful for narrowing the differential diagnosis of lesions occurring in the area of Hoffa's fat pad.=20.

  1. Cephalometric evaluation of adenoids, upper airway, maxilla, velum length, need ratio for determining velopharyngeal incompetency in subjects with unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Avinash Gohilot

    2014-01-01

    Full Text Available Objectives: Children with cleft lip and palate (CLP are seen to have reduced airway size and large adenoids, which might lead to different characteristics in the upper airway and surrounding tissues from both morphological and functional perspectives. Decrease in adenoid size and increase in need ratio in cleft patients might lead to velopharyngeal incompetency (VPI and development of nasality in adulthood. No studies have been conducted on the Indian population with variables contributing to VPI. So the aim was to evaluate the size and position of the adenoids, upper airway, maxilla, velum length and need ratio contributing to VPI in subjects with and without unilateral cleft lip and palate (UCLP during juvenile and adolescent stages. Materials and Methods: Cephalograms of 120 subjects with 6-17 years were taken and various linear and angular measurements were measured and data was analyzed using the unpaired t test. Results: Adenoids were significantly larger and the upper airway smaller in the juvenile and adolescent cleft group than in the non-cleft group. In the adolescent cleft group, airway was larger than that in the adolescent non-cleft group. The maxilla was small and retropositioned in juvenile and adolescent subjects as compared to non cleft cases. Length of velum was smaller and need ratio was larger in both juvenile and adolescent groups as compared to the non-cleft group, suggestive of velopharyngeal incompetence. Conclusion: Decreased Adenoids, restricted airway, small, retruded maxilla, smaller velum length and larger need ratio larger were seen in the cleft group as compared to the non-cleft group, which was suggestive of VPI.

  2. Evaluation of fecal microorganisms of children with cleft palate before and after palatoplasty

    Directory of Open Access Journals (Sweden)

    Narciso Almeida Vieira

    2013-09-01

    Full Text Available This study isolated and quantified intestinal bacteria of children with cleft palate before and after palatoplasty. A prospective study was conducted from May 2007 to September 2008 on 18 children with cleft palate, aged one to four years, of both genders, attending a tertiary cleft center in Brazil for palatoplasty, to analyze the effect of surgical palate repair on the concentration of anaerobes Bacteroides sp, Bifidobacterium sp and microaerophiles Lactobacillus sp in feces of infants with cleft palate before and 24 hours after treatment with cefazolin for palatoplasty. There was significant reduction of Lactobacillus sp (p < 0.002, Bacteroides sp (p < 0.001 and Bifidobacterium sp (p = 0.021 after palatoplasty, revealing that surgery and utilization of cefazolin significantly influenced the fecal microbiota comparing collections before and after surgery. However, due to study limitations, it was not possible to conclude that other isolated factors, such as surgical stress, anesthetics and other medications used in palatoplasty might have a significant influence on the microbiota. Considering the important participation of the intestinal microbiota on both local and systemic metabolic and immunological activities of the host, professionals should be attentive to the possible influence of these changes in patients submitted to cleft repair.

  3. Haploinsufficiency of MEIS2 is associated with orofacial clefting and learning disability.

    Science.gov (United States)

    Johansson, Stefan; Berland, Siren; Gradek, Gyri Aasland; Bongers, Ernie; de Leeuw, Nicole; Pfundt, Rolph; Fannemel, Madeleine; Rødningen, Olaug; Brendehaug, Atle; Haukanes, Bjørn Ivar; Hovland, Randi; Helland, Gunnar; Houge, Gunnar

    2014-07-01

    MEIS2 is a homeodomain-containing transcription factor of the TALE superfamily that has been proven important for development. We confirm and extend a recent single clinical report stating that deletions in MEIS2 can cause cleft palate [Crowley et al. (2010); Am J Med Genet 152A:1326-1327]. Here we report on five additional patients with 15q14 deletions of sizes 0.6, 0.6, 1.0, 1.9, and 4.8 Mb, respectively, all involving MEIS2. In addition, we present a family with four affected individuals and an intragenic 58 kb direct duplication disrupting MEIS2. In total, 7/9 cases had clefting, from mild (submucous cleft palate) to severe (cleft lip and palate), and 3/9 cases had ventricular septal defects. All cases had delayed motor development and most had learning disability, at worst in the mild intellectual disability range. The cases had overlapping facial features (broad forehead, finely arched eyebrows, mildly shortened philtrum, and tented upper lip) but individually they were not considered to be dysmorphic. Our results show that MEIS2 is a gene needed for palate closure. In syndromic cases of cleft palate, MEIS2 should be considered among the candidate genes, for example, in cases without 22q11.2 deletions.

  4. White Roll Vermilion turn down flap in primary unilateral cleft lip repair: A novel approach

    Directory of Open Access Journals (Sweden)

    R K Mishra

    2015-01-01

    Full Text Available Aim: Numerous modifications of Millard′s technique of rotation - advancement repair have been described in literature. This article envisions a new modification in Millard′s technique of primary unilateral chieloplasty. Material and Methods: Eliminating or reducing the secondary deformities in children with cleft lip has been a motivating factor for the continual refinement of cleft lip surgical techniques through the years. Vermilion notching, visibility of paramedian scars and scar contracture along the white roll are quite noticeable in close-up view even in good repairs. Any scar is less noticeable if it is in midline or along the lines of embryological closure. White Roll Vermilion turn down Flap (WRV Flap, a modification in the Millard′s repair is an attempt to prevent these secondary deformities during the primary cleft lip sugery. This entails the use of white roll and the vermilion from the lateral lip segment for augmenting the medial lip vermilion with the final scar in midline at the vermilion. Result: With an experience of more than 100 cases of primary cleft lip repair with this technique, we have achieved a good symmetry and peaking of cupid′s bow with no vermilion notching of the lips. Conclusion: WRV flap aims to high light the importance of achieving a near normal look of the cleft patient with the only drawback of associated learning curve with this technique.

  5. Straight line repair of unilateral cleft lip: new operative method based on 25 years experience.

    Science.gov (United States)

    Nakajima, T; Tamada, I; Miyamoto, J; Nagasao, T; Hikosaka, M

    2008-08-01

    The resultant scar in the primary repair of unilateral cleft lip should ideally be straight and the mirror image of the philtrum on the non-cleft side. In 1993, we reported a new operative technique for unilateral cleft lip, in which we designed a straight line for the incision on the white lip. In order to produce the nostril floor, we used the white lip tissue in the area between the alar base and alveolus at the cleft side as a flap. We also used a small triangular flap above the white skin roll to prevent Cupid's peak from being drawn up. Unlike the rotation-advancement method, our technique does not leave a transverse scar at the alar base. Instead, it leaves a scar only along the line coincident with the natural philtral ridge. However, during observations of our patients, we noticed that the small triangular flap designed to be 1.5mm tended to become a conspicuous angular scar as the patients grew older. In addition, drooping of Cupid's peak on the cleft side was often observed with this small triangular flap. To make it less conspicuous, we made some modifications to the small flap above the white skin roll. With this new technique, we designed a semi-circular flap (1.5 x 3mm) above the white skin roll, instead of the small triangular flap. The suture line of our refined procedure draws a gentle curve, which looks almost straight because of skin elasticity. Moreover, the semi-circular flap causes less drooping of the upper lip than the triangular flap. We believe that revising the shape of the small flap on the white skin roll greatly improves patients' appearance. In this report, we present our refined techniques of primary repair of unilateral cleft lip.

  6. Lexical selectivity in Danish toddlers with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2013-01-01

    Objective: To study if Danish toddlers with cleft palate display lexical selectivity in their early lexicon at 18 months of age. Design: A cross-sectional study. Participants: Thirty-four children with unilateral cleft lip and palate and 35 children without cleft palate, matched for gender and age...... productions establishing an observed productive vocabulary size for each participant. Results: At 18 months of age Danish toddlers with cleft palate showed marked lexical selectivity in their early words. The distribution of consonant classes observed at 11 months of age in a previous study of the children...... with cleft palate was almost perfectly reflected in their early lexicon at 18 months. The early lexicon of children with cleft palate differed from the early lexicon of their non cleft peers. Conclusions & Implications: Danish toddlers with cleft palate display lexical selectivity in the early lexicon...

  7. Dermatoglyphic peculiarities in children with oral clefts

    Directory of Open Access Journals (Sweden)

    Mathew L

    2005-01-01

    Full Text Available In humans, the development of the primary palate and the lip is completed by the 7th week of intra uterine life and that of secondary palate by 12th week. The dermal ridges develop in relation to the volar pads, which are formed by the 6th week of gestation and reach maximum size between 12th and 13th weeks. This means that the genetic message contained in the genome - normal or abnormal is deciphered during this period and is also reflected by dermatoglyphics.Hence this study was done in order to observe the differences in dermatoglyphic patterns between the children with oral clefts and normal children and to determine the usefulness of dermatoglyphics in studying the genetic etiology of oral clefts.Dermatoglyphic data from 50 oral cleft children and 50 normal children were collected using the ink method and comparison was done between them. In the present study, we found an increase in the ulnar loop patterns on the distal phalanges of the ten fingers, an increase in the atd angle and an increase in the fluctuating asymmetry of the atd angle in the oral cleft children which indicates the degree of developmental instability of the oral cleft individual.

  8. Cleft palate caused by congenital teratoma.

    Science.gov (United States)

    Veyssière, Alexis; Streit, Libor; Traoré, Hamady; Bénateau, Hervé

    2017-02-01

    A cleft palate results from incomplete fusion of the lateral palatine processes, the median nasal septum and the median palatine process. This case report describes a rare case of congenital teratoma originating from the nasal septum that may have interfered with the fusion of the palatal shelves during embryonic development, resulting in a cleft palate. An infant girl was born at 40 weeks of gestation weighing 3020 g with a complete cleft palate associated with a large central nasopharyngeal tumour. Computed tomography (CT) of the head showed a well defined mass of mixed density. The tumour was attached to the nasal septum in direct contact with the cleft palate. A biopsy confirmed the teratoma. Tumour resection was performed at 5 months, soft palate reconstruction at 7 months and hard palate closure at 14 months. There was no sign of local recurrence 1 year later. Most teratomas are benign and the prognosis is usually good. However, recurrence is not rare if germ cell carcinomatous foci are present within the teratoma. For these reasons, we advocate the use of a two-stage procedure in which closure of the cleft palate is postponed until histological examination confirms complete excision of the teratoma.

  9. Congenital Palatal Fistula Associated with Submucous Cleft Palate

    OpenAIRE

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H. Wolfgang; Spiess, Alexander M.

    2016-01-01

    Background: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and managemen...

  10. Modified Intraoral Repositioning Appliance in Complete Bilateral Cleft Lip and Palate

    OpenAIRE

    Raghav, Pradeep; Ahuja, NK; Gahlawat, Subhash

    2010-01-01

    Objective The purpose of the modified repositioning appliance was to overcome the shortcoming of existing design for repositioning protruded premaxilla in a child with bilateral cleft lip and palate. Methods The basic principles of design were similar to Latham’s appliance but the surgical pinning of premaxillary segment was avoided and instead acrylic splint was prepared. Conclusions This technique avoids any invasive procedure, is useful to reposition protruded premaxillary segment in bilat...

  11. Reconstruction during phase II of unilateral cleft lip improving function of musculus orbicularis oris%单侧唇裂Ⅱ期整复改善口轮匝肌功能

    Institute of Scientific and Technical Information of China (English)

    马新亮; 陈传俊; 韩立显

    2002-01-01

    @@ Background:Nasolabial deformity secondary to operation of cleft lip seriously affect patients' physiological and psychological function.Plasticity or reposition of musculus orbicularis oris received more attention in recent years.Since 1995,nasolabial deformity secondary to operation of unilateral complete cleft lip was reduced in 17 patients,and therapeutic effect is satisfying.

  12. Isolated congenital palatal fistula without submucous cleft palate.

    Science.gov (United States)

    Karacan, Mehmet; Olgun, Haşim; Tan, Onder; Caner, Ibrahim

    2009-09-01

    Congenital fistula of the palate is a rare deformity. It has been generally associated with cleft palate. Treatment of cleft palate is surgical intervention. We present a child with congenital fistula of palate that was not associated with submucous cleft and closed spontaneously at 18 months.

  13. Parent and child ratings of satisfaction with speech and facial appearance in Flemish pre-pubescent boys and girls with unilateral cleft lip and palate.

    Science.gov (United States)

    Van Lierde, K M; Dhaeseleer, E; Luyten, A; Van De Woestijne, K; Vermeersch, H; Roche, N

    2012-02-01

    The purpose of this controlled study is to determine satisfaction with speech and facial appearance in Flemish pre-pubescent children with unilateral cleft lip and palate. Forty-three subjects with unilateral cleft lip and palate and 43 age and gender matched controls participated in this study. The Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Both the cleft palate subjects and their parents were satisfied with the speech and facial appearance. The Pearson χ(2) test revealed significant difference between the cleft palate and the control group regarding hearing, nasal aesthetics and function, and the appearance of the lip. An in depth analysis of well specified speech characteristics revealed that children with clefts and their parents significantly more often reported the presence of an articulation, voice and resonance disorder and experienced /s/ /r/ /t/ and /d/ as the most difficult consonants. To what extent the incorporation of specific motor oriented oral speech techniques regarding the realisation of specific consonants, attention to vocal and ear care, and the recommendation of secondary velopharyngeal surgery, with the incorporation of primary correction of the cleft nose deformity simultaneously with primary lip closure, will aid these patients are future research subjects.

  14. Expanding the phenotypic spectrum of Lenz-Majewski syndrome: facial palsy, cleft palate and hydrocephalus.

    Science.gov (United States)

    Wattanasirichaigoon, Duangrurdee; Visudtibhan, Anannit; Jaovisidha, Suphaneewan; Laothamatas, Jiraporn; Chunharas, Amornsri

    2004-07-01

    We report a sporadic case of Lenz-Majewski syndrome (LMS) with newly recognized manifestations including facial palsy, cleft palate and hydrocephalus developing later in infancy. The clinical course of the patient and neuroimaging studies are described. Increased intracranial pressure was recognized and treated early with the aim of preventing neurological morbidity.

  15. Reliability of linear measurements on a virtual bilateral cleft lip and palate model

    NARCIS (Netherlands)

    Oosterkamp, B.C.M.; van der Meer, W.J.; Rutenfrans, M.; Dijkstra, P.U.

    2006-01-01

    Objective: To assess the reliability and validity of measurements performed on three-dimensional virtual models of neonatal bilateral cleft lip and palate patients, compared with measurements performed on plaster cast models. Materials and Methods: Ten high-quality plaster cast models of bilateral c

  16. 三维测量分析单侧完全性唇腭裂术后成年患者的上颌骨形态%Three-dimensional measurement and analysis of maxillary morphology in postoperative adult-patients with unilateral complete cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    李宏权; 杨育生; 王国民; 余锦豪; 唐小山; 杨华伟

    2012-01-01

    PURPOSE: To use spiral CT aided with SimPlantll.04 software to 3-d reconstruct, measure and analyze the malformed maxillae in postoperative adult patients with unilateral complete cleft lip and palate. METHODS: 30 maxillae of adult patients(17 men , 13 women ,mean age was 19.07 years) who underwent repair of unilateral complete cleft lip and palate were scanned and three -dimensionally reconstructed 35 landmarks were marked,the reproducibility of the landmarks was confirmed and the distances between landmarks and the 3 -D coordinate system was measured and analyzed with spiral CT aided with SimPlantll.04. SAS 6.12 software package was used for statistical analysis. RESULTS: There was perfect reproducibility for all 35 landmarks (P>0.05). Mean distances and standard deviations from patients' landmarks to three -dimensional coordinate planes were gained. Among 7 centered landmarks, A and ANS significantly deviated to noncleft side (P<0.01).The asymmetric ratio between cleft sides and noncleft sides in symmetric landmarks demonstrated that there were remarkable asymmetric deformity at the distance to coordinate sagittal plane S between INM'-INM, SNM'- SNM and SPr'-SPr landmarks. However, there was no asymmetric deformity in three-dimensional directions among MA' -MA, SoF' -SoF and LPAC-LPA landmarks in infraorbital region and piriform aperture peritreme. The data showed that the cleft sides were hypoplastic compared with the noncleft sides as well as patients' maxillae compared with normal adults, especially in posterior -anterior direction. CONCLUSION: The method of measuring maxillary morphology by spiral CT aided with SimPlant 11.04 software could precisely measure the distances from landmarks to 3-D coordinate system, which could be used for evaluating maxillary deformity between cleft side and noncleft side of adults' patients' maxilla before operation. Supported by Shanghai Leading Academic Discipline Project (S30206).%目的:探讨单侧完全性唇腭裂术

  17. The Fetal Cleft palate: V. Elucidation of the Mechanism of Palatal Clefting in the Congenital Caprine Model

    Science.gov (United States)

    Maternal ingestion of Nicotiana glauca from gestation days 32 through 41 results in a high incidence of cleft palate in Spanish goats. This caprine cleft palate model was used to evaluate the temporal sequence of palatal shelf fusion throughout the period of cleft induction with the poisonous plant...

  18. Stability of reverse headgear treatment in unilateral cleft lip and palate patients with crossbite%单侧完全性唇腭裂前方牵引治疗后的稳定性研究

    Institute of Scientific and Technical Information of China (English)

    李巍然; 傅振; 王爱萍; 周琳

    2013-01-01

    Objective To investigate the stability of unilateral cleft lip and palate patients with crossbite after reverse headgear treatment Methods 18 unilateral cleft lip and palate patients with anterior crossbite before growth spurt were treated with reverse headgear and followed after treatment for (2.71± 0.77) years.The average age of the patients was (9.63±1.24) years before treatment.All patients had positive overjet after treatment.12 patients remained in the study after two years' of follow-up.Cephalograms of before (T0),after (T1) reverse headgear treatment and at least two years follow-up(T2) were taken for each patient.9 angular and 15 linear measurements were analyzed.Paired t test and stepwise regression were done to compare the differences in dentofacial structures.Results NA-PA decreased by 2.92°±3.52° (P<0.05)、OJ decreased by (2.83±3.83) mm (P<0.05),and L1-TL,B-TL,Po-TL increased by (1.38±4.22) mm (P<0.05),(1.29±4.85) mm (P<0.05),(1.79±5.18) mm (P<0.05) after two years' follow up.The measurement of facial height (N-ME,ANS-ME,S-GO) increased by (5.33±3.11) mm (P<0.01),(5.42±2.61) mm (P< 0.01) and (5.25±3.79) mm (P<0.01) during the follow up.After 2.71±0.77 years' follow up the SNA,ANB,NA-PA,U1-SN,Y-axis,MP-SN remained larger and the L1-MP,OP-SN,and UL-U1 were smaller than that of pretreatment.Compared to that of the pretreatment U1-TL,A-TL and overjet increased by (5.38±2.79) mm (P<0.01)、(3.13±1.60) mm (P<0.01)、(4.78±2.96) mm (P<0.01) when recalled.While LT-TL,B-TL,PO-TL,UL-EL showed no significant difference compared to pretreatment.Overjet relapse amount (T2-T1) was chosen as the dependent factor,the predict equation was:20.43-1.172OJT1-T0-0.548 L1-T1-T0-0.229U6-PPT1-T0 (R2 =0.969).Conclusions Relapse after reverse headgear treatment in UCLP patients was mainly due to the excessive growth of mandible during pubertal period,and the maxillary forward movement caused by treatment remained stable.%目的 通过对

  19. Intensive care and pregnancy: Epidemiology and general principles of management of obstetrics ICU patients during pregnancy.

    Science.gov (United States)

    Zieleskiewicz, Laurent; Chantry, Anne; Duclos, Gary; Bourgoin, Aurelie; Mignon, Alexandre; Deneux-Tharaux, Catherine; Leone, Marc

    2016-10-01

    In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary. This team must work effectively together with regular staff aiming to evaluate daily the need to maintain the patient in intensive care unit or to prompt delivery. Keeping mother and baby together and fetal well-being must be balanced with the need of specialized advanced life support for the mother. The maternal physiological changes imply various consequences on management. The uterus aorto-caval compression implies tilting left the parturient. In case of cardiac arrest, uterus displacement and urgent cesarean delivery are needed. The high risk of aspiration and difficult tracheal intubation must be anticipated. Even during acute respiratory distress syndrome, hypoxemia and permissive hypercapnia must be avoided due to their negative impact on the fetus. Careful analysis of the benefit-risk ratio is needed before all drug administration. Streptococcal toxic shock syndrome and perineal fasciitis must be feared and a high level of suspicion of sepsis must be maintained. Finally the potential benefits of an ultrasound-based management are detailed.

  20. Incorporating the principles of the patient- centered medical home into a student-run free clinic

    Directory of Open Access Journals (Sweden)

    Riddle MC

    2014-09-01

    Full Text Available Megan C Riddle,1,* Jiahui Lin,3,* Jonathan B Steinman,2 Joshua D Salvi,2 Margaret M Reynolds,3 Anne S Kastor,3,† Christina Harris,4 Carla Boutin-Foster3 1Department of Psychiatry and Behavioral Sciences, University of Washington, 2Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program, 3Department of Internal Medicine, Weill Cornell Medical College, New York, NY, 4Department of Medicine, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, LA, USA *These authors contributed equally to this work †Anne S Kastor passed away on July 5, 2013. Abstract: As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC, a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87

  1. Occipital meningoencephalocele with Cleft Lip, Cleft Palate and Limb Abnormalities- A Case Report.

    Science.gov (United States)

    Ganapathy, Arthi; T, Sadeesh; Swer, Mary Hydrina; Rao, Sudha

    2014-12-01

    A 21-week-old still born female fetus with occipital encepholocele, cleft lip and cleft palate was received from the Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry and was studied in detail. It was born to Primigravida, of a second degree consanguineous marriage, with unremarkable family history. The biometric measurements were noted which corresponded to the age of the fetus. Further the fetus was embalmed and dissected. On examination an encephalocele of 2.7×1.5 cm was seen in the occipital region with a midline defect in the occipital bone and herniated brain tissue. Other anomalies observed were right unilateral cleft lip, right cleft palate, and bilateral syndactyly of the lower limbs and associated Congenital Talipus Equino Varus of the right foot. Other internal organs were developed appropriate for the age of the fetus.

  2. The incidence, classification, etiology, and embryology of oral clefts.

    Science.gov (United States)

    Thornton, J B; Nimer, S; Howard, P S

    1996-09-01

    There are numerous problems encountered among individuals with a cleft lip and/or cleft palate. Addressing these problems necessitates a multidisciplinary approach, requiring a team of experts to facilitate care for these individuals. Dentists play a vital role on the team. An orthodontist, pediatric dentist, oral maxillofacial surgeon, and prosthodontist usually represent the dental members of the team. The success of this team depends on expertise within each discipline but also depends on each member having a broad base of knowledge in general about oral clefts. An understanding of other disciplines and how they approach the treatment of oral clefts is important for each team member. Also, each team representative should appreciate the need to understand the causes of oral clefts, how clefts develop in utero, how various populations are affected, and how to recognize and classify an oral cleft. It is difficult to communicate effectively within the team if we fail to recognize the importance of expanding our knowledge to include other aspects of oral clefts beyond treatment perspectives. This article provides the orthodontist with basic information as it relates to the etiology of oral clefts (ie, genetics, teratogens, and medical conditions), the demographics and incidence of oral clefts, the embryology and classification of clefts.

  3. Fetal genetic risk of isolated cleft lip only versus isolated cleft lip and palate: A subphenotype analysis using two population-based studies of orofacial clefts in scandinavia

    DEFF Research Database (Denmark)

    Jugessur, Astanand; Shi, Min; Gjessing, Håkon Kristian

    2010-01-01

    BACKGROUND: Cleft lip only (CLO) and cleft lip and palate (CLP) are commonly regarded as variants of the same defect and are traditionally combined to form the single group of cleft lip with or without cleft palate (CL/P) prior to analysis. However, recent data have suggested that at least...... a subgroup of isolated CLO may be etiologically distinct from isolated CLP. METHODS: To explore fetal genetic risk of isolated CLO separately from isolated CLP, we performed a subphenotype analysis using two population-based studies of clefts in Scandinavia. One hundred twenty-one isolated CLO, 190 isolated...... CLP, and 592 control triads were available from Norway (1996-2001), and a further 76 isolated CLO and 107 isolated CLP triads were available from Denmark (1991-2001). Genotypes for 1315 SNPs in 334 autosomal cleft candidate genes were analyzed using two complementary statistical methods, Triad Multi...

  4. Lexical selectivity in danish toddlers with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2013-01-01

    Objective : To study if Danish children with cleft palate display lexical selectivity in their early lexicon at 18 months of age. Design : A cross-sectional study. Participants : Thirty-four children with unilateral cleft lip and palate and 35 children without cleft palate, matched for gender...... also analyzed with respect to word productions, establishing an observed productive vocabulary size for each participant. Results : At 18 months of age Danish children with cleft palate showed marked lexical selectivity in their early words. The distribution of consonant classes observed at 11 months...... of age in a previous study of the children with cleft palate was almost perfectly reflected in their early lexicon at 18 months. The early lexicon of children with cleft palate differed from the early lexicon of their noncleft peers. Conclusions and Implications : Danish toddlers with cleft palate...

  5. Cleft Lip and Palate (For Parents)

    Science.gov (United States)

    ... to latch on and suck during breastfeeding or bottle feeding. As a result, a baby with a cleft palate may need a special nipple and bottle to receive pumped breast milk or formula. ... with feeding issues should be seen regularly by a doctor ...

  6. Neuroembryology and functional anatomy of craniofacial clefts

    Directory of Open Access Journals (Sweden)

    Ewings Ember

    2009-10-01

    Full Text Available The master plan of all vertebrate embryos is based on neuroanatomy. The embryo can be anatomically divided into discrete units called neuromeres so that each carries unique genetic traits. Embryonic neural crest cells arising from each neuromere induce development of nerves and concomitant arteries and support the development of specific craniofacial tissues or developmental fields. Fields are assembled upon each other in a programmed spatiotemporal order. Abnormalities in one field can affect the shape and position of developing adjacent fields. Craniofacial clefts represent states of excess or deficiency within and between specific developmental fields. The neuromeric organization of the embryo is the common denominator for understanding normal anatomy and pathology of the head and neck. Tessier′s observational cleft classification system can be redefined using neuroanatomic embryology. Reassessment of Tessier′s empiric observations demonstrates a more rational rearrangement of cleft zones, particularly near the midline. Neuromeric theory is also a means to understand and define other common craniofacial problems. Cleft palate, encephaloceles, craniosynostosis and cranial base defects may be analyzed in the same way.

  7. CLEFT-PALATE REPAIR - FURLOW VERSUS VONLANGENBECK

    NARCIS (Netherlands)

    SPAUWEN, PHM; GOORHUISBROUWER, SM; SCHUTTE, HK

    1992-01-01

    The Furlow cleft palate repair using a double opposing Z-plasty appears to be very promising. In order to detect advantages and disadvantages concerning the technique as well as speech- and hearing results, the Furlow palatoplasty was compared with the classical von Langenbeck technique. Data analys

  8. Real -time 3D ultrasound prenatal diagnosisof the clinical significance of fetal typical facial cleft deformity%实时三维超声产前诊断胎儿典型面裂畸形的临床意义

    Institute of Scientific and Technical Information of China (English)

    龚海英; 李琴; 艾明义

    2012-01-01

    Objective; To determine the value of Real - time 3D ultrasound prenatal diagnosis of the clinical significance of fetal for typical facial cleft deformity Improving the diagnosticaccuracy of fetal cleft lipand/or palate cleft. Methods; Application of real - time three dimensional echocardiography prenatal fetal normal fetal cleft lip and palate cleft lip and palate parts of two - dimension control. Result; 10 cases of normal fetal lip display rates 100% , On alveolar show 100% , and palate, 70% (7/10) . 10 cases of fetal cleft lip and palate cleft lip includes 7 simple, merge hard on 1 case of cleft lip and palate and 1 cleft lip patients with cleft of soft palate. Real - time 3D diagnostic all 7 example simple cleft palates, diagnostic rate 100% . Diagnosis of unilateral cleft lip with cleft palate in 1 case. There are 1 case of unilateral cleft lip with cleft palate only diagnosis and missed diagnosis of cleft lip and cleft palate, diagnosed in 70% ( Seven - tenths). 1 cases of cleft lip with cleft of soft palate only soft diagnosis and missed diagnosis of cleft lip and cleft palate. Conclusions: Real - time three dimensional echocardiography prenatal diagnosis of fetal cleft lip, especially hard and alveolar process cleft lip with cleft palate diagnostic has a large value, but on the fetus are not merged alveolar cleft of the soft palate and some of the hard palate to make diagnosis and still has a great deal of difficulty.%目的 探讨实时三维超声产前诊断胎儿面裂畸形的临床意义,寻求提高胎儿唇腭裂诊断准确性的有效方法.方法 应用实时三维超声产前对面裂畸形;唇腭裂胎儿和正常胎儿唇腭部位的二维进行对照.结果 10例正常胎儿面部显示率100%,上牙槽突显示率100%,硬腭显示率70% (7/ 10).10例唇腭裂胎儿包括7例单纯唇裂,2例上唇裂合并硬腭裂和1例唇裂合并软腭裂.实时三维诊断了所有7例单纯唇裂,诊断率100%;诊

  9. Fetal cleft lip with and without cleft palate: Comparison between MR imaging and US for prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Wang Guangbin, E-mail: wgb7932596@hotmail.com [Shandong Medical Imaging Research Institute, 324 Jingwu Road, Jinan, 250021 (China); Shan Ruiqin [Jinan Maternity and Child Care Hospital, Jinan (China); Zhao Lianxin; Zhu Xiangyu; Zhang Xinjuan [Shandong Medical Imaging Research Institute, 324 Jingwu Road, Jinan, 250021 (China)

    2011-09-15

    Objective: To describe the magnetic resonance (MR) imaging findings of fetal CL/CP and evaluate its diagnostic value. Methods and materials: Twelve fetuses with CL/CP diagnosed by transabdominal US underwent MR imaging within 2 days of US. Half-Fourier acquisition single-shot turbo spin echo (HASTE) sequence on T2-weighted images was performed on sagittal, coronal, and axial planes anatomic to the fetuses during maternal breath holding. US and MR imaging findings were compared with final diagnoses obtained from post-natal physical examination or fetal autopsy. Results: Final diagnoses confirmed incomplete midline cleft lip (n = 1), unilateral cleft lip and palate (n = 7), bilateral cleft lip and palate (n = 1), midline cleft lip and palate (n = 3). US and MR imaging diagnosed all 12 fetuses with cleft lip and the laterality. 5 (45.5%) of 11 cleft palates were identified with US, 2 of 7 fetuses with unilateral cleft palate, 2 of 3 fetuses with midline cleft palate, and one fetus with bilateral cleft palate. On MR imaging, 10 (91%) of 11 cleft palates were correctly detected. One fetus with unilateral cleft palate was not detected. No false-positives occurred. Conclusion: MR imaging is valuable for diagnosis of fetal CL/CP. It can demonstrate additional findings and provide more information compared with US.

  10. Considerations on morphological abnormalities of permanent teeth in children with cleft lip and palate.

    Science.gov (United States)

    Răducanu, Anca Maria; Didilescu, Andreea Cristiana; Feraru, Ion Victor; Dumitrache, Mihaela Adina; Hănţoiu, Tudor Alexandru; Ionescu, Ecaterina

    2015-01-01

    Oral clefts are commonly associated with dental anomalies of number, size, shape, structure, position and eruption affecting both dentitions. Dental malformations may affect the development, growth and functions of the dento-maxillary apparatus (chewing, aesthetics, speech). The purpose of this paper was to assess the dental morphological variations in a group of patients with cleft lip and/or palate (CLP), as compared with a group of healthy subjects. The study sample included 48 patients with various types of CLP (15 girls and 33 boys) aged between 12.6 years and 17.3 years. The control group (without CLP) consisted of 1447 patients (545 girls and 903 boys). The proportion of patients with dental shape anomalies in the control group was 8.6%, while the proportion of patients with dental shape anomalies in the CLP group was 56.3% (pdental hemiarch affected by CLP were most affected in their morphology.

  11. A modified procedure for velopharyngeal sphincteroplasty in primary cleft palate repair and secondary velopharyngeal incompetence treatment and its preliminary results.

    Science.gov (United States)

    Cheng, Ningxin; Zhao, Min; Qi, Kemin; Deng, Hui; Fang, Zeng; Song, Ruyao

    2006-01-01

    During cleft repair, velopharyngeal sphincter reconstruction is still a challenge to plastic surgeons. To improve the surgical treatment for cleft palate and secondary velopharyngeal incompetence (VPI), a carefully designed modified procedure for primary palatoplasty and secondary VPI was presented. Fifty-six patients (48 for primary cleft palate repair and eight for secondary VPI of previously repaired clefts) underwent this procedure from 1988 to 2001. The modified procedure is a combination of the tunnelled palatopharyngeus myomucosal flap for dynamic circular reconstruction of the pharyngeal element of the velopharyngeal sphincter and the double-reversing Z-plasty with levator velo palatini muscles reposition in the velar element of the sphincter. The satisfactory velopharyngeal competence (complete velopharyngeal closure and marginal velopharyngeal closure) was achieved in 23 of 25 patients with primary cleft palate repair examined by nasendoscopy and the nasality, speech articulation and intelligibility are also assessed in 25 primary cleft palate repaired patients with 92% satisfactory result (normal speech and speech with mild VPI) in single word test and 88% in continuous speech evaluation. Based on our experience, we believe that this modified procedure is a reasonable choice for primary cleft repair and secondary VPI treatment because it is in accord with normal physiology and anatomy of the velopharyngeal sphincter, can lengthen the soft palate, decrease the enlarged velopharynx, augment the posterior pharyngeal wall, and enhance the relationship between the muscles of velopharyngeal sphincter which results in a dynamic neo-sphincter in palatopharyngoplasty. Further study of the procedure is needed. The theoretical basis, operative highlights, velopharyngeal function, advantages and disadvantages of the modified procedure were discussed.

  12. Review of the role of potential teratogens in the origin of human nonsyndromic oral clefts.

    Science.gov (United States)

    Wyszynski, D F; Beaty, T H

    1996-05-01

    Oral clefts are common birth defects affecting approximately 1 every 1,000 caucasian newborns. While many syndromes with cleft lip with or without cleft palate (CL/P) or with cleft palate (CP) are recognized, the majority of oral clefts fall into the category of "nonsyndromic oral clefts" and the etiology of this group remains incompletely understood. Investigators agree that oral clefts are multifactorial in origin, with both genetic and environmental factors in their etiology. While animal models have identified several teratogens for oral clefts, their precise relevance for humans remains unclear. The goal of this work is to review literature on environmental exposures potentially associated with non-syndromic oral clefts.

  13. Controle químico da microflora oral em pacientes fissurados labiopalatais durante o tratamento ortodôntico-cirúrgico: estudo piloto Oral microflora chemical control in cleft lip and palate patients during orthodontic-surgical treatment pilot study

    Directory of Open Access Journals (Sweden)

    Alcion Alves Silva

    2004-06-01

    Full Text Available O risco de infecção é uma preocupação durante o tratamento ortodôntico-cirúrgico, principalmente em pacientes como os fissurados lábio palatais, pois as condições anatômicas e oclusais contribuem para a proliferação microbiana. Métodos manuais para o controle da microflora oral são muitas vezes insuficientes para a obtenção de uma higiene satisfatória. Técnicas alternativas, como agentes químicos, têm sido propostas como procedimentos auxiliares. O objetivo deste estudo foi comparar a eficiência de dois agentes químicos como auxiliares no controle da microflora, em pacientes ortodôntico-cirúrgicos (fissurados lábio-palatais. O delineamento da pesquisa foi um estudo exploratório, microbiológico (piloto, duplo-cego, para testar os seguintes agentes químicos: triclosan 0,03% (Plax-Colgate Palmolive e clorexidina digluconada 0,12% (Duplak-Herpro/Dentsply. A amostra foi composta por 30 voluntários divididos em 3 grupos: Grupo I (controle, Grupo II (teste _ clorexidina digluconada 0,12% e Grupo III (teste _ triclosan 0,03%. Todos os grupos receberam orientação de higiene bucal prévia à primeira coleta de material. Depois de sete dias de uso dos agentes químicos uma segunda coleta foi realizada e o uso do agente foi suspenso. Uma terceira coleta foi realizada após sete dias a partir da suspensão do agente. A técnica semiquantitativa proposta por Pilonetto e Pilonetto20 foi adotada para avaliar o crescimento de colônias bacterianas. Os resultados mostraram diferenças entre a eficácia dos agentes químicos, sendo que o Grupo II mostrou uma redução mais significativa da microflora quando comparado ao grupo III.The infection risk is a preoccupation during orthodontic-surgical treatment, mainly at cleft lip and palate patients, for their anatomical and occlusal condictions, that contributs to oral microflora proliferation. Manual methods for microflora control are frequently unsuccessful to obtain a sctisfactory

  14. Syntax and Discourse in Near-Native French: Clefts and Focus

    Science.gov (United States)

    Donaldson, Bryan

    2012-01-01

    This study examines aspects of the syntax-discourse interface in near-native French. Two cleft structures--"c'est" clefts and "avoir" clefts--are examined in experimental and spontaneous conversational data from 10 adult Anglophone learners of French and ten native speakers of French. "C'est" clefts mark focus, and "avoir" clefts introduce new…

  15. Presurgical orthopedic premaxillary alignment in cleft lip and palate reconstruction.

    Science.gov (United States)

    Papay, F A; Morales, L; Motoki, D S; Yamashiro, D K

    1994-11-01

    Premaxillary malposition is a difficult problem in cleft lip and palate repair. Orthopedic palatal devices are excellent in positioning the premaxilla, though they are somewhat cumbersome and require complex techniques in adjusting precisely the position of the premaxilla prior to repair. A new technique has been developed for premaxillary repositioning in conjunction with palatal shelf expansion and obturation. The procedure implements microplate fixation anterior to the premaxillary segment and linked to a palatal splint by adjustable elastics. The microplate is inserted through a nasal floor incision and secured by a tight submucosal tunnel through minimal dissection between the prolabium and premaxilla. The last hole of each microplate protrudes through the mucosa and is attached to a pin-retained palatal splint by an elastic chain. Differential tension is applied to the chains to allow gradual repositioning of the protruding maxilla while the splint expands and maintains positioning of the lateral palatal segments. These elastic retractors can be adjusted by staff in the outpatient office. During the past 2 years, this technique has been used successfully in 21 consecutive patients with unilateral or bilateral cleft lip and palate. Its technical ease and design allows simple adjustments to control premaxillary positioning and growth before definitive surgical closure.

  16. Cranio-facial clefts in pre-hispanic America.

    Science.gov (United States)

    Marius-Nunez, A L; Wasiak, D T

    2015-10-01

    Among the representations of congenital malformations in Moche ceramic art, cranio-facial clefts have been portrayed in pottery found in Moche burials. These pottery vessels were used as domestic items during lifetime and funerary offerings upon death. The aim of this study was to examine archeological evidence for representations of cranio-facial cleft malformations in Moche vessels. Pottery depicting malformations of the midface in Moche collections in Lima-Peru were studied. The malformations portrayed on pottery were analyzed using the Tessier classification. Photographs were authorized by the Larco Museo.Three vessels were observed to have median cranio-facial dysraphia in association with midline cleft of the lower lip with cleft of the mandible. ML001489 portrays a median cranio-facial dysraphia with an orbital cleft and a midline cleft of the lower lip extending to the mandible. ML001514 represents a median facial dysraphia in association with an orbital facial cleft and a vertical orbital dystopia. ML001491 illustrates a median facial cleft with a soft tissue cleft. Three cases of midline, orbital and lateral facial clefts have been portrayed in Moche full-figure portrait vessels. They represent the earliest registries of congenital cranio-facial malformations in ancient Peru.

  17. Ⅲ类颌间牵引治疗无生长潜力唇腭裂术后患者前牙反(牙合)的机制研究%Mechanism of Class Ⅲ Elastics Treatment on Unilateral Cleft Lip and Palate Patients with Cressbite.

    Institute of Scientific and Technical Information of China (English)

    魏志强; 王建国; 张锡忠

    2011-01-01

    目的:比较单侧完全性唇腭裂术后患者前牙反(牙合)解除前后颅面结构变化,探讨Ⅲ类颌间牵引治疗单侧完全性唇腭裂术后患者前牙反(牙合)的机制.方法:选择单侧完全性唇腭裂术后前牙反(牙合)患者20名,其中男15名,女5名,平均年龄(14.36±1.06)岁.所有患者在牙列排齐和整平的基础上行Ⅲ类颌间牵引,测量前牙反(牙合)解除前后头颅定位侧位片上反映颅面结构的各项指标,用配对t检验比较治疗前后的变化.结果:前牙反(牙合)解除后,SNB、L1-MP、OP-SN、NLA、ULP减小,ANB、MP-SN、NA-PA、U1-SN、U6-FH、L1-MP、L6-MP、ULL、LLL、LLP、UL-EP增大,差异有统计学意义.前牙反(牙合)解除前后SNA、U1-FH、LL-EP、ISD差异无统计学意义.结论:对于恒牙期唇腭裂术后反(牙合)的患者,Ⅲ类颌间牵引在纠正上下颌牙齿及牙槽关系不调的同时,能掩饰颌骨矢状向Ⅲ类关系,使软组织侧貌得到显著改善.%Objective: This study was conducted to evaluate the craniofacial morphology changes after correction of anterior teeth crossbite by using Class Ⅲ elastics in operated patients with complete unilateral cleft lip and palate,discussing the mechanism of class Ⅲ elastics treating opreated unilateral cleft lip and palate patients with crossbite.Methods: 20 patients after complete unilateral cleft lip and palate repair with crossbite of anterior teeth were included in this study.There were 15 male and 5 female patients, with an average age of 14.36± 1.06 years.All the patients underwent Class Ⅲ elastics after dentition ligned and leveled.Before and after correction of anterior teeth crossbite,lateral cephalograms were compared, and paired T test was used to evaluate the changes in craniofacial morphology.Results: SNB, L1 - MP, OP - SN, NLA, ULP (mm) decreased and ANB, MP - SN, NA - PA, U1 - SN, U6 - FH (mm), L1- MP(mm), L6 - MP(mm), ULL(mm), LLL(mm), LLP(mm), UL- EP(mm) increased significantly

  18. Definition of critical periods for Hedgehog pathway antagonist-induced holoprosencephaly, cleft lip, and cleft palate.

    Directory of Open Access Journals (Sweden)

    Galen W Heyne

    Full Text Available The Hedgehog (Hh signaling pathway mediates multiple spatiotemporally-specific aspects of brain and face development. Genetic and chemical disruptions of the pathway are known to result in an array of structural malformations, including holoprosencephaly (HPE, clefts of the lip with or without cleft palate (CL/P, and clefts of the secondary palate only (CPO. Here, we examined patterns of dysmorphology caused by acute, stage-specific Hh signaling inhibition. Timed-pregnant wildtype C57BL/6J mice were administered a single dose of the potent pathway antagonist vismodegib at discrete time points between gestational day (GD 7.0 and 10.0, an interval approximately corresponding to the 15th to 24th days of human gestation. The resultant pattern of facial and brain dysmorphology was dependent upon stage of exposure. Insult between GD7.0 and GD8.25 resulted in HPE, with peak incidence following exposure at GD7.5. Unilateral clefts of the lip extending into the primary palate were also observed, with peak incidence following exposure at GD8.875. Insult between GD9.0 and GD10.0 resulted in CPO and forelimb abnormalities. We have previously demonstrated that Hh antagonist-induced cleft lip results from deficiency of the medial nasal process and show here that CPO is associated with reduced growth of the maxillary-derived palatal shelves. By defining the critical periods for the induction of HPE, CL/P, and CPO with fine temporal resolution, these results provide a mechanism by which Hh pathway disruption can result in "non-syndromic" orofacial clefting, or HPE with or without co-occurring clefts. This study also establishes a novel and tractable mouse model of human craniofacial malformations using a single dose of a commercially available and pathway-specific drug.

  19. 20 years of cleft lip and palate missions.

    Science.gov (United States)

    Lambrecht, J Thomas; Kreusch, Thomas; Marsh, Jeff L; Schopper, Christian

    2014-01-01

    Volunteer missions for cleft lip and palate (CLP) care in Indonesia (1991-1992), India (1994-2003), Bhutan (2005-2010), and Kenya (2011), took place always at the same Hospital in each country. Altogether over a thousand patients were operated using a conservative protocol: Safety first - no experiments. Five months and 5 kg were the basic rules. For the native doctors, training help for self-help was priority. In the announcements, patients with CLP were primarily addressed. Burns, contractions, tumors, and trauma-cases were the second priority. Fresh trauma was done in night shifts with the local surgeons in order not to interfere. Besides facial esthetics speech was the number one issue, following priorities fell into place. Cultural aspects played a certain role in the different countries and continents.

  20. FOXE1 association with both isolated cleft lip with or without cleft palate, and isolated cleft palate

    Science.gov (United States)

    Moreno, Lina M.; Mansilla, Maria Adela; Bullard, Steve A.; Cooper, Margaret E.; Busch, Tamara D.; Machida, Junichiro; Johnson, Marla K.; Brauer, David; Krahn, Katherine; Daack-Hirsch, Sandy; L'Heureux, Jamie; Valencia-Ramirez, Consuelo; Rivera, Dora; López, Ana Maria; Moreno, Manuel A.; Hing, Anne; Lammer, Edward J.; Jones, Marilyn; Christensen, Kaare; Lie, Rolv T.; Jugessur, Astanand; Wilcox, Allen J.; Chines, Peter; Pugh, Elizabeth; Doheny, Kim; Arcos-Burgos, Mauricio; Marazita, Mary L.; Murray, Jeffrey C.; Lidral, Andrew C.

    2009-01-01

    Nonsyndromic orofacial clefts are a common complex birth defect caused by genetic and environmental factors and/or their interactions. A previous genome-wide linkage scan discovered a novel locus for cleft lip with or without cleft palate (CL/P) at 9q22–q33. To identify the etiologic gene, we undertook an iterative and complementary fine mapping strategy using family-based CL/P samples from Colombia, USA and the Philippines. Candidate genes within 9q22–q33 were sequenced, revealing 32 new variants. Concurrently, 397 SNPs spanning the 9q22–q33 2-LOD-unit interval were tested for association. Significant SNP and haplotype association signals (P = 1.45E − 08) narrowed the interval to a 200 kb region containing: FOXE1, C9ORF156 and HEMGN. Association results were replicated in CL/P families of European descent and when all populations were combined the two most associated SNPs, rs3758249 (P = 5.01E − 13) and rs4460498 (P = 6.51E − 12), were located inside a 70 kb high linkage disequilibrium block containing FOXE1. Association signals for Caucasians and Asians clustered 5′ and 3′ of FOXE1, respectively. Isolated cleft palate (CP) was also associated, indicating that FOXE1 plays a role in two phenotypes thought to be genetically distinct. Foxe1 expression was found in the epithelium undergoing fusion between the medial nasal and maxillary processes. Mutation screens of FOXE1 identified two family-specific missense mutations at highly conserved amino acids. These data indicate that FOXE1 is a major gene for CL/P and provides new insights for improved counseling and genetic interaction studies. PMID:19779022

  1. [The experience of complex treatment of children with bilateral cleft lip and palate].

    Science.gov (United States)

    Supiev, T K; Mamedov, A A; Negametzianov, N G; Nurmaganov, S B; Utepov, D K; Katasonova, E S; Kozhabekov, E M

    2014-01-01

    Three grades of premaxilla deformation were revealed in children with bilateral cleft lip and palate. All patients with grade I and some children with grade II deformation received early orthopedic treatment by Sharova appliance while in patients with grade III deformation orthodontic devices with bone fixation with microimplants were used or microimplants alone for orthodontic anchorage. This approach allowed achieving full side contact of premaxilla and maxillary fragments in 1-2 months thus creating favorable conditions for surgical procedure.

  2. Clinical analysis of 302 cases of cleft palate%腭裂患者302例临床资料分析

    Institute of Scientific and Technical Information of China (English)

    刘瑞红; 李新明

    2011-01-01

    目的 通过回顾性调查,了解河南省先天性腭裂的患病情况与特点,从而规范河南省唇腭裂患者的综合序列治疗.方法 收集2005年8月至2009年12月期间在郑州大学第一附属医院口腔科进行腭裂手术及腭裂术后二期修复的302例腭裂患者的临床病历资料,并将所得数据进行统计分析.结果 在本组病例中,男性患者172例,女性患者130例,年龄1.5~41岁,中位年龄3.6岁,男女比例约为1.32∶1; 单纯腭裂的发生男女差异无统计学意义,而唇腭裂的发生男女性别差异有统计学意义; 单纯腭裂和腭裂伴有唇裂的发生率差异有统计学意义;在腭裂的构成比中,主要以不完全腭裂为主,占70.86%,完全腭裂占19.87%,腭裂术后穿孔占6.29%.结论 单纯腭裂的发生男女无明显性别差异;而唇腭裂的发生男女性别差异有统计学意义,男性约是女性的3倍;单纯腭裂的发病率明显高于腭裂伴有唇裂的发病率;在腭裂的构成比中,主要以不完全腭裂为主;腭瘘仍是目前腭裂术后最常见的并发症.%Objective To investigate the characteristics and features of cleft palate and improve comprehensive and sequential therapy of cleft lip and palate (CLP) in Henan province by a retrospective study. Methods A total of 302 CLP were included in the retrospective study, who underwent primary and secondary cleft palate repair during August 2005 to December 2009. Results Three hundred and two patients (172 males,130 females,age ranged from 1.5 years to 41 years with a median age of 3.6 years)were included in the study. There was no significant gender difference in cleft palate, but in cleft lip and palate. And there was significant rate difference between cleft palate and cleft lip and palate. According to cleft types, 214 patients (70.86%) were incomplete cleft palate, 60 patients(19.87%) were complete cleft palate, 12 patients(3.97%) were cleft soft palate, 19 patients(6.29%) were palate fistula

  3. Papillary Thyroid Carcinoma in a Branchial Cleft Cyst without a Thyroid Primary: Navigating a Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Douglas S. Ruhl

    2013-01-01

    Full Text Available We report a rare case of papillary thyroid carcinoma incidentally found within a branchial cleft cyst. Only four other cases have been described in the literature. A total thyroidectomy and selective neck dissection was performed, and no evidence of occult primary disease was found after review of fine sections. Branchial cleft cysts are the most common lateral neck masses. Ectopic thyroid tissue within a branchial cleft cyst is an unusual phenomenon, and papillary thyroid carcinoma arising from this tissue is extremely rare. Clinicians are left with a diagnostic dilemma when presented with thyroid tissue neoplasm within a neck cyst in the absence of a thyroid primary—is this a case of metastatic disease with a missed primary or rather carcinoma arising in ectopic thyroid tissue? A thorough discussion of the etiologies of these lateral neck masses is reviewed including the embryogenesis of thyroid tissue in a branchial cleft cyst. The prognosis of patients with papillary thyroid carcinoma in lateral neck cysts without a primary site identified appears to be good following excision of the cyst and total thyroidectomy. Other management recommendations regarding these unique lateral neck malignancies are also presented.

  4. Nasoalveolar Molding: A new Method for Cleft Lip and Palate Rehabilitation

    Directory of Open Access Journals (Sweden)

    A Jahanbin

    2014-04-01

    Full Text Available Introduction: Cleft lip and palate is a congenital anomaly occurring in 3 in 1000 live birth. One the major concern in this patient is about cleft gap and its surgical problems. Several surgical and non-surgical procedures have been done to decrease this gap. They aimed to achieve the more esthetic results as well as feeding success. Nasoalveolar Molding (NAM is a new method for reshaping nasal and alveolar bones, presurgically. Matsuo et al described that auricular cartilage could be molded permanently when treatment was done within 6 weeks of life. High levels of maternal estrogen in the fetal circulation can triggers hyaluronic acid which can alter the cartilage, ligament and connective tissue elasticity.Estrogen level continue to drop after 6 weeks of age. This concept was applied for the correction of nasal deformities in cleft lip patients. Nasolaveolar molding may stimulate immature nasal chondroblasts and produce interstitial expansion.   Aims of Nasoalveolar Molding: a. Active molding and repositioning of the deformed nasal cartilages and alveolar processes. b. Appropriate Lengthening of the columellac. Better bone healing after surgey due to reducing the gaped. Reduces the need for secondary alveolar bone grafts. Correction of lip position with minimal scarf. Reducing hospital stay for nasal esthetic surgeryg. Better weight gain in early infancy   Conclusion: Management of cleft lip and palate has been changed with more emphasis on the nasal and alveolar molding prior to the primary lip repair. This method reduces the number reconstructive surgeries  for the purpose of esthetics as well as may cause better feeding in early infancy.   Keywords: Cleft Lip and Palate, Infant Orthopedics, Nasal Molding.  

  5. Quantitative computer-based assessment of lip symmetry following cleft lip repair.

    Science.gov (United States)

    McKearney, Richard M; Williams, John V; Mercer, Nigel S

    2013-03-01

    Objective : To demonstrate an objective method of measuring lip symmetry after cleft lip repair by comparing patients with unilateral cleft lip (UCL) to non-cleft lip controls using the SymNose computer program. Design : Retrospective cohort study comparing several parameters of lip symmetry between UCL cases and controls. Participants were represented by digital photographs that were traced using SymNose. Setting : This study was performed at the South West Cleft Unit, Bristol, U.K. Participants : Forty-four participants aged 10 years (±1 year) were recruited into and completed the study. A consecutive case series of 22 patients with UCL ± palate had previously undergone primary repair. Twenty-two age-matched controls were recruited from a local primary school. Main Outcome Measures : Lip symmetry, expressed as the percentage mismatch of an overlaying of the left upper lip area and upper vermillion border area over the right, horizontal lip tilt, and lateral deviation of the lips. Results : A significant increase in labial asymmetry was seen in the UCL group in the following parameters: upper lip mismatch and upper vermillion border mismatch. No significant differences were observed in horizontal lip tilt or lateral lip deviation. Conclusion : This study supports the use of SymNose for the objective quantitative assessment of lip symmetry as an outcome measure of surgery following cleft lip repair. It allows comparison of surgical techniques and can be used to perform audits. It is a time-efficient process, relatively inexpensive, and straightforward to use.

  6. Minor-form/microform cleft lip repair: the importance of identification and utilization of Cupid bow peak on the lateral lip.

    Science.gov (United States)

    Oyama, Akihiko; Funayama, Emi; Furukawa, Hiroshi; Hayashi, Toshihiko; Saito, Akira; Yamamoto, Yuhei

    2014-01-01

    In minor-form or microform cleft lip, normal anatomical structures with slight displacement remain and should be used effectively to obtain symmetrical results. We treated 7 patients with minor-form or microform cleft lip between 2005 and 2009. In all patients, the peak of Cupid bow with a natural curve of the white roll was recognized on the lateral lip. We modified the incision line to maintain the natural curve and obtained a symmetrical and natural-looking Cupid bow. In this article, we emphasize the importance of preserving the remaining normal structure, particularly the curve of the white roll on the lateral lip, and suggest that the peak of the curve should be defined as Cupid bow peak of the cleft side. Details of our concept for the correction of minor-form or microform cleft lip are also introduced.

  7. Mutational analysis of the Sonic Hedgehog gene in 220 newborns with oral clefts in a South American (ECLAMC) population.

    Science.gov (United States)

    Orioli, Iêda M; Vieira, Alexandre R; Castilla, Eduardo E; Ming, Jeffrey E; Muenke, Maximilian

    2002-02-15

    Oral clefts generally have a multifactorial etiology. A number of genes contribute to the formation of the face and palate. Cleft lip and/or palate can occur in pedigrees with autosomal dominant holoprosencephaly due to mutations in Sonic Hedgehog (SHH). In addition, animal models have shown that SHH is involved in face development. We thus examined the human SHH gene in 220 newborn infants with nonsyndromic oral clefts registered by the Estudio Colaborativo Latinoamericano de Malformaciones Congenitas: ECLAMC (Latin American Collaborative Study of Congenital Malformations). We found 15 variant bands in 13 patients with oral clefts, representing five different base changes, all of which were found by sequencing to represent silent polymorphisms. Four occurred in introns. The alteration occurring in an exon, Ser190Ser, may create a consensus sequence for the 3'splice site 6 bp downstream of the original consensus sequence. Thus, we did not identify any clearly disease-causing mutation in SHH in these patients, and conclude that SHH mutations are not a frequent cause of isolated oral clefts in humans.

  8. Oronasal fistula in cleft palate surgery

    Directory of Open Access Journals (Sweden)

    Sadhu Partha

    2009-10-01

    Full Text Available Oronasal fistula (ONF is the commonest complication associated with cleft palate surgery. The main symptoms associated with ONF are nasal regurgitation of food matter and hypernasality of voice. Repair of cleft palate under tension is considered to be the main reason of ONF though vascular accidents and infection can also be the cause. Most of the ONFs are situated in the hard palate or at the junction of hard and soft palate. Repair of ONF depends on its site, size and mode of presentation. A whole spectrum of surgical procedures starting from small local flaps to microvascular tissue transfers have been employed for closure of ONF. Recurrence rate of ONF is 25% on an average after the first attempt of repair.

  9. Cleft lip and/or palate in two cases of 46,X,i(Xq) Turner syndrome.

    Science.gov (United States)

    Corona-Rivera, J R; Corona-Rivera, E; Bobadilla-Morales, L; Garcia-Cobia, T A; Corona-Rivera, A

    2002-01-01

    Cleft lip (CL) and/or palate (CP) are uncommon anomalies in Turner syndrome (TS) series. We report two unrelated sporadic 46,X,i(Xq) patients exhibiting orofacial clefts and a peculiar facial appearance masking the clinical diagnosis. CL, and CP in case 1 and CP in case 2, though non-specific of TS, may not be fortuitous findings. The increased frequency of CP and bifid uvula in poly X syndromes, the dermatoglyphic similarities between iXq TS and X polysomies, and the occurrence of Klinefelter phenotype when extra Xq material is present in a male, are all indirect evidences suggesting that Xq material cannot be considered phenotipically inert and facial clefts found in our patients may be syndromal manifestation of trisomic Xq dosage.

  10. A genome-wide association study of cleft lip with and without cleft palate identifies risk variants near MAFB and ABCA4

    DEFF Research Database (Denmark)

    Beaty, Terri H; Murray, Jeffrey C; Marazita, Mary L

    2010-01-01

    Case-parent trios were used in a genome-wide association study of cleft lip with and without cleft palate. SNPs near two genes not previously associated with cleft lip with and without cleft palate (MAFB, most significant SNP rs13041247, with odds ratio (OR) per minor allele = 0.704, 95% CI 0...

  11. Stability after Cleft Maxillary Distraction Osteogenesis or Conventional Orthognathic Surgery

    Directory of Open Access Journals (Sweden)

    Kristian Andersen

    2015-06-01

    Full Text Available Objectives: To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. Material and Methods: Inclusion criteria: 1 cleft lip and palate, 2 advancement > 8 mm. Eleven patients comprised the distraction osteogenesis group (DOG. Seven patients comprised the orthognathic treatment group (CONVG. Skeletal and soft tissue points were traced on lateral cephalograms: T1 (preoperatively, T2 (after surgery, T3 (follow-up. Group differences were analyzed using Students t-test. Results: At T1-T2, advancement of 6.98 mm (P = 0.002 was observed in DOG. Horizontal overjet increased 11.62 mm (P = 0.001. A point-nasion-B point (ANB angle increased 8.82° (P = 0.001. Aesthetic plane to upper lip was reduced 5.44 mm (P = 0.017 and the naso-labial angle increased 16.6° (P = 0.001. Vertical overbite (VOB increased 2.27 mm (P = 0.021. In T2-T3, no significant changes were observed in DOG. In T1-T2, horizontal overjet increased 8.45 mm (P = 0.02. The ANB angle, 9.33° (P = 0.009 in CONVG. At T2-T3, VOB increased, 2.35 mm (P = 0.046, and the ANB angle reduced, 3.83° (P = 0.003. In T2-T3, no parameters changed in CONVG. At follow-up (T3, VOB increased in CONVG compared with DOG, (P = 0.01. Vertical position of A point differed between the groups (P = 0.04. No significant intergroup differences between soft tissue parameters occurred. Conclusions: Distraction osteogenesis resulted in a stable position of the maxilla and movement upwards in vertical plane, however in case of orthognathic treatment sagittal relapse and a continued postoperatively downward movement was registered.

  12. The development of speech production in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Chapman, Kathy

    2012-01-01

    The purpose of this chapter is to provide an overview of speech development of children with cleft palate +/- cleft lip. The chapter will begin with a discussion of the impact of clefting on speech. Next, we will provide a brief description of those factors impacting speech development...... for this population of children. Finally, research examining various aspects of speech development of infants and young children with cleft palate (birth to age five) will be reviewed. This final section will be organized by typical stages of speech sound development (e.g., prespeech, the early word stage...

  13. THREE-DIMENSIONAL ASSESSMENT OF THE PHARYNGEAL AIRWAY AND MAXILLARY SINUS VOLUMES IN INDIVIDUALS WITH NON-SYNDROMIC CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Ana NEMȚOI

    2015-09-01

    Full Text Available Introduction: Children with cleft lip and palate (CLP are known to have airway problems. Introduction of ConeBeam CT (CBCT and imaging software has facilitated generation of 3D images for assessing the volume of maxillary sinuses and pharyngeal airway. Consequently, the present study aimed at evaluating and comparing the maxillary sinus and pharyngeal airway volume of patients with cleft lip and palate in healthy patients, using cone beam computed tomography (CBCT images. Materials and method: The sample group included 27 individuals (15 with cleft lip and palate subjects and 12 healthy subjects. The pharyngeal airway and each maxillary sinus were three-dimensionally assessed, segmented and their volume was calculated. A comparison between the right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA. Results: No statistically significant differences were found when the maxillary sinuses volumes from each side were compared (p >0.05. The unilateral CLP patients presented the lowest sinus volume. Individuals with CLP did not exhibit a total airway volume smaller than the nonCLP controls. Conclusions: 3D imaging using CBCT and Romexis software is reliable for assessing maxillary sinus and pharyngeal airway volume. The present study showed that the pharyngeal airway is not compromised in CLP individuals. The unilateral CLP individuals present maxillary sinuses with smaller volumes, no differences being recorded between the cleft and non-cleft side.

  14. Craniofacial Morphology and Growth Comparisons in Children With Robin Sequence, Isolated Cleft Palate, and Unilateral Complete Cleft Lip and Palate

    DEFF Research Database (Denmark)

    Hermann, N. V.; Kreiborg, S.; Darvann, Tron Andre

    2003-01-01

    Objective: Comparison of early craniofacial morphology and growth in children with nonsyndromic Robin Sequence (RS), isolated cleft palate (ICP), and unilateral complete cleft lip and palate (UCCLP). Subjects: One hundred eight children with cleft: 7 with RS, 53 with ICP, and 48 with UCCLP were...... included in the study. The children were drawn from the group of all Danish children with cleft born 1976 through 1981. Method: Three-projection infant cephalometry. Results: The craniofacial morphology in the RS, ICP, and UCCLP groups had some common characteristics: a wide maxilla with decreased length...

  15. 唇腭裂患者的牙周健康状况及其影响因素%Periodontal status and its influencing factors in patients with cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    章筱悦; 陈振琦

    2014-01-01

    index compared with normal controls. Patients with unilateral and bilateral CLP(UCLP and BCLP) exhibit significant plaque accumulation and gingivitis bleeding. The prevalence of plaque accumulation and gingivitis is higher in patients with CLP than in controls, and plaque accumulation is significantly higher in patients with BCLP than in patients with UCLP. The cleft sides present a higher plaque index and probing depth than the noncleft sides. Periodontal problems in soft and hard tissues have often been reported in patients with CLP. Such problems include reduced keratinized gingiva, gingival recession, gingival inflammation, and decreased alveolar bone height, and all of which can affect the periodontal status. The colonization rate of Saccharomyces in patients with CLP is significantly higher than in healthy control subjects and is highest in patients with CLP who had undergone at least three surgeries and in patients with BCLP. Grafting an alveolar bone to the cleft area is a method to improve the alveolar morphology and increase bone mass. This method helps improve the periodontal status and provides healthy periodontal support for the teeth adjacent to the cleft. The incidence of gingival inflammation is also reduced. Therefore, the aim of this study is to summarize the oralhygiene and periodontal status, including its influencing factors, of patients with CLP.

  16. Characterization of subtle brain abnormalities in a mouse model of Hedgehog pathway antagonist-induced cleft lip and palate.

    Science.gov (United States)

    Lipinski, Robert J; Holloway, Hunter T; O'Leary-Moore, Shonagh K; Ament, Jacob J; Pecevich, Stephen J; Cofer, Gary P; Budin, Francois; Everson, Joshua L; Johnson, G Allan; Sulik, Kathleen K

    2014-01-01

    Subtle behavioral and cognitive deficits have been documented in patient cohorts with orofacial clefts (OFCs). Recent neuroimaging studies argue that these traits are associated with structural brain abnormalities but have been limited to adolescent and adult populations where brain plasticity during infancy and childhood may be a confounding factor. Here, we employed high resolution magnetic resonance microscopy to examine primary brain morphology in a mouse model of OFCs. Transient in utero exposure to the Hedgehog (Hh) signaling pathway antagonist cyclopamine resulted in a spectrum of facial dysmorphology, including unilateral and bilateral cleft lip and palate, cleft of the secondary palate only, and a non-cleft phenotype marked by midfacial hypoplasia. Relative to controls, cyclopamine-exposed fetuses exhibited volumetric differences in several brain regions, including hypoplasia of the pituitary gland and olfactory bulbs, hyperplasia of the forebrain septal region, and expansion of the third ventricle. However, in affected fetuses the corpus callosum was intact and normal division of the forebrain was observed. This argues that temporally-specific Hh signaling perturbation can result in typical appearing OFCs in the absence of holoprosencephaly--a condition classically associated with Hh pathway inhibition and frequently co-occurring with OFCs. Supporting the premise that some forms of OFCs co-occur with subtle brain malformations, these results provide a possible ontological basis for traits identified in clinical populations. They also argue in favor of future investigations into genetic and/or environmental modulation of the Hh pathway in the etiopathogenesis of orofacial clefting.

  17. Behavioral pattern in Chinese school-aged children with cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    Pin Ha; Xu-Qing Zhuge; Qian Zheng; Bing Shi; Cai-Xia Gong; Yan Wang

    2013-01-01

    Objective:To obtain descriptive information of behavioral pattern inChinese school-aged children with cleft lip and palate.Methods:A total of93 cleft lip and palate patients between the age of6-11 year-old and treated atWestChinaStomatologyHospital were selected.And another 100 unaffected controls, matched for age and gender, were recruited randomly from a common primary school inChengdu.Chart review of medical records was used to obtain psychosocial checklists.Scores were compared with published norms and controls to evaluate the risk of problems, separately for three diagnostic groups.Results:The patients group had lower scores of social and academic competencies, especially those with facial deformity or speech problem. No difference was found in the aspect of activity competency.All patients showed elevations in behavior problems.But the type of behavior problems varied in different genders.Conclusions:Chinese school-aged children with cleft lip and palate are at raised risk for social and academic difficulties.Specific pattern of behavior problems displays differently depending on gender of the patient.

  18. Goldenhar syndrome associated with cleft lip and palate. A case report.

    Directory of Open Access Journals (Sweden)

    Nayaret Soto

    2012-12-01

    Full Text Available In the literature is possible to find an extense variety of syndromes associated with cleft palate, so in patients with this condition is essential to ask if the damage is or not associated with some syndrome. Necessary to provide adequate treatment. Case report: To the Service of Orthodontics, Las Higueras Hospital was derived a female patient, born on June 22th, 2012. Clinical diagnosis was cleft lip and full cracked palate with a GAP of 17mm, left and right macrostomia, malformed ears, epibulbar cyst in left eyeball, serie of oral papillomas and headphone level, apparently associating this condition to some kind of syndrome. It was made an acrylic plate for the patient can feed and initiates the treatment presurgical orthopedics. The mother recounts in the clinical History suffer diabetes, one of his sons has cognitive delay, not associated to syndrome. Imaging test shows mild hydrocephalus, jaw fully formation, normal audiometry. All changes are in facial area at the rest of the body is shown within normal parameters.Was performed a complete clinical and imaging examination and request help from geneticist, who collected all the facts confirm the presumptive diagnosis of Goldenhar syndrome.Many syndromes that manifest cleft palate are associated with genetic component, except that even Goldenhar syndrome of unknown cause.It is important to note that there are syndromes expressing varying degrees of severity of cracked palate to also give the patient a full treatment.

  19. "Nara" knot for suturing of cleft lip in children to make removal easy

    Directory of Open Access Journals (Sweden)

    Obaidullah

    2006-01-01

    Full Text Available Cleft patients usually go through a lifetime of repeated hospital admissions and multiple procedures. Suture removal at a tender age and on a sensitive area like the lip becomes a challenge for the nursing staff. It is also emotionally demanding on the part of the parents. Hence, in most centres these patients are at least sedated if not anaesthetised. We have been using a simple knot and running prolene material so that undoing of the knot becomes easy and suture removal more or less atraumatic. We would like to share our experience with readers through this article. An analysis of 53 cleft lip repairs has shown that this knot is safe and easily removable.

  20. Research on orthodontic treatment for complete unilateral cleft lip and palate patients in late permanent dentition%恒牙晚期单侧完全性唇腭裂患者正畸治疗临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    刘毅; 王春玲; 孙慧芳; 王海任

    2011-01-01

    Objective By measuring the post-surgery characteristics of complete unilateral cleft lip and palate (UCLP) patients' teeth, occlusion, soft and hard tissues in late permanent dentition, the purpose of this study was to investigate the clinical effects of orthodontic treatments for complete UCLP patients on face types, maxillary dental arch and occlusion relations and to provide reliable theoretic basis for treating these kinds of patients. Methods Ten post-surgery complete UCLP patients who had cleft lip and palate in late permanent dentition( From 15 to 17 years old) were selected in this research. Every patient was treated with maxillary slow arch expansion and fixed appliance. The related data about X-ray lateral skull films before therapy and after six months' maxillary expansion, as well as teeth models before expansion, after expansion and after six months' were measured. The Statistical Methods were paired t-test for dependent samples and two-way ANOVA, LSD-test were used for the mutual comparison between two groups. Results After orthodontic treatments, some measured data of soft and hard tissues in complete UCLP patients' lateral skull films had relatively significant changes (P <0.01 ). Arch width increased significantly in canine area and premolar area( P < 0. 01 ). The increase in premolar area could be maintained steadily (P < 0.05). Conclusions After orthodontic treatments, bone, soft and hard tissues and occlusion relations of complete UCLP patients in late permanent dentition who had get cleft lip and palate had relatively ideal effects.%目的 通过测量恒牙晚期单侧完全性唇腭裂(UCLP)患者术后牙(牙合)、软硬组织的相关数据,观察正畸治疗对患者面型、牙弓及咬合关系的临床疗效.方法 选择10例UCLP恒牙晚期(15~17岁)术后患者,采用上颌慢速扩弓联合固定矫治,对治疗前、扩弓保持半年后X线头颅侧位片及扩弓治疗前、扩弓结束后、保持半年后牙(牙合)

  1. Unilateral cleft nasal deformity correction using conchal cartilage lily flower graft.

    Science.gov (United States)

    Hwang, Kun; Kim, Han Joon; Paik, Moo Hyun

    2012-11-01

    We present a conchal cartilage lily flower graft for correcting depressed and laterally displaced alar cartilage for correction of unilateral cleft nasal deformity.After making a V incision at the base of the columellar and then marginal incisions, the alar cartilages were exposed. A fusiform-shaped cartilage larger than 2.5 cm in length and 1 cm in width was obtained. The midline long axis was scored with a No. 15 knife, and the lateral one third was split. Two-thirds length portions were folded in half, and they became straightened in the shape of a stalk of a lily flower. Two symmetrical one-third length portions were fanned out bilaterally in the shape of the leaf of a lily flower. The stalk portion was positioned in a pocket between the medial crura, and the 2 leaf portions were placed on the dome of the alar cartilages. The marked points of the cleft side and contralateral side were secured with sutures. The V incision at the base of the columellar and the marginal incisions were closed with a V-Y shape. In this technique, the 2 leaf portions were placed on the dome of the alar cartilages and sutured; therefore, the suture holds the dome of the cleft side to the contralateral side without peaking.Thirteen patients (6 male and 7 female subjects; age range, 13-30 years) were operated. Among them, 6 patients were very satisfied, and 5 patients were satisfied with the results. Two patients felt they were improved.We think the conchal cartilage lily flower graft might be a good method for correction of depressed and laterally displaced alar cartilage in unilateral cleft nasal deformity.

  2. Pallister-Killian syndrome: additional manifestations of cleft palate and sacral appendage.

    OpenAIRE

    McLeod, D R; Wesselman, L R; Hoar, D I

    1991-01-01

    We report a case of Pallister-Killian syndrome in a 28 week gestation infant. In addition to the characteristic phenotype, this patient had a cleft palate, diaphragmatic hernia, sacral appendage, and imperforate anus. The lymphocyte karyotype showed 96% 46,XX/4% 47,XX+i (12p) and the fibroblast karyotype 47,XX,+marker (presumed i(12p]. Fibroblast cytogenetic studies should be considered in all cases of diaphragmatic hernia associated with other malformations.

  3. Changing lifestyles and oral clefts occurrence in Denmark

    DEFF Research Database (Denmark)

    Bille, Camilla; Knudsen, Lisbeth B.; Christensen, Kaare

    2005-01-01

    The aim of this project was to access whether any changes in the birth prevalence of cleft lip with/without cleft palate (CL(P)) occurred in Denmark during the period 1988 through 2001. In this period an official recommendation of a supplementation of folic acid to pregnant women was introduced...

  4. Lexical selectivity in danish toddlers with cleft palate.

    Science.gov (United States)

    Willadsen, Elisabeth

    2013-07-01

    Objective : To study if Danish children with cleft palate display lexical selectivity in their early lexicon at 18 months of age. Design : A cross-sectional study. Participants : Thirty-four children with unilateral cleft lip and palate and 35 children without cleft palate, matched for gender and age. Methods : All participants were video recorded at 18 months of age during play interaction with a parent. The video recordings were transcribed according to the International Phonetic Alphabet and an individual consonant inventory was established for each participant. The video recordings were also analyzed with respect to word productions, establishing an observed productive vocabulary size for each participant. Results : At 18 months of age Danish children with cleft palate showed marked lexical selectivity in their early words. The distribution of consonant classes observed at 11 months of age in a previous study of the children with cleft palate was almost perfectly reflected in their early lexicon at 18 months. The early lexicon of children with cleft palate differed from the early lexicon of their noncleft peers. Conclusions and Implications : Danish toddlers with cleft palate display lexical selectivity in the early lexicon as it has been described for English-speaking toddlers with and without cleft palate, even though some qualitative differences were found.

  5. Prenetal Detection of Oral Clefts : Diagnostic, Genetic and Ethical Aspects

    NARCIS (Netherlands)

    Maarse, W.

    2015-01-01

    Since the introduction of routine prenatal screening with ultrasound in the Netherlands in 2007, parents are confronted with the diagnosis of oral cleft (OC) already during pregnancy. This imposed a new dimension in cleft care in the Netherlands. As a consequence to increasing prenatal detection rat

  6. Feeding Techniques for Children Who Have Cleft Lip and Palate.

    Science.gov (United States)

    Klein, Marsha Dunn

    This pamphlet on feeding techniques for children who have cleft lip and palate emphasizes the role of the parent as part of a team involving many specialists. The pamphlet begins with explanations of complete and incomplete separations of the lip, unilateral and bilateral cleft lips, corrective surgical procedures, etc. The importance of weight…

  7. Cone-Beam computed tomography evaluation of maxillary expansion in twins with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Luciane Macedo de Menezes

    2012-04-01

    Full Text Available OBJECTIVE: The establishment of normal occlusal relationships in patients with cleft lip and palate using rapid maxillary expansion may promote good conditions for future rehabilitation. OBJECTIVE: This study describes the clinical case of monozygotic twins with unilateral cleft lip and palate at the age of mixed dentition, who were treated using the same rapid maxillary expansion protocol, but with two different screws (conventional and fan-type expansion screw. Results were evaluated using plaster models, intraoral and extraoral photographs, and Cone-Beam computed tomography (CBCT scans obtained before the beginning of the treatment, (T1. METHODS: The patients were followed up for 6 months after maxillary expansion, when the same tests requested at T1 were obtained again for review (T2. T1 and T2 results were compared using lateral cephalometric tracings and measurements of the intercanine and intermolar distances in the plaster models using a digital caliper. RESULTS: The two types of expansion screws corrected the transverse discrepancy in patients with cleft lip and palate. The shape of the upper arches improved at 10 days after activation. CONCLUSION: CBCT scans provide detailed information about craniofacial, maxillary and mandibular changes resulting from rapid maxillary expansion. The most adequate screw for each type of malocclusion should be chosen after detailed examination of the dental arches.

  8. Spectrographic analysis of pain cry in neonates with cleft palate.

    Science.gov (United States)

    Michelsson, K; Sirviö, P; Koivisto, M; Sovijärvi, A; Wasz-Höckert, O

    1975-01-01

    52 phonations of 13 cleft palate neonates were analyzed by sound spectrographic methods. 17 phonetical attributes were included in the study and the first signal after the pain stimulus was analyzed. The cries of the cleft palate infants were compared with the crying of 75 normal babies of the same age. No change in the fundamental frequency, melody type and duration of the cries was seen in association with these anatomical defects. Two of the characteristics studied, vibrato and the 'tonal pit', occurred significantly more often in cries of the cleft palate infants than in cries of the control series. The changes in the qualities seen in association with cleft palate and/or cleft lip do not mimic the abnormalities produced by brain damage.

  9. Cross-linguistic perspectives on speech assessment in cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Henningsson, Gunilla

    2012-01-01

    This chapter deals with cross linguistic perspectives that need to be taken into account when comparing speech assessment and speech outcome obtained from cleft palate speakers of different languages. Firstly, an overview of consonants and vowels vulnerable to the cleft condition is presented. Then......, consequences for assessment of cleft palate speech by native versus non-native speakers of a language are discussed, as well as the use of phonemic versus phonetic transcription in cross linguistic studies. Specific recommendations for the construction of speech samples in cross linguistic studies are given....... Finally, the influence of different languages on some aspects of language acquisition in young children with cleft palate is presented and discussed. Until recently, not much has been written about cross linguistic perspectives when dealing with cleft palate speech. Most literature about assessment...

  10. One-stage (Warsaw) and two-stage (Oslo) repair of unilateral cleft lip and palate: Craniofacial outcomes

    NARCIS (Netherlands)

    Fudalej, P.S.; Wegrodzka, E.; Semb, G.; Hortis-Dzierzbicka, M.

    2015-01-01

    The aim of this study was to compare facial development in subjects with complete unilateral cleft lip and palate (CUCLP) treated with two different surgical protocols. Lateral cephalometric radiographs of 61 patients (42 boys, 19 girls; mean age, 10.9 years; SD, 1) treated consecutively in Warsaw w

  11. Same Noses, Different Nasalance Scores: Data from Normal Subjects and Cleft Palate Speakers for Three Systems for Nasalance Analysis

    Science.gov (United States)

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone

    2006-01-01

    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences.…

  12. Dating brittle tectonic movements with cleft monazite

    DEFF Research Database (Denmark)

    Berger, Alfons; Gnos, E.; Janots, E.;

    2013-01-01

    . Deformation events of the area have been subdivided into three steps: (D1) main thrusting including formation of a new schistosity; (D2) dextral transpression; and (D3) local crenulation including a new schistosity. The two younger deformational structures are related to a subvertically oriented intermediate...... phases. This allows the high precision isotope dating of cleft monazite. 232Th/208Pb ages are not affected by excess Pb and yield growth domain ages between 8.03 ± 0.22 Ma and 6.25 ± 0.60 Ma. Monazite crystallization in brittle structures is coeval or younger than 8 Ma zircon fission track data...

  13. Cleft Lip Repair: The Hybrid Subunit Method.

    Science.gov (United States)

    Tollefson, Travis T

    2016-04-01

    The unilateral cleft lip repair is one of the most rewarding and challenging of plastic surgery procedures. Surgeons have introduced a variety of straight line, geometric, and rotation-advancement designs, while in practice the majority of North American surgeons have been using hybrids of the rotation-advancement techniques. The anatomic subunit approach was introduced in 2005 by Fisher and has gained popularity, with early adopters of the design touting its simplicity and effectiveness. The objectives of this article are to summarize the basic tenets of respecting the philtral subunit, accurate measurement and planning, and tips for transitioning to this subunit approach.

  14. Epidemiology of orofacial clefts in Africa: Methodological challenges in ascertainment.

    Directory of Open Access Journals (Sweden)

    Peter Mossey

    2009-04-01

    Full Text Available Background:To carry out a systematic review of the birth prevalence of cleft lip with or without cleft palate (CLP and cleft palate (CP in Africa based on available published data. Methods:Using the Cochrane search strategy and the following keywords words “cleft palate”, “prevalence”, “incidence”, “cleft lip” and “Africa” to screen Ovid Medline (1966 to March 2007, Cinahl (1982-March 2007, Pub Med, Scopus, and Web-Google. All identified published, prospective and retrospective studies on the birth prevalence of CLP and CP in Africa were included. The dates, location, sources, number of births (live births, still births, number of cleft cases, prevalence rates, sex ratio, cleft types, and clefts with associated anomalies were extracted. Results:Ascertainment of cases was through the hospitals. Overall there were 57 CL/P, 56 CL and 36 CP reported from all the studies. From seven studies combined, 21 males and 20 females had CL, 10 males and 22 females with CP and 26 males and 24 females with CL/P. There were 3 cases with CL/P, 2 with CP and 2 with CL from the three studies that reported clefts with associated anomalies. Conclusion:For an improved ascertainment of cleft cases, there is a need to set up a birth defects surveillance system in the form of a national birth registry. Future studies should then aim to include the entire population in geographically defined regions. Reliable data on incidence is an essential pre-requisite for studies into aetiology and prevention.

  15. Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair

    Directory of Open Access Journals (Sweden)

    Mosaad Abdel-Aziz

    Full Text Available ABSTRACT INTRODUCTION: Adenoid hypertrophy may play a role in velopharyngeal closure especially in patients with palatal abnormality; adenoidectomy may lead to velopharyngeal insufficiency and hyper nasal speech. Patients with cleft palate even after repair should not undergo adenoidectomy unless absolutely needed, and in such situations, conservative or partial adenoidectomy is performed to avoid the occurrence of velopharyngeal insufficiency. Trans-oral endoscopic adenoidectomy enables the surgeon to inspect the velopharyngeal valve during the procedure. OBJECTIVE: The aim of this study was to assess the effect of transoral endoscopic partial adenoidectomy on the speech of children with repaired cleft palate. METHODS: Twenty children with repaired cleft palate underwent transoral endoscopic partial adenoidectomy to relieve their airway obstruction. The procedure was completely visualized with the use of a 70° 4 mm nasal endoscope; the upper part of the adenoid was removed using adenoid curette and St. Claire Thompson forceps, while the lower part was retained to maintain the velopharyngeal competence. Preoperative and postoperative evaluation of speech was performed, subjectively by auditory perceptual assessment, and objectively by nasometric assessment. RESULTS: Speech was not adversely affected after surgery. The difference between preoperative and postoperative auditory perceptual assessment and nasalance scores for nasal and oral sentences was insignificant (p = 0.231, 0.442, 0.118 respectively. CONCLUSIONS: Transoral endoscopic partial adenoidectomy is a safe method; it does not worsen the speech of repaired cleft palate patients. It enables the surgeon to strictly inspect the velopharyngeal valve during the procedure with better determination of the adenoidal part that may contribute in velopharyngeal closure.

  16. Principles of dispensary observation of patients with Parkinson's disease in a specialized clinical diagnostic room

    Directory of Open Access Journals (Sweden)

    Krivonos О.V.

    2013-12-01

    Full Text Available Aim: to develop and implement of the order of the dispensary observation of Parkinson's disease patients. Material and methods, the dispensary observation of Parkinson's disease patients had been performed by neurologist and diagnostic room (CDR based on the outpatient department of health care institutions obeyed by FMBA of Russia in six Closed Administrative-Territorial Units: Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk. Neurologist examined of patients and put data to the Register's database. Register's database had 588 Parkinson's disease examined patients, 112 of them (19,1% had stage II of the disease by Hoehn and Yahr, 231 (39,3% patients — stage III by Hoehn and Yahr, 187 (31,8% patients — stage IV byHoehn and Yahr, 58 (9,9% patients — stage V by Hoehn and Yahr. The duration of the dispensary observation of Parkinson's disease patients was 4 years (2009-2012. Results. There are and implement the order of the observed and accounting of adult's group of Parkinson's disease patients were developed, who are registered in the clinical and diagnostic rooms, including the frequency of physician's visits, the list of diagnostic and treatment activities and efficiency endpoint of the dispensary observation. Conclusion. Implementation of the order of the dispensary observation according to the Register allowed to identify the main disabling PD's symptoms (depression, dementia, motor fluctuations and dyskinesia and timely correction of therapy.

  17. One-staged correction of alveolar cleft and lip and nasal deformities secondary to lip cleft%牙槽嵴裂和唇裂继发唇鼻畸形的同期联合矫治

    Institute of Scientific and Technical Information of China (English)

    袁冶; 袁华; 王东苗; 吴煜农; 江宏兵; 陶震江

    2009-01-01

    目的 探讨牙槽嵴裂和唇裂继发唇、鼻畸形矫治的方法. 方法 对唇、腭裂术后畸形患者同期行牙槽嵴裂和唇裂继发唇、鼻畸形联合矫正. 结果 2004年~2007年,于临床应用37例.33例牙槽受植床创口一期愈合,3例松质骨外露,经清除外露骨和冲洗换药后愈合.本组患者术后正面观唇部饱满,红唇两侧高度基本对称,干湿唇线连续;仰视位鼻翼基底部高度恢复良好,两侧基本对称,鼻孔方向一致,但患侧鼻孔仍稍小于健侧. 结论 同期联合矫治牙槽嵴裂和唇裂继发唇、鼻畸形效果良好.%Objective To investigate Individualized one-staged correction of alveolar cleft and lip and nasal deformities secondary to lip cleft. Methods The alveolar cleft and lip and nasal deformities secondary to lip cleft were corrected in one stage. Results From 2004 to 2007, 37 cases were treated. 33 patients were treated successfully with primary healing in bony recipient area. Cancellous bone exposure happened in 3 cases. The wounds healed after debridement and drainage. The cosmetic results were satisfactory. Conclusions Onestaged correction of alveolar cleft and the lip and nasal deformities secondary to lip cleft can achieve good results.

  18. Communicative abilities in toddlers and in early school age children with cleft palate

    NARCIS (Netherlands)

    Ruiter, Jolien S.; Korsten-Meijer, Astrid G. W.; Goorhuis-Brouwer, Siena M.

    2009-01-01

    Objectives: Evaluation of improvement in communicative abilities in children with nonsyndromic cleft palate. Methods: Longitudinal retrospective case history Study. Out of 117 children with cleft lip and/or cleft palate born in 1998, 1999 and 2000 and enrolled in the cleft palate team of the Univers

  19. SOME EPIDEMIOLOGIC DATA ON ORAL CLEFTS IN THE NORTHERN NETHERLANDS, 1981-1988

    NARCIS (Netherlands)

    CORNEL, MC; SPREEN, JA; MEIJER, [No Value; SPAUWEN, PHM; DHAR, BK; TENKATE, LP

    1992-01-01

    Cleft lip with or without cleft palate [CL(P)] has a high incidence in the northern Netherlands. Several epidemiological parameters for oral clefts, including both CL(P) and cleft palate (CP), were analysed and compared with the literature. Except for the high prevalence at birth of isolated CL(P) n

  20. [Antihelicobacteric therapy for the patients with recurrent complicated postoperative gastroduodenal ulcer: indications, principles of conduction, efficacy].

    Science.gov (United States)

    Veligotskiĭ, N N; Buka, G Iu

    2009-01-01

    After performance of organ preserving operations the cytotoxic stamms of H. pylori were revealed in 47 (94%) patients with recurrent ulcer. after gastric resection--in 27 (58.6%). The conduction of antihelicobacteric therapy is indicated to all the patients, in whom recurrent ulcer had occurred after organ preserving operations performance, its indication after gastric resection performance must be individual, after the patient examination succession. Application of a combined preparation, consisting of 20 mg of omeprazol, 500 mg of clarithromycin, 1000 mg amoxicillin, in a standard dosage of 3 tablets twice a day during 7 days have permitted to achieve the H. pylori cytotoxic stamms eradication in 94.2% of the patients. The preparation is well endured by the patients, the adverse reactions are minimal, temporary, their occurrence does not necessitate the preparation abolition.

  1. ALTERNATIVE APPROACH IN THE TREATMENT OF A GINGIVAL CLEFT ASSOCIATED WITH LABIAL FRENULUM. A 3-YEAR FOLLOW-UP. (Case Report

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2015-07-01

    Full Text Available INTRODUCTION: The term Gingival cleft refers to a fissure in the gingival tissues and is usually caused by traumatic oral hygiene, abnormal frenula, trauma from occlusion, orthodontic, or pierce related trauma. Gingival clefts are classified depending on the extent of the inclusion of the gingival thickness into red and white. The recommended treatment approach for the incomplete white clefts is the gingivectomy of the affected keratinized tissue followed by a coronally advanced flap for the root coveradge, while the complete white clefts are treated with a laterally moved, coronally advanced flap, or a free gingival graft procedure. OBJECTIVE: This report presents a case with a spontaneous healing of an incomplete gingival cleft associated with a maxillary labial frenulum after an alternative frenuloectomy approach. METHODS: M.G. (45 with a localized chronic periodontitis, an abnormal papillary maxillary frenulum and an incomplete white cleft on the marginal gingiva of the left central incisor. An alternative frenuloectomy approach combined with a free gingival graft was selected for the correction of the abnormal frenulum. RESULTS:On the sixth month after the surgical procedure an almost complete recovery of the gingival margin was observed.The result at the third year demonstrates a stable gingival margin with a complete tissue recovery. CONCLUSION: The applied combined surgical approach led to a complete gingival recovery of the incomplete white gingival cleft without the commonly used gingivectomy and CAF. Further research is recommended to clarify the adjunctive benefits of the FGG in patients with gingival clefts associated with abnormal frenula.

  2. Postdistraction stability of hypoplastic maxilla in unilateral cleft lip and palate treated using rigid external distraction device: An audit

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2015-01-01

    Full Text Available Introduction: Maxillary hypoplasia resulting in skeletal class III malocclusion is common among patients with cleft lip and palate. Large anteroposterior discrepancies and surgical scaring often leads to unpredictable stability of maxillary advancement with Le Fort I osteotomy and is known for a high degree of relapse. The aim of this retrospective study was to evaluate the postdisraction stability after 1-year of maxillary advancement done with rigid external distraction (RED device in patients with unilateral cleft lip and palate. Materials and Methods: Records of 11 cases treated with RED device used for distraction of maxilla in cleft lip and palate cases were assessed. Lateral cephalograms selected were taken at the end of presurgical (T1, immediate postdistraction (T2 and 1-year postdistraction (T3. Five angular measurements and nine linear measurements were used to assess the position of maxilla in all three planes. P values were obtained for repeated measurement by analysis of variance with Bonferroni′s correction for multiple comparisons. Normality was tested using Shapiro-Wilk′s test. Results: The average 1-year postdistraction measurements (T3 did not differ significantly compared to the corresponding average postdistraction measurements (T2 (P > 0.05. Conclusion: Midface distraction with RED device provides a significant structural improvement for patients with cleft lip and palate. There was marked an improvement in dentofacial structures and results were stable during the retention phase.

  3. Novel FGFR1 and KISS1R Mutations in Chinese Kallmann Syndrome Males with Cleft Lip/Palate

    Directory of Open Access Journals (Sweden)

    Hao Xu

    2015-01-01

    Full Text Available Kallmann syndrome (KS is characterized by isolated hypogonadotropic hypogonadism (IHH with anosmia and is sometimes associated with cleft lip/palate (CLP. In order to describe the clinical features, genetic etiology, and treatment outcome of KS males with CLP, we performed genetic screening for 15 known causal IHH genes (KAL1, FGFR1, NELF, FGF8, CHD7, WDR11, SEMA3A, KISS1R, KISS1, PROKR2, PROK2, TAC3, TACR3, GNRH1, and GNRHR in four KS with CLP patients and six IHH patients without CLP. Two novel heterozygous missense mutations in FGFR1, (NM_001174066: c.776G>A (p.G259E and (NM_001174066: c.358C>T (p.R120C, were identified in a 23-year-old KS male with cleft lip and an 18-year-old KS patient with cleft lip and palate, dental agenesis, and high arched palate, respectively. These two mutations were not presented in their healthy parents and 200 normal controls. One novel heterozygous missense mutation in KISS1R, (NM_032551: c.587C>A (p.P196H, was identified in an 18-year-old KS male with cleft lip and dental agenesis who developed sperm after being treated with gonadotropin. This mutation was also presented in his healthy father and grandfather. These results have implications for the diagnosis, genetic counseling, and treatment of KS and CLP males with mutations in FGFR1 gene.

  4. Surgical Treatment as a Principle for Patients with High-Grade Pancreatic Neuroendocrine Carcinoma

    DEFF Research Database (Denmark)

    Haugvik, Sven-Petter; Janson, Eva Tiensuu; Österlund, Pia;

    2016-01-01

    BACKGROUND: This study aimed to evaluate the role of surgery for patients with high-grade pancreatic neuroendocrine carcinoma (hgPNEC) in a large Nordic multicenter cohort study. Prior studies evaluating the role of surgery for patients with hgPNEC are limited, and the benefit of the surgery is u....... Patients selected for resection of the primary tumor and synchronous liver metastases had a high 3-year survival rate. Selected patients with both localized hgPNEC and metastatic hgPNEC should be considered for radical surgical treatment.......BACKGROUND: This study aimed to evaluate the role of surgery for patients with high-grade pancreatic neuroendocrine carcinoma (hgPNEC) in a large Nordic multicenter cohort study. Prior studies evaluating the role of surgery for patients with hgPNEC are limited, and the benefit of the surgery...... is uncertain. METHODS: Data from patients with a diagnosis of hgPNEC determined between 1998 and 2012 were retrospectively registered at 10 Nordic university hospitals. Kaplan-Meier curves were used to compare the overall survival of different treatment groups, and Cox-regression analysis was used to evaluate...

  5. Hospital acquired blood stream infection as an adverse outcome for patients admitted to hospital with other principle diagnosis

    Directory of Open Access Journals (Sweden)

    Hamdan H Al-Hazmi

    2014-01-01

    Full Text Available Background: Hospital acquired infections (HAI have emerged as an important public health problem and are a leading cause of morbidity and mortality worldwide. They affect both developed and resource-poor countries and constitute a significant burden both for the patient and for the health care system. Specific objectives in this study are assessment of HAI rate among patients admitted with other principle diagnosis, to identifying the causative agents of hospital acquired infections and to identify some possible risk factors associated with each type of infection, both health related and non-health related. Patients and Methods: The study was done on selected diagnosis groups during year 2010. The infections were found among 250 patients (43.6% males have been exposed to episodes of infections. Median age of patients was 56. Data were abstracted from the archived patients′ files in medical record department using the annually infection control log-book prepared by the infection control department. The Data collected were demographic information about the patients (age and sex, clinical condition (diagnosis and the length of hospital stay and possible risk factors for infection as smoking, diabetes mellitus, hypertension and exposure to invasive devices or exposure to surgical procedures. Results: Liver diseases 22.8%, cardiac diseases 22.8%, Gastro-Intestinal System diseases 20%, urinary system diseases 13.6%, and endocrinal disorder 13.6% Prostate gland diseases 7.2%. Episodes of infections caused by 9 types of organisms divided into 47.2% for blood stream infection and 52.8% for other types. 66% acquired blood stream infection were exposed to central venous line. Conclusion: Most common type of HAIs was blood stream infections. Liver, cardiac diseases and gastro-intestinal diseased patients show more proportion of HAIs while urinary system and prostate disease patients show less proportion of HAIs. Gram negative bacilli were the most common

  6. Status of larynx in children with congenital cleft of upper lip and palate

    Directory of Open Access Journals (Sweden)

    Nigora Makhkamova

    2010-09-01

    Full Text Available Study of 215 children with congenital cleft of upper lip and palate in the age of 1.5 to 15 years has established the organic dysphonia in 27.4% of patients. Of the organic diseases of larynx there were edema, hypertrophy, nodules of vocal folds and chronic laryngitis whose frequency is directly dependent on duration and severity of the defect, age of patient and the timing of recovery of velopharyngeal ring. Pathology of the larynx gradually disappears with the growth of the patient after plastic reconstruction of oronasal defect.

  7. Sphincterplasty for Velopharyngeal Insufficiency in the Child Without a Cleft-Palate: Etiologies and Speech Outcomes.

    Science.gov (United States)

    Golinko, Michael S; Mason, Kazlin; Nett, Katie; Riski, John E; Williams, Joseph K

    2015-10-01

    The aim of this study is to report on speech outcomes following surgery for velopharyngeal insufficiency (VPI) on a broad spectrum of patients without a cleft palate. Inclusion criteria included patients without a cleft palate operated on by a single surgeon (JKW) over a 10-year period and postoperative speech evaluation within 1 year. All patients underwent a sphincter pharyngoplasty. The main outcome measures were perceptual speech assessment using a 6-point scale (1 = none or normal, 6 = severe); velopharyngeal function (VPF) (1 = adequate, 2 = marginal, 3 =  dequate); and quantitative nasalance score. Forty children (mean age 7.5 y) were included. Eight unique conditions were identified; the most common was 22q deletion syndromes (27.5%). All patients had a deep nasopharynx, mean nasopharyngeal depth >0.67. Two novel cases are presented in each child with mosaic Trisomy 14 and ring chromosome 18 abnormality. Of all patients, 87.5% improved their postoperative hypernasality score. Preoperatively, all patients had either marginal or inadequate VPF (2 or 3). Postoperatively, 90% of patients (n = 36) achieved adequate velar function, the remainder did not improve at the first postoperative evaluation. Intelligibility and audible nasal emissions improved in between 57% and 65% of patients. Articulation proficiency was the only perceptual rating not to improve initially, but then did so on the most recent postoperative speech evaluation. This study demonstrates successful speech outcomes in a diverse group of patients. It also increases awareness of noncleft VPI amenable to surgical correction.

  8. Nonsyndromic cleft lip with or without cleft palate: New BCL3 information

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C.; Hecht, J.T. [Univ. of Texas Medical School, Houston, TX (United States); Gasser, D. [Univ. of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    1996-09-01

    We did not previously provide LOD scores for linkage assuming heterogeneity, as suggested by Ott for the linkage analysis of cleft lip with or without cleft palate (CL/P) and BCL3, ApoC2, and D19S178 in the paper by Stein et al. The results from analysis using the HOMOG program, allowing for heterogeneity under the reduced penetrance model, gave a maximum LOD score of 1.85 for ApoC2, 0.41 for BCL3, 0.03 for D19S178, and 1.72 for multipoint analysis in the interval. For the affecteds-only model, the values are 1.96 for ApoC2, 0.41 for BCL3, 0.01 for D19S178, and 1.44 for the multipoint analysis. 8 refs.

  9. Candidate pathway based analysis for cleft lip with or without cleft palate.

    Science.gov (United States)

    Zhang, Tian-Xiao; Beaty, Terri H; Ruczinski, Ingo

    2012-01-06

    The objective of this research was to identify potential biological pathways associated with non-syndromic cleft lip with or without cleft palate (NSCL/P), and to explore the potential biological mechanisms underlying these associated pathways on risk of NSCL/P. This project was based on the dataset of a previously published genome-wide association (GWA) study on NSCL/P (Beaty et al. 2010). Case-parent trios used here originated from an international consortium (The Gene, Environment Association Studies consortium, GENEVA) formed in 2007. A total of 5,742 individuals from 1,908 CL/P case-parents trios (1,591 complete trios and 317 incomplete trios where one parent was missing) were collected and genotyped using the Illumina Human610-Quad array. Candidate pathways were selected using a list of 356 genes that may be related to oral clefts. In total, 42 candidate pathways, which included 1,564 genes and 40,208 SNPs were tested. Using a pathway-based analysis approach proposed by Wang et al (2007), we conducted a permutation-based test to assess the statistical significance of the nominal p-values of 42 candidate pathways. The analysis revealed several pathways yielding nominally significant p-values. However, controlling for the family wise error rate, none of these pathways could retain statistical significance. Nominal p-values of these pathways were concentrated at the lower tail of the distribution, with more than expected low p-values. A permutation based test for examining this type of distribution pattern yielded an overall p-value of 0.029. Thus, while this pathway-based analysis did not yield a clear significant result for any particular pathway, we conclude that one or more of the genes and pathways considered here likely do play a role in oral clefting.

  10. 完全性唇腭裂婴儿期手术对上颌骨发育的影响%The effect of early cleft palate repair on maxillary growth in infantile complete cleft lip and palate children

    Institute of Scientific and Technical Information of China (English)

    赵瑞红

    2011-01-01

    Objective: To obsewe the effect of infantile cleft palate repair on maxillary growth in children with complete cleft lip and palate. Methods: 18 children with complete cleft lip and palate were divided into two groups according to whether cleft palate repair was performed or not in infancy. In the one-stage repair group, 10 children received cleft lip and palate repair in infancy, the mean age was (10.15±0.76) years in follow-up. In the cleft lip repair group (10 patients),cleft lip repair was performed without cleft palate surgery in infancy, the mean age of this group was (10.25±0.75) years in follow-up. 20 cases of noncleft children (ages lO) were normal control group. The X-ray cephalometry and dentognathic models of three groups were obtained and compared. Results: The data analysis of cephalometry and dental cast showed that the difference between the two groups had no obvious significance (P>0.05); but compared with the normal group, the cleft lip and palate patients all had the growth inhibition (P<0.05). Conclusion: The cleft palate repair is not the reason of the difference existing;. Earlier cleft palate operation is favorable to functional recovery for infants.%目的:观察婴儿早期行唇腭裂手术对完全性唇腭裂患儿上颌骨发育的近期影响.方法:18例完全性唇腭裂患儿在婴儿期接受唇腭裂手术作为唇腭裂修复组,随访时平均年龄(10.15±0.76)岁;10例未行唇腭裂手术的单纯唇裂患儿为单纯唇腭裂组,随访时平均年龄(10.25±0.75)岁;另20例正常的10岁龄学童作为正常对照组.三组分别取头颅侧位片与上牙颌模型,进行测量分析.结果:两组唇腭裂患儿之间的上颌骨发育无明显差异(P>0.05),与正常对照组比较,均有生长抑制(P<0.05).结论:早期对完全性唇腭裂患儿行唇裂修复术对上颌骨发育的影响不大,还可以使患者获得正常的语言功能.

  11. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    Science.gov (United States)

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis.

  12. Genetic determinants of facial clefting: analysis of 357 candidate genes using two national cleft studies from Scandinavia.

    Directory of Open Access Journals (Sweden)

    Astanand Jugessur

    Full Text Available BACKGROUND: Facial clefts are common birth defects with a strong genetic component. To identify fetal genetic risk factors for clefting, 1536 SNPs in 357 candidate genes were genotyped in two population-based samples from Scandinavia (Norway: 562 case-parent and 592 control-parent triads; Denmark: 235 case-parent triads. METHODOLOGY/PRINCIPAL FINDINGS: We used two complementary statistical methods, TRIMM and HAPLIN, to look for associations across these two national samples. TRIMM tests for association in each gene by using multi-SNP genotypes from case-parent triads directly without the need to infer haplotypes. HAPLIN on the other hand estimates the full haplotype distribution over a set of SNPs and estimates relative risks associated with each haplotype. For isolated cleft lip with or without cleft palate (I-CL/P, TRIMM and HAPLIN both identified significant associations with IRF6 and ADH1C in both populations, but only HAPLIN found an association with FGF12. For isolated cleft palate (I-CP, TRIMM found associations with ALX3, MKX, and PDGFC in both populations, but only the association with PDGFC was identified by HAPLIN. In addition, HAPLIN identified an association with ETV5 that was not detected by TRIMM. CONCLUSION/SIGNIFICANCE: Strong associations with seven genes were replicated in the Scandinavian samples and our approach effectively replicated the strongest previously known association in clefting--with IRF6. Based on two national cleft cohorts of similar ancestry, two robust statistical methods and a large panel of SNPs in the most promising cleft candidate genes to date, this study identified a previously unknown association with clefting for ADH1C and provides additional candidates and analytic approaches to advance the field.

  13. Modified technique of presurgical infant maxillary orthopedics for complete unilateral cleft lip and palate.

    Science.gov (United States)

    Choo, Hyeran; Maguire, Meg; Low, David W

    2012-01-01

    This article introduces a modified device fabrication and facial taping method that increases the efficiency and efficacy of presurgical infant maxillary orthopedic therapy for babies born with complete cleft lip and palate. Interarch and intra-arch relationships of the maxillary and mandibular dental arches were evaluated on mounted stone models before and after treatment. The palatal plate device was custom-fabricated in a manner that bypassed the need for periodic acrylic addition and removal, thereby eliminating the risk of natural maxillary growth restriction during therapy. Elastic labial tapes were fabricated and applied in a configuration that mimicked normal function of the orbicularis oris muscle. A nasal stent wire was utilized from the initiation of therapy to enhance intraoral retention and stability of the device. Examples of infants undergoing a unilateral complete cleft lip and palate treatment protocol are presented. Treatment objectives were achieved within 7 to 8 weeks of therapy for patients who had an initial alveolar cleft size more than 10 to 12 mm. The modified protocol of presurgical infant maxillary orthopedic therapy is an effective and efficient treatment modality in reversing the pre-existing orofacial dysmorphism by redirecting the infant's natural growth.

  14. Bone regeneration by octacalcium phosphate collagen composites in a dog alveolar cleft model.

    Science.gov (United States)

    Matsui, K; Matsui, A; Handa, T; Kawai, T; Suzuki, O; Kamakura, S; Echigo, S

    2010-12-01

    Octacalcium phosphate (OCP) and porcine atelocollagen sponge composites (OCP/Col) markedly enhanced bone regeneration in a rat cranial defect model. To assess clinical application, the authors examined whether OCP/Col would enhance bone regeneration in an alveolar cleft model in an adult dog, which was assumed to reflect patients with alveolar cleft. Disks of OCP/Col or collagen were implanted into the defect and bone regeneration by OCP/Col or collagen was investigated 4 months after implantation. Macroscopically, the OCP/Col-treated alveolus was obviously augmented and occupied by radio-opacity, and the border between the original bone and the defect was indistinguishable. Histological analysis revealed it was filled and bridged with newly formed bone; a small quantity of the remaining implanted OCP was observed. X-ray diffraction patterns of the area of implanted OCP/Col indicated no difference from those of dog bone. In the collagen