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Sample records for repaired unilateral cleft

  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. 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.

  3. Comparison of three incisions to repair complete unilateral cleft lip.

    NARCIS (Netherlands)

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.

    2010-01-01

    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  4. Comparison of three incisions to repair complete unilateral cleft lip.

    NARCIS (Netherlands)

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.

    2010-01-01

    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  5. Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate.

    Science.gov (United States)

    Xu, Xue; Kwon, Hyuk-Jae; Shi, Bing; Zheng, Qian; Yin, Heng; Li, Chenghao

    2015-01-01

    To address the question of whether one- or two-stage palatal treatment protocol has fewer detrimental effects on craniofacial growth in patients aged 5 years with unilateral complete cleft lip and palate. Forty patients with non-syndromic unilateral complete cleft lip and palate (UCCLPs) who had received primary cleft lip repair at age 6-12 months and cleft palate repair at age 18-30 months were selected in this study. Eighteen UCCLP patients who received two-stage palate repair were selected as group 1, and 22 UCCLP patients who received one-stage palate repair were selected as group 2. The control group consisted of 20 patients with unilateral incomplete cleft lip (UICL patients) whose age and gender matched with UCCLP patients. A one-sample Kolmogorov-Smirnov test was used to analyze the nature of data distribution. Bonferroni test and Kruskal-Wallis H tests were used for multiple comparisons. Both case groups showed reduced maxillary sagittal length (ANS-PMP, A-PM, p palate repair had a reduced posterior maxillary vertical height (R-PMP, p palate repair. Vomer flap repair inhibited maxilla vertical growth. Delayed hard palate repair showed less detrimental effects on maxillary growth compared to early hard palate repair in UCCLP patients aged 5 years. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. A new incision for unilateral cleft lip repair developed using animated simulation of repair on computer

    Directory of Open Access Journals (Sweden)

    Sahay A

    2007-01-01

    Full Text Available Background: Unilateral cleft lip repair continues to leave behind some amount of dissatisfaction, as a scope for further improvement is always felt. Most surgeons do not like to deviate from the standard Millard′s/ triangular techniques, or their minor modifications, as no one likes to experiment on the face for fear of unfavourable outcomes. The computer can be utilized as a useful tool in the analysis and planning of surgery and new methods can be developed and attempted subsequently with greater confidence. Aim: We decided to see if an improved lip repair could be developed with the use of computers. Materials and Methods: Analysis of previous lip repairs was done to determine where an improvement was required. Movement of tissues, by simulating an ideal repair, using image warping software, on digital images of cleft lip was studied in animation sequences. A repair which could reproduce these movements was planned. A new incision emerged, which had combined the principles of Millard′s and Randall / Tennyson repairs, with additional features. The new method was performed on 30 cases. Conclusions: The results were encouraging as the shortcomings of these methods were minimized, and the advantages maximized.

  7. Treatment outcome after neonatal cleft lip repair in 5-year-old children with unilateral cleft lip and palate.

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    Košková, Olga; Vokurková, Jitka; Vokurka, Jan; Bryšova, Alena; Šenovský, Pavel; Čefelínová, Julie; Lukášová, Darina; Dorociaková, Petra; Abelovský, Juraj

    2016-08-01

    The aim of this study was to assess speech outcomes and dental arch relationship of 5-year-old Czech patients with unilateral cleft lip and palate (UCLP) who have undergone neonatal cleft lip repair and one-stage palatal closure. Twenty-three patients with UCLP, born between 2009 and 2010, were included in the study. Three universal speech parameters (hypernasality, articulation and speech intelligibility) have been devised for speech recordings evaluation. Outcomes of dental arch relationship were evaluated by applying the GOSLON Yardstick and subsequently compared with the GOSLON outcome of other cleft centers. Moderate hypernasality was present in most cases, the mean value for articulation and speech intelligibility was 2.07 and 1.93, respectively. The Kappa values for inter-examiner agreement for all the three speech outcomes ranged from 0.786 to 0.808. Sixty-three percent of patients were scored GOSLON 1 and 2, 26% GOSLON 3, and 10% GOSLON 4. GOSLON mean score was 2.35. Interrater agreement was very good, represented by kappa value of 0.867. The treatment protocol, involving neonatal cleft lip repair and one-stage palatal repair performed up to the first year of UCLP patient's life, has shown good speech outcomes and produced very good treatment results in regard to maxillary growth, comparable with other cleft centers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. 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.

  9. Straight line repair of unilateral cleft lip: new operative method based on 25 years experience.

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    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.

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

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    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.

  11. 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). ...

  12. Bite force of children with repaired unilateral and bilateral cleft lip and palate.

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    Garcia, Michele Alves; Rios, Daniela; Honório, Heitor Marques; Trindade-Suedam, Ivy Kiemle

    2016-08-01

    To assess the bite force (BF) of children with repaired cleft lip and palate (CLP). Children aged 6-12 years, with and without CLP, were divided into the following 5 groups: (1) control group (CON): 34 children without CLP (17 female, 17 male, mean age 8.2±1.4); (2) cleft lip group (CL): 31 children with cleft lip involving the pre-maxilla (15 female, 16 male, mean age 9.7±1.3); (3) unilateral CLP group (UCLP): 36 children with complete unilateral CLP (11 female, 25 male, mean age 9.4±1.6); (4) bilateral CLP group (BCLP): 32 children with complete bilateral CLP (11 female, 21 male, mean age 9.5±1.7); and 5) cleft palate group (CP): 17 children with complete cleft palate (9 female, 8 male, mean age 9.4±1.6). Briefly, in this clinical trial, BF was assessed before alveolar bone grafting with a gnathodynamometer (IDDK, Kratos, Cotia, SP, Brazil). For CON, BCLP, CL and CP groups, BF was obtained in the anterior and posterior region of the maxilla. For the UCLP group, BF was assessed in the anterior and posterior regions of both segments. Differences among groups were evaluated by ANOVA test, and Tukey's test was used to assess any correlations among variables (Pcleft groups. However, a stronger BF was observed in the CL group when compared to the UCLP and BCLP groups. Next, no differences were observed between the cleft side and the noncleft side in the UCLP group. Lastly, in all groups, BFs from the anterior region of the maxilla were less when compared to the posterior regions. The BF of children with CLP is no different from children without CLP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate

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    Othman, Siti Adibah; Aidil Koay, Noor Airin

    2016-08-01

    We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra- and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions.

  14. 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.

  15. 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.

  16. Vomer flap for hard palate repair is related to favorable maxillary growth in unilateral cleft lip and palate.

    Science.gov (United States)

    Liao, Yu-Fang; Lee, Ying-Hsin; Wang, Ruby; Huang, Chiung-Shing; Chen, Philip Kuo-Ting; Lo, Lun-Jou; Chen, Yu-Ray

    2014-05-01

    Vomer flap repair is assumed to improve maxillary growth because of reduced scarring in growth-sensitive areas of the palate. Our aim was to evaluate whether facial growth in patients with unilateral cleft lip and palate was significantly affected by the technique of hard palate repair (vomer flap versus two-flap). For this retrospective longitudinal study, we analyzed 334 cephalometric radiographs from 95 patients with nonsyndromic complete unilateral cleft lip and palate who underwent hard palate repair by two different techniques (vomer flap versus two-flap). Clinical notes were reviewed to record treatment histories. Cephalometry was used to determine facial morphology and growth rate. The associations among facial morphology at age 20, facial growth rate, and technique of hard palate repair were assessed using generalized estimating equation analysis. The hard palate repair technique significantly influenced protrusion of the maxilla (SNA: β = -3.5°, 95 % CI = -5.2-1.7; p = 0.001) and the anteroposterior jaw relation (ANB: β = -4.2°, 95 % CI = -6.4-1.9; p = 0.001; Wits: β = -5.7 mm, 95 % CI = -9.6-1.2; p = 0.01) at age 20, and their growth rates (SNA p = 0.001, ANB p cleft lip and palate, vomer flap repair has a smaller adverse effect than two-flap on growth of the maxilla. This effect on maxillary growth is on the anteroposterior development of the alveolar maxilla and is progressive with age. We now perform hard palate closure with vomer flap followed by soft palate closure using Furlow palatoplasty. These findings may improve treatment outcome by modifying the treatment protocol for patients with unilateral cleft lip and palate.

  17. Unilateral cleft lip and palate: Simultaneous early repair of the nose, anterior palate and lip

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    Laberge, Louise Caouette

    2007-01-01

    Unilateral cleft lip and palate is a defect involving the lip, nose and maxilla. These structures are inter-related, and simultaneous early correction of all the aspects of the defect is necessary to obtain a satisfactory result that will be maintained with growth. The surgical technique combining various procedures is presented and compared with previously published reports. PMID:19554125

  18. Intraoperative vascular anatomy, arterial blood flow velocity, and microcirculation in unilateral and bilateral cleft lip repair

    NARCIS (Netherlands)

    Mueller, A.A.; Schumann, D.; Reddy, R.R.; Schwenzer-Zimmerer, K.; Mueller-Gerbl, M.; Zeilhofer, H.F.; Sailer, H.F.; Reddy, S.G.

    2012-01-01

    BACKGROUND: Cleft lip repair aims to normalize the disturbed anatomy and function. The authors determined whether normalization of blood circulation is achieved. METHODS: The authors measured the microcirculatory flow, oxygen saturation, and hemoglobin level in the lip and nose of controls (n = 22)

  19. Objective assessment of internal nasal dimensions and speech resonance in individuals with repaired unilateral cleft lip and palate after rhinoseptoplasty.

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    Trindade, Inge Elly Kiemle; Bertier, Carlos Eduardo; Sampaio-Teixeira, Ana Claudia Martins

    2009-03-01

    The objective of the current study was to analyze the effects of rhinoseptoplasty on internal nasal dimensions and speech resonance of individuals with unilateral cleft lip and palate, estimated by acoustic rhinometry and nasometry, respectively. Twenty-one individuals (aged 15-46 years) with previously repaired unilateral cleft lip and palate were analyzed before (PRE), and 6 to 9 (POST1) and 12 to 18 months (POST2) after surgery. Acoustic rhinometry was used to measure the cross-sectional areas (CSAs) of segments corresponding to the nasal valve (CSA1), anterior portion (CSA2), and posterior portion (CSA3) of the lower turbinate, and the volumes at the nasal valve (V1) and turbinate (V2) regions at cleft and noncleft sides, before and after nasal decongestion with a topical vasoconstrictor. Nasometry was used to evaluate speech nasalance during the reading of a set of sentences containing nasal sounds and other devoid of nasal sounds. At the cleft side, before nasal decongestion, there was a significant increase (P nasalance values at PRE, POST1, and POST2 were not different from each other in both oral and nasal sentences. The measurement of CSAs and volumes by acoustic rhinometry revealed that rhinoseptoplasty provided, in most cases analyzed, a significant increase in nasal patency, without concomitant changes in speech resonance, as estimated by nasalance assessment.

  20. 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.

  1. Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique.

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    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.

  2. Cleft lip repair - slideshow

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    ... 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 ...

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

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    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.

  4. Evaluation of the Use of Auricular Composite Graft for Secondary Unilateral Cleft Lip Nasal Alar Deformity Repair

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    Percy Rossell-Perry

    2014-01-01

    Full Text Available The purpose of this study is to evaluate the surgical outcome after using composite grafts for secondary cleft lip nasal deformities. A retrospective cohort study of one surgeon’s outcome of 35 consecutive performed secondary cleft lip nasal deformity repair. Thirty-five patients with secondary nose deformity related to unsatisfactory cleft lip repair were operated using the proposed surgical technique since 2008. All these patients met the study criterion of having anthropometric measurements performed at least one year postoperatively. Measurement of nostril size was performed at the right and left side of the nose, preoperatively and at least one year postoperatively. The study found statistically significant differences between the preoperatory and postoperatory nose measurements. In addition, we have not found statistically significant differences between the cleft and noncleft nostril sizes measured at least one year postoperatively. The findings suggest that the proposed technique is a good alternative to address secondary nose deformity related to cleft lip primary repair.

  5. A novel computer system for the evaluation of nasolabial morphology, symmetry and aesthetics after cleft lip and palate treatment. Part 2: Comparative anthropometric analysis of patients with repaired unilateral complete cleft lip and palate and healthy individuals.

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    Pietruski, Piotr; Majak, Marcin; Pawlowska, Elzbieta; Skiba, Adam; Antoszewski, Boguslaw

    2017-04-01

    The aim of this study was to use a novel system, 'Analyse It Doc' (A.I.D.) for a complex anthropometric analysis of the nasolabial region in patients with repaired unilateral complete cleft lip and palate and in healthy individuals. A set of standardized facial photographs in frontal, lateral and submental view have been taken in 50 non-cleft controls (mean age 20.6 years) and 42 patients with repaired unilateral complete cleft and palate (mean age 19.57 years). Then, based on linear, angular and area measurements taken from the digital photographs with the aid of the A.I.D. system, a photogrammetric analysis of intergroup differences in nasolabial morphology and symmetry was conducted. Patients with cleft lip and palate differed from the controls in terms of more than half of analysed angular measurements and proportion indices derived from linear and area measurements of the nasolabial region. The findings presented herein imply that despite primary surgical repair, patients with unilateral complete cleft lip and palate still show some degree of nasolabial dysmorphology. Furthermore, the study demonstrated that the novel computer system is suitable for a reliable, simple and time-efficient anthropometric analysis in a clinical setting. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Cleft lip and palate repair

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    ... 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 ...

  7. 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

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

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    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.

  9. Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life.

    NARCIS (Netherlands)

    Hortis-Dzierzbicka, M.; Radkowska, E.; Fudalej, P.S.

    2012-01-01

    An evaluation of the results of one-stage repair of unilateral cleft lip and palate (UCLP) performed at the Institute of Mother and Child, Warsaw, Poland, has shown that the dentofacial outcomes are comparable with those of the best cleft centres. The aim of this study was to assess speech developme

  10. Incisor and molar overjet, arch contraction, and molar relationship in the mixed dentition in repaired complete unilateral cleft lip and palate: A qualitative and quantitative appraisal.

    Science.gov (United States)

    Disthaporn, Suteeta; Suri, Sunjay; Ross, Bruce; Tompson, Bryan; Baena, Diogenes; Fisher, David; Lou, Wendy

    2017-07-01

    To compare the mixed dentition incisor and molar overjet, severity of contraction of the dental arch, and the sagittal molar relationship on the cleft side vs the noncleft side in children with repaired complete unilateral cleft of the lip and palate (UCLP). Orthodontic records taken prior to orthodontic preparation for alveolar bone grafting were screened to select study casts from patients with nonsyndromic repaired complete UCLP who did not have mandibular skeletal or dental asymmetry. The study sample comprised dental casts from 74 children aged 8.9 ± 1 years. Standardized digital photographs were acquired at 1:1 magnification. A coordinate system was developed using digital image-processing software (Photoshop CS4 and Adobe Illustrator). Incisor and molar overjet, Angle's classification, and arch contraction were recorded. Descriptive statistics, paired t-tests, and kappa statistics were used to compare the cleft and noncleft sides. A negative overjet of -1 to -5 mm was often present at the incisors, with greater frequency and magnitude on the cleft side. Class II molar relation was more frequent on the cleft side (61.1%) than on the noncleft side (47.2%). Significantly greater contraction of the cleft side deciduous canine and deciduous first molar was noted, while the difference was very minor at the first permanent molar. Cleft side maxillary arch contraction was most severe in the deciduous canine and first deciduous molar region and progressively less severe in the posterior region of the arch. A greater frequency and severity of negative overjet and Class II molar relationship was seen on the cleft side.

  11. Speech outcomes of early palatal repair with or without intravelar veloplasty in children with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Doucet, Jean-Charles; Herlin, Christian; Captier, Guillaume; Baylon, Hélène; Verdeil, Mélanie; Bigorre, Michèle

    2013-12-01

    We compared the early speech outcomes of 40 consecutive children with complete unilateral cleft lip and palate (UCLP) who had been treated according to different 2-stage protocols: the Malek protocol (soft palate closure without intravelar veloplasty at 3 months; lip and hard palate repair at 6 months) (n=20), and the Talmant protocol (cheilorhinoplasty and soft palate repair with intravelar veloplasty at 6 months; hard palate closure at 18 months) (n=20). We compared the speech assessments obtained at a mean (SD) age of 3.3 (0.35) years after treatment by the same surgeon. The main outcome measures evaluated were acquisition and intelligibility of speech, velopharyngeal insufficiency, and incidence of complications. A delay in speech articulation of one year or more was seen more often in patients treated by the Malek protocol (11/20) than in those treated according to the Talmant protocol (3/20, p=0.019). Good intelligibility was noted in 15/20 in the Talmant group compared with 6/20 in the Malek group (p=0.010). Assessment with an aerophonoscope showed that nasal air emission was most pronounced in patients in the Malek group (p=0.007). Velopharyngeal insufficiency was present in 11/20 in the Malek group, and in 3/20 in the Talmant group (p=0.019). No patients in the Talmant group had an oronasal fistula (ppalate, early speech outcomes were better in the Talmant group because intravelar veloplasty was successful and there were no fistulas after closure of the hard palate in 2 layers.

  12. 单侧唇裂的个体化修复设计应用%Individual design of surgical repair for unilateral cleft lip

    Institute of Scientific and Technical Information of China (English)

    董希银; 魏明勇; 唐友盛

    2011-01-01

    目的:探讨单侧唇裂的临床分型,根据分型制定个体化修复术式,评价手术效果.方法:50例单侧上唇裂患者,平均年龄4.8个月,包括单侧完全性唇裂、单侧不完全性唇裂,根据唇高分为4型,分别对各型应用个体化设计手术方法、制定术后效果评定方法,观察术后近期效果.结果:所有患者手术后近期唇弓、唇红、唇珠恢复好,鼻畸形得到改善.结论:单侧唇裂修复根据临床分型应用个体化唇裂修复设计,手术疗效满意.%Objective To evaluate the effect of individual design of surgical repair for unilateral cleft lip. Methods Fifty patients (mean age of 4.8 months) with unilateral cleft lip were divided into 4 types according to the lip heightjndividual design of surgical repair was applied based on the type of unilateral cleft lip.The postoperative effect was observed and compared among the 4 groups. Results All patients had a good postoperative upper lip shape.Lip bow.vermilion.lip beads.lip kiss-line recovery were satisfactory at the same time proper correction of nasal deformities. Conclusion The individual design of surgical repair is feasible for various type for unilatreal cleft lip.

  13. Effect of Relaxing Incisions on the Maxillary Growth after Primary Unilateral Cleft Palate Repair in Mild and Moderate Cases: A Randomized Clinical Trial

    Science.gov (United States)

    Cotrina-Rabanal, Omar; Figallo-Hudtwalcker, Olga; Gonzalez-Vereau, Alicia

    2017-01-01

    Background: The purpose of this study was to evaluate the association between the use of relaxing incisions and maxillary growth disturbance after primary palatoplasty in patients with unilateral cleft lip and palate. Methods: This is a prospective, randomized, double-blind controlled trial study with ethical committee approval between 2 groups of patients with unilateral cleft lip and palate who were operated on using the two-flap and one-flap techniques from 2008 to 2011. Two groups of patients with unilateral cleft lip and palate were operated on using the mentioned techniques by the Outreach Surgical Center Program Lima since 2008. Data collection was accomplished by evaluation of maxillary arch dimensions and dental arch relationships (scored using the 5-year-olds’ index). Results: The mean score for the 5-year-olds’ index was 2.57 for two-flap technique and 2.80 for one-flap technique without statistical significant differences (P = 0.71). Our comparative study did not find statistically significant differences in maxillary arch dimensions between the studied techniques for unilateral cleft palate repair. Good levels of agreement were observed according to the κ statistics. Conclusions: The results arising from this clinical trial do not provide statistical evidence that one technique let us obtain better maxillary development than the other at 5 years. The use of relaxing incisions was not associated with maxillary growth impairment. A technique with limited relaxing incisions does not has better maxillary growth. Additional longer term study is necessary to confirm this preliminary report. PMID:28203502

  14. 反转切口在单侧唇裂整复术中的应用%Application of back cut in the repair of unilateral cleft lip

    Institute of Scientific and Technical Information of China (English)

    冯大军; 陈传俊; 陈晓阳; 丁常春

    2012-01-01

    目的 探讨改良Millard术式对单侧唇裂修复的效果.方法 对64例单侧唇裂患者进行唇裂修复,采用Millard术式并作以下改良:取消患侧鼻翼基部切口,在健侧做反转切口,充分延长患侧人中嵴保持两侧唇峰高度的对称性.结果 所有病例术后1、3、6、12月、两年随访,唇弓清晰,患侧唇峰与健侧对称,双侧唇峰高度无视觉上差异.结论 反转切口弥补了传统的Millard法术后患侧唇高不足、唇峰不对称等缺点,效果良好,可为临床参考.%Objective To present a modified Millard technique for the repair of unilateral cleft lip. Methods 64 cases with unilateral cleft lip were operated by the Millard' s method:Alar base incisim of cleft was canceled and a modification of the back cut was made to lengthen philtrum column, and the reason for further rotation was to maintain the symmetry of the peaks of Cupids bow. Results The follow-up period ranged from 1 to 24 months. A lampros Cupid's bow was achieved and there was no discrepancy between in-cleft-side and non-cleft-side lip height for the eye to notice. Conclusion Back cut improved some deficiency of Millard s method and procure the aesthetic results.

  15. Clinical Study of Unilateral Cleft Lip Repair Improvement%单侧唇裂修复改良的临床研究

    Institute of Scientific and Technical Information of China (English)

    黎军

    2014-01-01

    Objective:To study and analyze unilateral cleft lip repair improvement surgery. Methods:Selecting 25 cases of children with unilateral cleft lip repair surgery in the hospital from January,2011 to June,2012,including 19 men and 6 women.The age of patients was more than 3 to 9 months. The clinical data were retrospectively analyzed. Result:All children with cleft lip repair operation time was 0.5~1 hour,with an average of (0.75±0.25) hours,and the bleeding is 6~14 ml. Experts and families of children are satisfied with the surgery effect. Conclusion:The unilateral cleft lip repair surgery can greatly improve the treatment effect,and is worthy of clinical popularization and application.%目的:对单侧唇裂修复改良手术进行研究和分析。方法:选取了2011年1月至2012年6月期间,有25例患儿在我院接受单侧唇裂修复手术,其中19例为男性,6例为女性;上述患者年龄均为3~9个月以上。对其临床资料进行回顾性分析。结果:所有患儿的唇裂修复手术时间为0.5~1h,平均为(0.75±0.25)h,出血量为6~14ml。专家及患儿家属对手术效果均表示满意。结论:本研究所述的单侧唇裂修复改良手术能够较大程度地提高治疗效果,值得临床推广应用。

  16. 修复单侧唇裂继发鼻畸形的临床疗效%Repairing Effect of Secondary Nasal Deformity of Unilateral Cleft Lip

    Institute of Scientific and Technical Information of China (English)

    庞雪晶; 张伶; 李素君; 左志慧

    2015-01-01

    Objective To analyze the repairing effect of secondary nasal deformity of unilateral cleft lip repair medical efficacy. Methods The clinical data of 50 children who had received unilateral cleft lip nasal deformity repair from April 2012 to December 2013 were selected and repairing effect and adverse reaction were retrospectively analyzed. Results of 50 cases of children with cleft lip nasal deformity appearance had changed dramatically, with a higher rate of. Keep the postoperative patients with symmet-rical nostril incision hidden, postoperative scar was not significant. After followed up for 1-3 years after the discovery, in which the performance of gifted children in 41 cases, good performance in children with 5 people, the excellent and good rate reached 97.1%, and children with no adverse reaction and other complications. Conclusion Repair therapy on infants with cleft lip nasal deformity, not only can let the patient nose uplift, nostril symmetry, to maintain a good shape condition of the patients, the surgical incision was hidden at the same time, postoperative scar was not obvious.%目的:分析单侧唇裂继发鼻畸形的修复医学疗效。方法回顾性的选择50例2012年4月-2013年12月来该院进行修复单侧唇裂继发鼻畸形患儿临床资料,对患儿修复的效果以及不良反应等进行分析。结果50例患儿唇裂继发鼻畸形外形有了显著的改变,满率较高。患儿术后鼻孔保持对称,手术切口隐秘,术后斑痕不显著。经过随访1~3年后发现,其中表现优的患儿有41例,表现良的患儿者有5例,优良率达到97.1%,同时患儿没有出现不良反应以及其他综合并发症。结论对唇裂继发鼻畸形患儿进行修复治疗,不但能够让患者鼻翼隆起,鼻孔对称,保持患者较好的外形条件,同时手术切口非常隐秘,术后瘢痕不显著。

  17. Presurgical nasoalveolar moulding in unilateral cleft lip and palate.

    Science.gov (United States)

    Zuhaib, Mohammed; Bonanthaya, Krishnamurthy; Parmar, Renu; Shetty, Pritham N; Sharma, Pradeep

    2016-01-01

    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. The study was conducted to evaluate the efficacy 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. Prospective study. 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. Student's t-test for paired comparisons. Results of the study showed a promising reduction in the cleft size before the surgery, significant improvement in nasal symmetry, including the columellar length on the cleft side. 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 closure in unilateral clefts.

  18. 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

  19. 单侧唇裂的红唇修复的临床研究%Vermilion repair of unilateral cleft lip

    Institute of Scientific and Technical Information of China (English)

    方绍伟; 池朝玲; 仇元新

    2016-01-01

    Objective To investigate the treatment of vermilion repair of unilateral cleft lip,and get experiences of the cleft lip surgery.Methods 334 cases of vermilion repair of unilateral cleft lip from 2009 to 2015 were conducted retrospective research. We compared three methods of vermilion repair.Results The ifrst method inserting the uninjured and dry lip into the affected side reaching about 55.6% achieved satisfactory effect clinically.The second method using the Noordhooff vermilion repair was about 88%.The third method putting dry and wet lip of the affected side together to form a large triangular lfap was about 65%,which got the satisfactory effect. Conclusion The Noordhooff lip repair method was an effective method in the treatment of vermilion deformity.%目的:探讨单侧唇裂红唇修复的治疗方法,总结手术经验。方法:笔者对2009-2015年的334例单侧唇裂术中的红唇修复情况进行回顾性研究,对于三种红唇修复方法的手术效果进行对比总结。结果:术后临床效果满意率统计如下:①方法1:健侧干性红唇插入患侧,约为55.6%;②方法2:罗慧夫红唇修复方法,约为88%;③方法3:即将患侧的红唇干唇与湿唇共同形成一个大的三角瓣,约为65%。结论:罗慧夫红唇修复方法是临床处理红唇畸形的一种有效方法。

  20. How various surgical protocols of the unilateral cleft lip and palate influence the facial growth and possible orthodontic problems? Which is the best timing of lip, palate and alveolus repair? literature review.

    Science.gov (United States)

    Farronato, Giampietro; Kairyte, Laima; Giannini, Lucia; Galbiati, Guido; Maspero, Cinzia

    2014-01-01

    OBJECTIVES. Cleft lip palate is congenital growth disease with unknown etiology, probably linked to both genetically and external causes. The aim of this work consists in presenting the effects of these diseases on cranio facial growth and the surgical protocols described in literature. MATERIALS AND METHODS. The literature review articles conducted by Medline ranged from 1998 to 2011 have been selected. The key words of the research were "cleft lip palate", "cleft lip palate facial growth", "cleft lip palate surgery". The inclusion criteria were articles that analyzed surgical protocols and the growth of unilateral lip and palate clefts, the timing repair of lip, palate and alveolus. We excluded case reports, studies without control group in the sample and the other types of publication as thesis or conference presentation. 60 articles had the selection criteria of the research. RESULTS. The cleft lip and palate is one of the most common birth defects that needs long rehabilitation between birth and adulthood. Several authors have presented surgical protocols and timing. The effects of these diseases on cranio facial growth and the importance of the early intervention have been described. CONCLUSIONS. The review describes the main surgical protocols and treatment strategies of the unilateral lip and palate clefts. The review discusses how surgery effects the midfacial skeletal growth. Studies agree that the palate repair is the main cause of the maxilla growth disturbances. About the timing of palate repair in the unilateral clefts it can be concluded that most studies found no difference between one or two stages palate repair techniques for the midfacial growth. Also from the research, studies agree that delayed hard palate repair has more positive effects on maxillary growth than that of early hard palate repair. Nevertheless good results, delayed hard palate repair technique is abandoned by many hospital centres because of worse speech outcome. The best

  1. 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/ ...

  2. Autologous cartilage repair of nasal deformity secondary to unilateral cleft lip%单侧唇裂继发鼻畸形自体肋软骨修复术临床体会

    Institute of Scientific and Technical Information of China (English)

    曹玮; 张晖; 唐鸿波; 黄立

    2012-01-01

    Objective To analyze the mechanism of nasal deformity secondary to unilateral cleft lip and to explore the treatment to nasal deformity secondary to unilateral cleft lip. Methods To use Autologous cartilage for repairing the deformity secondary to unilateral cleft lip. Results A total of 32 cases were treated by the method above and all the patients were satisfied with their results during the following time from 1 month to 10 months after operation. Conclusion Transplantation of autologous cartilage is a good method to correct the deformity secondary to unilateral cleft lip%目的:分析单侧唇裂继发鼻畸形的产生机制,探讨单侧唇裂继发鼻畸形的治疗方法.方法:采用自体肋软骨移植修复单侧唇裂继发鼻畸形.结果:本组患者共32例,随访时间1~10月,均取得了良好的治疗效果.结论:自体肋软骨移植对单侧唇裂继发鼻畸形有良好的治疗效果.

  3. 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.

  4. Occlusal Classification in Relation to Original Cleft Width in Patients With Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Huang, Andrew H; Patel, Kamlesh B; Maschhoff, Clayton W; Huebener, Donald V; Skolnick, Gary B; Naidoo, Sybill D; Woo, Albert S

    2015-09-01

    To determine a correlation between the width of the cleft palate measured at the time of lip adhesion, definitive lip repair, and palatoplasty and the subsequent occlusal classification of patients born with unilateral cleft lip and palate. Retrospective, observational study. Referral, urban, children's hospital Participants : Dental models and records of 270 patients were analyzed. None. Angle occlusion classification. The mean age at which occlusal classification was determined was 11 ± 0.3 years. Of the children studies, 84 were diagnosed with Class I or II occlusion, 67 were diagnosed with Class III occlusion, and 119 were lost to follow up or transferred care. Mean cleft widths were significantly larger in subjects with Class III occlusion for all measures at time of lip adhesion and definitive lip repair (P cleft widths were significantly greater at the alveolus (P = .025) but not at the midportion of the hard palate (P = .35) or posterior hard palate (P = .10). Cleft widths from the lip through to the posterior hard palate are generally greater in children who are diagnosed with Class III occlusion later in life. Notably, the alveolar cleft width is significantly greater at each time point for patients who went on to develop Class III occlusion. There were no significant differences in cleft widths between patients diagnosed later with Class I and Class II occlusions.

  5. Treatment outcome after one-stage repair in children with complete unilateral cleft lip and palate assessed with the Goslon Yardstick.

    NARCIS (Netherlands)

    Fudalej, P.S.; Hortis-Dzierzbicka, M.; Obloj, B.; Miller-Drabikowska, D.; Dudkiewicz, Z.; Romanowska, A.

    2009-01-01

    OBJECTIVE: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. MATERIALS AND METHODS: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and

  6. Repair research of nose deformities of unilateral cleft lip(265 example reports)%单侧唇裂鼻畸形美学修复临床研究(265例报告)

    Institute of Scientific and Technical Information of China (English)

    李丽雅; 黄金井; 施生根; 董占海

    2011-01-01

    Objective:discuss the repair and means of deformities of nose in unilateral cleft lip's deformities.Methods:To repair deformities nose of unilateral cleft lip with secondary problem of 265 cases, to make synthesis treatment according to different case in such as are incision of nosewing,combined incision of columella with shape of bird and nosewing,and excision of lunular skin of nosewing's vault position on illness'side and etc, Results:cracked extent of unilateral cleft lip proportional to extent of nose's deformities,means of repair is intricacy and multiplicity.Conclusion:The main reason effected deformities of nose of chapped lips is not to pay great attention and not redressed on deformities of nose as initial repair of chapped lips, the repair on deformities of nose of chapped lips need to be symmetrical design on cartilage of nosewing with esthetics analysis,so that to obtain esthetics effect.%目的:探讨对单侧唇裂畸形中鼻畸形的修复和方法选择.方法:在265例单侧唇裂进行鼻翼畸形修复,根据不同情况进行鼻翼弧形切口、飞鸟状鼻小柱、鼻翼联合切口、患侧鼻翼穹隆部新月形皮肤切除等方法综合治疗.结果:单侧唇裂的裂度与鼻畸形的程度成正比,修复方法较为复杂和多样术式.结论:唇裂鼻畸形修复采用美学的分析对鼻翼软骨进行对称性设计,达到美学效果.

  7. Phonetic features by babies with unilateral cleft lip and palate.

    Science.gov (United States)

    O'Gara, M M; Logemann, J A; Rademaker, A W

    1994-11-01

    Twenty-three babies with nonsyndromic unilateral cleft lip and palate were audiotaped at regular intervals from 5 to 35 months of age. Narrow phonetic transcription of their comfort-state vocalizations and word approximations was accomplished to describe phonetic development over time and according to the nonrandomized age of palatoplasty. The babies that had earlier palatal repair produced significantly higher percentages of oral stops after 12 months of age than babies with similar clefts that had later palatal repair. No significant differences are evident, however, according to age of palatoplasty, for mean frequency use of oral fricatives up to 3 years of age. For all 23 babies, regardless of the age of palatoplasty intervention, time is an even stronger variable than age of palatoplasty for development of palatal, alveolar and velar place features, oral stops, and oral fricatives.

  8. Unfavourable results in the repair of the cleft lip

    Science.gov (United States)

    Narayanan, Puthucode V.; Adenwalla, Hirji Sorab

    2013-01-01

    Introduction: Unfavorable results in unilateral and bilateral cleft lip repair are often easy to spot but not always easy to prevent as to treat. We have tried to deal with the more common problems and explain possible causes and the best possible management options from our experience. Unilateral cleft lip repair: Unfavorable results immediately after repair involve Dehiscence and Scaring. Delayed blemishes include vermillion notching, a short lip, deficiency in the height of the lateral vermillion on the cleft side, white roll malalignment, oro-vestibular fistula, the cleft lip nose deformity, a narrow nostril and a “high-riding” nostril. We analyze the causes of these blemishes and outline our views regarding the treatment of these. Bilateral cleft lip: Immediate problems again include dehiscence as also loss of prolabium or premaxilla. Delayed unfavorable results are central vermillion deficiency, a lip that is too tight, bilateral cleft lip nose deformity, problems with the premaxilla and maxillary growth disturbances. Here again we discuss the causation of these problems and our preferred methods of treatment. Conclusion: We have detailed the significant unfavorable results after unilateral and bilateral cleft lip surgery. The methods of treatment advocated have been layer from our own experience. PMID:24501453

  9. 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.

  10. 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.

  11. Repair of unilateral cleft using the methods of Millard Ⅱ and vermilion labial margin flap%MillardⅡ术式加唇缘瓣法修复单侧唇裂

    Institute of Scientific and Technical Information of China (English)

    王占; 孔金聪; 杨晓丹

    2012-01-01

    Vermilion labial margin flap and Millard E design were applied for the repair of unilateral cleft lip in 28 cases. One week after operation, dermal sutures were removed, at the same time, the effects were evaluated by 3 professional doctors. The labial bow of both sides was symmetrical after operation in both dynamic and static state. Morphology of upper lip was satisfied. The rations of morphologic measur-ments of cleft side vt normal side was 0.91 -1.10 in 19 cases. The operation design is feasible for unilateral cleft lip repair.%用唇缘瓣法与MillardⅡ联合修复术式对28例单侧唇裂患者行唇裂修复术.术后第7天拆除缝线,由3名专科医师进行主观评价.健、患侧唇峰对称,取得满意的动态和静态效果.表示健、患侧对称性的客观评价数值19例为0.91~1.10之间,接近正常人群.是一种可靠实用的单侧唇裂修复术式.

  12. Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair.

    Science.gov (United States)

    Morén, Staffan; Mani, Maria; Lilian, Stålhammar; Lindestad, Per Åke; Holmström, Mats

    2017-01-31

      To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.   Cross-sectional study with long-term follow-up.   All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.   Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.   Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.   The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.

  13. Individualized surgical management of unilateral cleft lip repair%单侧唇裂的个体化整复

    Institute of Scientific and Technical Information of China (English)

    石冰

    2015-01-01

    To improve surgical outcome of unilateral cleft lip repair, and to innovate method of cheiloplasty. The idea of personal treatment in precise medical care was applied to analyze disadvantages of nowadays unilateral cleft lip repair. New theory and technology designed by the author was applied to form the better personal cheiloplasty. According to the three degree category of unilateral cleft lip, special personal surgical design was formed for microform cleft lip, incomplete cleft lip and complete cleft lip separately.%为了持续提高单侧唇裂整复的手术效果,努力创新手术方法,特应用精准医疗中个体化治疗理念,分析了当今单侧唇裂治疗的不足,同时应用笔者不断挖掘的新理论与技术,依据单侧唇裂三度分类方法,分别对微小型唇裂、不完全性唇裂和完全性唇裂,完成了有针对性的新个体化手术方法。

  14. 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.

  15. Speech outcomes at age 5 and 10 years in unilateral cleft lip and palate after one-stage palatal repair with minimal incision technique - a longitudinal perspective.

    Science.gov (United States)

    Nyberg, Jill; Peterson, Petra; Lohmander, Anette

    2014-10-01

    To investigate speech outcomes in 5- and 10-year-old children with unilateral cleft lip and palate (UCLP) treated according to minimal incision technique (MIT) - a one-stage palatal method. A retrospective, longitudinal cohort study of a consecutive series of 69 patients born with UCLP, treated with MIT (mean age 13 months) was included. Forty-two children (43%) received a velopharyngeal flap; 12 before 5 years and another 18 before 10 years of age. Cleft speech variables were rated from standardized audio recordings at 5 and 10 years of age, independently by three experienced, external speech-language pathologists, blinded to the material. The prevalences of cleft speech characteristics were determined, and inter- and intra-rater agreement calculated. More than mild hypernasality, weak pressure consonants and perceived incompetent velopharyngeal function were present in 19-22% of the children at 5 years, but improved to less than 5% at 10 years. However, audible nasal air leakage, prevalent in 23% at 5 years, did not improve by age 10. Thirty percent had frequent or almost always persistent compensatory articulation at 5 years, and 6% at age 10. The general impression of speech improved markedly, from 57% giving a normal impression at 5 years to 89% at 10 years. A high prevalence of distorted/s/was found at both 5 and 10 years of age. A high occurrence of speech deviances at 5 years of age after MIT was markedly reduced at 10 years in this study of children with unilateral cleft lip and palate. The high pharyngeal flap rate presumably accounted for the positive speech development. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. 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。

  17. The Effects of Secondary Cleft Procedures on Alar Base Position and Nostril Morphology in Patients with Unilateral Clefts.

    Science.gov (United States)

    Power, Stephanie M; Matic, Damir B

    2017-07-01

    To compare effects of secondary cleft procedures on alar base position and nostril morphology. Retrospective review. Multidisciplinary cleft clinic at tertiary center. Seventy consecutive patients with unilateral clefts were grouped according to secondary procedure. Alveolar bone graft versus total lip takedown with anatomic muscle repair versus single-stage total lip with cleft septorhinoplasty (nose-lip) versus rhinoplasty alone. Anthropometric measurements were recorded from pre- and postoperative photographs. Ratios of cleft to noncleft side were compared within and across groups pre- and postoperatively using parametric and nonparametric tests. Within the bone graft group, no differences were seen postoperatively in alar base position in long-term follow-up. The total lip group demonstrated greater symmetry at the alar base (P alar base support (P alar base symmetry on worm's-eye view (P Alar base asymmetry in patients with unilateral clefts may be related to soft tissue deficiency and was not affected by alveolar bone grafting. Total lip takedown with anatomic muscle reapproximation was associated with increased alar base symmetry and vertical lip dimension on cleft to noncleft side. Greatest symmetry at the alar base was seen following single-stage nose-lip reconstruction, which may be an effective technique for correcting the secondary cleft lip nasal deformity.

  18. Correction of secondary deformity of unilateral cleft lip with refined anatomic repair in orbicularis oris muscle%口轮匝肌精细化解剖修复矫正单侧唇裂术后继发畸形

    Institute of Scientific and Technical Information of China (English)

    颜薇; 赵振民; 秦永平; 王玮; 尹宁北; 宋涛; 李海东; 吴嫡

    2010-01-01

    Objective To investigate the functional repair of secondary deformity of unilateral cleft lip. Methods The nasal branch, nasolabial branch, and labial branch of orbicularis otis muscle were dissected and repositioned precisely to correct the secondary deformity of unilateral cleft lip. Results 96 patients were treated successfully with this method during Jan. 2005 to Oct. 2008. Good cosmetic and functional results were achieved. 85 cases were followed up for 3 months to 5 years with a satisfactory rate of 94.1% ( 80/85 cases). Conclusions The application of refined anatomy and precise reposition in orbicularis otis muscle is important to ensure therapeutic effect in patients with secondary deformity of unilateral cleft lip.%目的 探讨单侧唇裂术后继发畸形功能性修复的方法.方法 采用基于对口轮匝肌的鼻束、鼻唇束、唇束进行精细化的解剖分离和精确复位的综合手术方法矫正单侧唇裂继发畸形.结果 2003年1月至2008年10月,于临床应用96例,术后患者唇、鼻形态和功能均得到明显改善.85例获得随访,时间为3个月至5年,患者满意度达94.1%(80/85例).结论 对口轮匝肌进行精细化解剖、精确复位,是单侧唇裂术后继发畸形获得良好治疗效果的重要保障.

  19. Evaluation of the Transverse Craniofacial Morphology of Adolescents With Repaired Unilateral Cleft Lip and Palate Using Cone-Beam Computed Tomography.

    Science.gov (United States)

    Buyuk, Suleyman Kutalmiş; Celikoglu, Mevlut; Benkli, Yasin Atakan; Sekerci, Ahmet Ercan

    2016-10-01

    The aim of the study was to evaluate the transverse craniofacial morphology of the adolescent patients affected by unilateral cleft lip and palate (UCLP) and to compare the findings with age- and sex-matched control group without any cleft using their cone-beam computed tomography (CBCT) images. The study sample (n = 56 patients; mean age: 14.35 ± 3.06 years) consisted of 26 UCLP (n = 26 patients; 10 women and 16 men; mean age: 13.70 ± 2.94 years) and 30 control (n = 30 patients; 19 women and 11 men; mean age: 14.90 ± 3.10 years) subjects. Twenty-five conventional skeletal and dental tissue landmarks were identified. Twenty widely used frontal cephalometric variables (14 linear distances, 3 angles, and 3 ratios) were measured. The data were analyzed using the independent t-test between the groups. Patients affected by UCLP had statistically significantly smaller interorbital width (89.83 ± 4.16 mm), maxillary width (58.02 ± 5.77 mm), maxillary intermolar width (52.83 ± 4.83 mm), and upper face height (57.64 ± 4.57 mm) (P cleft width had significant effect on Cr-ANS (r = 0.446, P = 0.022) and the ANS-isf (r = 0.459, P = 0.018) measurements. The UCLP group showed statistically significantly smaller values for interorbital width, maxillary width, maxillary intermolar width, and upper face height than the noncleft controls.

  20. Predictors of poor dental arch relationship in young children with unilateral cleft lip and palate.

    Science.gov (United States)

    Hsieh, Yuh-Jia; Liao, Yu-Fang; Shetty, Akshai

    2012-08-01

    The aim of this cross-sectional outcome study using retrospective data capture of treatment histories was to examine the characteristics of young children with unilateral cleft lip and palate who had poor dental arch relationship (i.e., Goslon 5). The study sample comprised 120 children born with nonsyndromic complete unilateral cleft lip and palate between 1995 and 2003, and were aged between 5.0 and 7.0 years (mean age, 5.1 years) at the time of data collection. The dental arch relationship was assessed using the Goslon yardstick from intraoral dental photographs. An independent investigator recorded treatment histories from the clinical notes. The inter- and intraexaminer agreements evaluated by weighted kappa statistics were high. There was no association between dental arch relationship and the type of presurgical orthopedics or pharyngeal flap. Dental arch relationship was associated with the initial cleft size (odds ratio, OR = 1.3; 95% confidence interval, CI = 1.1-1.5, p palate repair (OR = 5.0, 95% CI = 1.2-19.9, p cleft, high-volume surgeon, and primary gingivoperiosteoplasty are predictors of poor dental arch relationship outcome in young children with unilateral cleft lip and palate. These findings may improve treatment outcome by modifying the treatment protocol for patients with unilateral cleft lip and palate.

  1. The nose in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    C.D.A. Verwoerd (Carel); R. Mladina (R.); G.J. Nolst-Trenité (Gilbert J.); R.W. Pigott (R.)

    1995-01-01

    textabstractSurgeons and orthodontists are still challenged to achieve ‘better’ noses for children with a unilateral cleft or lip, alveolus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced

  2. 改进Tennsion法设计重建单侧唇裂鼻翼及上唇形态修复口轮匝肌功能%Reconstruct the form of unilateral cleft lip ala nasi and upper lip with improved Tennsion method to repair the function of orbicular muscle of mouth

    Institute of Scientific and Technical Information of China (English)

    程小兵; 何亚会; 胡小光; 孙沫逸; 李建虎; 洪咏龙

    2002-01-01

    Objective Improving the traditional Tennsion method to explore more reasonable repair method for unilateral cleft lip.Methods 37 cases were operated to reconstruct the ala nasi and upper lip philtrum ridge form with rotatory alae nasi triangle flap plus improved Tennsion method, and compared the operational results with that of traditional Tennsion method.Results The improved Tennison method acquired a more beautiful nose and upper lip, it rehabilitated the ala nasi and restored the physiological function of the orbiculars muscle.Conclusion Improved Tennsion method wins an essentially satisfactory operational result of unilateral cleft lip.

  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. Pedicled Lip Vermilion Mucosa Muscle Flap for Repairing Unilateral Cleft Lip with Secondary Vermilion Tubercle Defect%带蒂唇红黏膜肌瓣修复单侧唇裂继发唇珠缺失

    Institute of Scientific and Technical Information of China (English)

    常刚; 罗志军; 张莉

    2011-01-01

    [Objective] To explore the efficacy of pedicle lip vermilion mucosa muscle flap for repairing unilateral cleft lip with secondary vermilion. [Methods] The elliptical incision line in the excessive vermilion of lip of unilateral cleft lip with secondary deformity was designed. Retrograde lip vermilion mucosa muscle flap with the vermilion of lip in the incision line as the distal end and the pedicle at the deep layer of vermilion tubercle was designed. The horizon incision line in the recipient area was devised in the middle of vermilion of lip and intersected with elliptical incision of vermillion. The lip vermilion was dissected along incision line. The compound flap was obtained and transferred to the middle of upper lip. Then the mucosa and muscle layer were sutured. [Results] The appearance of postoperative vermilion tubercles of upper lip in 19 patients were improved obviously, and the scar in recipient and donor area was not conspicuous. [Conclusion] The pedicled lip vermilion mucosa muscle flap for repairing the unilateral cleft lip with secondary vermilion tubercle defect is simple and can draw the material from the neighborhood. The operation is completed by one stage, and has satisfactory efficacy.%[目的]探索使用带蒂唇红黏膜肌肉组织瓣修复单侧唇裂继发唇珠缺失的效果.[方法]在单侧唇裂继发畸形外侧过多的唇红处设计椭圆形切口线,以切口部唇红为唇红黏膜肌肉组织瓣的远端,逆行设计蒂位于重建唇珠部肌层深面的唇红黏膜肌肉组织瓣.唇红中部设计受区水平切口线,与唇红椭圆形切口线相交,依切口线切开唇红,切取复合瓣,水平转移至上唇正中,按黏膜,肌层分别缝合.[结果]19例患者术后上唇唇珠形态明显改善,受、供区瘢痕不明显.[结论]用带蒂唇红黏膜肌肉组织瓣修复单侧唇裂继发唇珠缺失方法简单,就近取材,手术I期完成,疗效满意.

  5. Phonetic description of babbling in Danish toddlers born with and without unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Albrechstn, Helle

    2006-01-01

    Objective: To investigate prelinguistic vocalization sequences of 1-year-old children with and without cleft lip and palate. Design: Prospective study. Participants: Thirty-eight children born with unilateral cleft lip and palate and 36 control children born without clefts. The cleft children had...... the lip, soft palate, and posterior part of the hard palate repaired at 4 months of age. The lip was closed ad modum Millard, the nose was corrected according to McComb, and the soft palate was closed with a posteriorly based vomer flap. Methods: Data were obtained from a clinical visit during which...... the canonical babbling stage. Results: No significant differences were observed between the cleft and control groups concerning frequency of occurrence of vocalization sequences, contoids, or vocoids. Structural differences between the groups seem to influence the contoid inventory, with a higher frequency...

  6. Preoperative lip measurement in patients with complete unilateral cleft lip/palate and its comparison with norms.

    Science.gov (United States)

    Chou, Pang-Yun; Luo, Chih-Cheng; Chen, Philip Kuo-Ting; Chen, Yu-Ray; Samuel Noordhoff, M; Lo, Lun-Jou

    2013-04-01

    There is prominent lip asymmetry in patients with unilateral complete cleft lip and palate. Measurement of the lip on cleft and non-cleft sides provides appraisal of the lip deformity and information for planning of surgical correction. The purpose of this retrospective study is to evaluate the degree of lip deformity and to compare it with normative data. From 1983 to 1997, data from a total of 168 patients with unilateral complete cleft lip and palate were collected. There were no other associated craniofacial anomalies in this patient group. The measurement was performed under general anaesthesia by a senior surgeon using a calliper prior to the first lip repair. Corresponding normative data were collected from 2002 to 2003 on 50 patients who had normal facial appearance prior to hernia repair. The measurements included lip height, lip width, philtrum length and vermilion thickness. Comparisons were made between the cleft side and the non-cleft side, as well as between cleft patients and norms. Comparisons between the cleft and the non-cleft sides revealed significantly longer lip on the non-cleft side, including lip height from alar base to Cupid's bow, lip width from Cupid's bow to commissure and the vermilion thickness. The lip measurements on the norms were longer than those on the cleft side of the lip, but were similar to the non-cleft side. A wide variety of tissue growth asymmetry is observed between the non-cleft and the cleft sides, indicating a deficiency of tissue development associated with the cleft deformity. These data can provide a fundamental basis for presurgical orthopaedic treatment, surgical planning, execution of surgery, postoperative assessment and may help to predict treatment outcome. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Evolution of my philosophy in the treatment of unilateral cleft lip and palate.

    Science.gov (United States)

    Brusati, Roberto

    2016-08-01

    At the end of 50-year-long clinical activity, the evolution of my approach to the treatment of unilateral cleft of the lip and palate is discussed. I had several teachers in this field (Rusconi, Reherman, Perko, Delaire, Talmant, Sommerlad and others) and I introduced in my approach what I considered to be improvements from all of them. My current protocol is related to the anatomy of the cleft: for wide clefts a two-stage protocol is applied (1° step: soft palate and lip and nose repair; 2° step: hard palate repair with gingivoalveoloplasty); for narrow cleft (less than 1 cm at the posterior border of hard palate) an "all in one" protocol is performed with or without gingivoalveoloplasty (in accordance to the presence or absence of contact between the stumps at alveolar level). The most important details regarding surgery of the lip and palate are discussed. Robust data collection on speech and skeletal growth is still needed to determine whether the "all in one" approach can be validated as the treatment of choice for unilateral complete lip and palate cleft in selected cases.

  8. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Heliövaara, Arja; Küseler, Annelise; Skaare, Pål

    2017-01-01

    BACKGROUND AND AIM: Good dentofacial growth is a major goal in the treatment of unilateral cleft lip and palate (UCLP). The aim was to evaluate dental arch relationships at age 5 years after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised clinical trials were...... undertaken as an international multi-centre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, D) were tested against a common procedure (Arm A) in the total cohort of 448 children born...

  9. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Lohmander, Anette; Persson, Christina; Willadsen, Elisabeth

    2017-01-01

    BACKGROUND AND AIM: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP......) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. DESIGN: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10...... cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children...

  10. Alar web in cleft lip nose deformity: study in adult unilateral clefts.

    Science.gov (United States)

    Agarwal, Rajiv; Chandra, Ramesh

    2012-09-01

    The correction of alar webbing in unilateral cleft lip nose deformity is challenging because of progressive distortions in the alar web region during the period of growth. Alar webbing is a persistent universal deformity in both the primary and secondary cleft lip noses. The purpose of this article is to study the alar web deformity in adult patients with unilateral cleft lip noses. Twenty-five patients aged 13 years and older presenting with unilateral cleft nasal deformity were included. Preoperative and postoperative measurements of the nose, along with detailed intraoperative recording of the deformed anatomy, were done. Preoperative magnetic resonance imaging was also done in selected cases. Transcolumellar open rhinoplasty was performed in all the cases, and nasal septal straightening with centralization was done. Cleft alar base augmentation was done using bone graft to restore symmetry of the nasal tripod. Both the cleft and noncleft alar cartilages were extensively mobilized from the skin and mucosal sides. The overgrown and caudally slumped cleft-side alar cartilage was resected caudally and was then resuspended in a symmetrical position with the noncleft alar cartilage. A midline-strut septal cartilage extension graft was used to restore the tip aesthetics. The skin overlying the alar web was in-rolled after semilunar cartilage resection, and skin excision was also done to restore symmetry with the opposite vestibule. The remaining secondary cleft nasal and lip deformities were corrected depending upon the specific presenting pathologic abnormality. The cleft alar cartilage was found to be caudally displaced in all the cases. The caudal border of the lateral crus was prolapsing in the cavity of the vestibule on the superomedial aspect and was tenting the skin in the area of the weak triangle, producing the characteristic alar web deformity. In the study group, the maximum width of the cleft alar cartilage at the level of the lateral crus was increased by

  11. Evaluation of Using Interdomal Suture and Crescentic Skin Excision with Standard Cleft Lip Repair for Correction of Cleft Lip-Nose Simultaneously with Primary Lip Repair

    Directory of Open Access Journals (Sweden)

    Mert Çalış

    2017-06-01

    Full Text Available Objective: The aim of this study is to compare the postoperative correction rates in the follow-up after simultaneous cleft lip nose (CLN repair with cleft lip repair using either interdomal suture or crescentic skin excision. Material and Methods: Eighty-three unilateral cleft lip patients were operated using modified Millard rotation advancement technique for cleft lip repair and simultaneous cleft lip repair using either interdomal suture or crescentic skin excision. The evaluation of the patients was made using routine standardized preoperative and early and later postoperative caudal nasal photographs. The distance between the nasal base and the most projectile point of the nostril was measured, and the ratio of the cleft side to the non-cleft side was calculated. Results: The highest rate was calculated in the early postoperative period in the crescentic skin excision group (1.07±0.29. The ratio was found to be 0.87±0.22 in patients with interdomal suture placement. The lowest rate was observed in patients who did not have any nasal reshaping procedure other than a standard cleft lip repair (0.71±0.16. The highest rate of recurrence was observed among the patients who had crescentic skin excision (0.39 ± 0.16. When recurrence rates were compared, a significant difference was observed in the crescentic skin excision group compared to the interdomal suture placed patients (p=0.005. Conclusion: The simultaneous primary rhinoplasty approach with cleft lip repair appears to be necessary for CLN repair in the long term. Although crescentic skin excision and placement of interdomal suture for this purpose achieve symmetry with the noncleft side and successful results in the early postoperative period, the probability of recurrence should always be taken in consideration. If either of these two techniques is to be preferred for CLN repair, then overcorrection should always be taken in consideration.

  12. A primary study on The Effect of Simultaneous Lip and Nose Repair for Unilateral Cleft and Nasal deformity%单侧唇裂鼻畸形同期整复术后疗效的初步观察

    Institute of Scientific and Technical Information of China (English)

    代晓明; 刘华; 李逸松; 王福科; 刘流

    2012-01-01

    0bjective To evaluate the effect of simultaneous lip and nose repair for unilateral cleft and Nasal deformity. Methods Patients were divided randomly into two groups. All patients accepted cleft lip repair with Millard II or improved technique. The simultaneous rhinoplasty had been fulfilled in test group. A silicon model was placed in nasal cavity to sustain appearance postoperatively. In a postsurgical interview, columella nasi without displacement, tip rising, no collapse of the ala and symmetry on the whole of bilateral nostrils were accepted as satisfactory result. Results 62 patients including 33 males and 29 females were treated between February 2007 and March 2011. Patients'age ranged from 3 months to 3 years and 11 months. 39 patients were accepted simultaneous rhinoplasty, while 23 without nose repair simultaneously were as control. The mean follow-up period was 14 months (range, 6-27mo). 28 cases and 3 cases with satisfactory results were obtained respectively in test and control group. There were statistic differences between them (P<0.05). Conclusion This technique we used is efficacious to rectify nasal deformity in unilateral cleft lip.%目的 初步观察在行先天性单侧唇裂修复术同期矫正鼻畸形的临床效果.方法 患者被随机分为实验组和对照组.2组均接受Millard Ⅱ或改良Ⅱ式唇裂修复术,实验组同时整复鼻畸形术后鼻腔内置硅胶管维持形态.术后随访,观察鼻小柱、鼻尖、鼻翼和鼻孔形态.鼻小柱居中,鼻尖抬高,鼻翼无塌陷、双侧鼻孔基本对称者为良好.结果 2007年2月至2011年3月间62例患者接受手术.患者年龄3月到3岁零11个月.男比女为33∶29.实验组39例,对照组23例.平均随访14月(6个月~2年零3个月).术后效果良好者实验组28例(28/39,72%),对照组3例(3/23,13%),二者差异有统计学意义(P<0.05).结论 对单侧唇裂患者同期矫正鼻畸形可取得较满意的临床效果.

  13. Preoperative Cleft Lip Measurements and Maxillary Growth in Patients With Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Antonarakis, Gregory S; Tompson, Bryan D; Fisher, David M

    2016-11-01

    Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP). Retrospective cross-sectional study. Children with cUCLP. Preoperative cleft lip measurements were made at the time of primary cheiloplasty and available for each patient. Maxillary growth was evaluated on lateral cephalometric radiographs taken prior to any orthodontic treatment and alveolar bone grafting (8.5 ± 0.7 years). The presence of associations between preoperative cleft lip measurements and cephalometric measures of maxillary growth was determined using regression analyses. In the 58 patients included in the study, the cleft lateral lip element was deficient in height in 90% and in transverse width in 81% of patients. There was an inverse correlation between cleft lateral lip height and transverse width with a β coefficient of -0.382 (P = .003). Patients with a more deficient cleft lateral lip height displayed a shorter maxillary length (β coefficient = 0.336; P = .010), a less protruded maxilla (β coefficient = .334; P = .008), and a shorter anterior maxillary height (β coefficient = 0.306; P = .020) than those with a less deficient cleft lateral lip height. Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and height.

  14. 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.

  15. Prevalence of dental anomalies in children with cleft lip and unilateral and bilateral cleft lip and palate.

    Science.gov (United States)

    Rullo, R; Festa, V M; Rullo, R; Addabbo, F; Chiodini, P; Vitale, M; Perillo, L

    2015-09-01

    To examine the prevalence of different types of dental anomalies in children with nonsyndromic cleft lip, unilateral cleft lip-palate, and bilateral cleft lip-palate. A sample of 90 patients (aged 4-20 years) affected by isolated cleft lip, unilateral and bilateral cleft lip and palate was examined. Cleft patients were classified into one of three groups according to cleft type: (1) Unilateral Cleft Lip-Palate, (2) Bilateral Cleft Lip-Palate, and (3) Cleft Lip. Intraoral exams, panoramic radiographs and dental casts, were used to analyse the prevalence of the various dental anomalies included in this study. There were no statistically significant differences between patients with cleft lip, unilateral cleft lip and palate and bilateral cleft lip and palate. The congenital absence of the cleft-side lateral incisor was observed in 40% of the sample, and a total of 30% patients showed supernumerary teeth at the incisors region. Second premolar agenesis was found in 4.4% of patients, whereas in 18.9% of the sample there was an ectopic dental eruption. Lateral or central incisors rotation was noted in 31.1% of the sample, while shape anomaly, lateral incisor microdontia, and enamel hypoplasia were detected respectively in 25.6%, 5.6% and 18.9% of cleft patients. High prevalence of different dental anomalies in children with cleft lip and unilateral and bilateral cleft lip and palate has been confirmed. This study, in particular, shows the presence of ectopic and rotated teeth in the cleft area.

  16. 单侧完全性唇腭裂胎儿宫内手术修复的解剖学基础%Anatomic basis on fetal intrauterine surgical repair of unilateral complete cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    黄海龙; 陈丽娟; 钟卫娟; 邹锦慧; 梁恩来

    2012-01-01

    目的 为单侧性唇腭裂胎儿宫内手术修复提供解剖学基础.方法 制作和观察21~32周正常和单侧完全性唇腭裂胎儿头颈部血管铸型标本,比较他们唇腭部血供的来源及吻合情况. 结果 ①正常胎儿唇腭部的血供主要由上唇动脉、鼻翼下缘动脉和腭大动脉组成.两侧上唇动脉在中线附近吻合成上唇动脉弓,并在鼻中隔前下部形成浅深两层血管网,且上唇动脉鼻中隔支也与腭大动脉穿支相互吻合;②单侧完全性唇腭裂胎儿唇腭部血供由于患侧裂隙的阻隔,导致左右上唇动脉不能吻合成弓,患侧腭大动脉穿过骨残端与患侧鼻腔内的血管相吻合. 结论 单侧完全性唇腭裂胎儿唇腭部血管非常丰富,尤以上唇动脉和腭大动脉为血供主干.%Objective To provide anatomic basis for fetal intrauterine surgical repair of complete cleft lip and palate. Methods Vascular cast specimens of the head and neck from 21 ~32W normal fetus and unilateral complete cleft lip and palate fetus were carried out. Blood supply source and arterial anastomosis of lip and palate were observed and compared. Results ① For healthy fetus, blood supply of lip and palate mainly came from superior labial artery, nasal alar artery and greater palatine artery. The arterial arch formed by the anastomosis between the left and the right superior labial artery. The superficial and deep vascular networks were formed in nasal septum,and the nasal septum branch of superior labial artery anastomosed with the perforator branch of greater palatine artery. ② Due to the slit separation, The lip and palate vessels of unilateral complete cleft lip and palate fetus absent the anastomosis between the left and the right superior labial artery, however the greater palatine artery and nasal vessel anastomosed with each other through bone stump. Conclusions For fetus of cleft lip and palate, blood supply of the lip and palate was plentiful, especially

  17. 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.

  18. 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

  19. 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.

  20. Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities

    Directory of Open Access Journals (Sweden)

    Cohen Mimis

    2009-10-01

    Full Text Available The treatment of patients with unilateral cleft lip has undergone significant development during the last decades. With better understanding of the anatomy of the unilateral cleft lip and nasal deformities, primary correction of the nasal deformity at the time of lip repair, critical evaluation of short and long-term results following various treatment protocols, and constant striving for perfection in both aesthetics and function, we have been able to design improved treatment strategies and more accurate surgical techniques so as to achieve overall superior and long-lasting results. In this review article, we present our protocols and experience for functional and aesthetic correction of secondary unilateral cleft lip nasal deformities and a retrospective review of 219 consecutive patients treated at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities. The protocols used in the treatment of 219 consecutive patients at our Craniofacial Centre for correction of secondary unilateral cleft lip nasal deformities were reviewed. In addition, analysis of the most recent 51 consecutive patients who underwent complete clinical and functional evaluation with rhinomanometry followed by correction of the cleft lip nasal deformity was performed. A variety of time-honoured techniques of rhinoplasty were applied in the correction of the residual deformities to achieve symmetry, aesthetic balance, and functional correction of the nose. Follow-up ranged from 5-11 years. Analysis of the data revealed that 39 patients (76.47% had significant functional and aesthetic improvement; seven patients (13.07% had significant aesthetic improvement but a modest functional improvement; and five patients (9.8% required additional surgery to improve their appearance and had no functional improvement. Further analysis demonstrated that five out of seven patients in the second group had pharyngeal flaps in place that were primarily

  1. Postoperative alar base symmetry in complete unilateral cleft lip and palate:A prospective study.

    Science.gov (United States)

    Vyloppilli, Suresh; Krishnakumar, K S; Sayd, Shermil; Latheef, Sameer; Narayanan, Saju V; Pati, Ajit

    2017-06-09

    In the evolution of cleft lip repair, there have been continuous attempts to minimize local trauma and to improve lip and nasal appearances. In order to obtain an aesthetically balanced development of midface, the primary surgical correction of the nasolabial area is of paramount importance. In this study, the importance of a back-cut extending cephalically above the inferior turbinate at the mucocutaneous junction which elevates the nostril floor on the cleft side for the purpose of achieving symmetry of the alar bases are analyzed by pre and postoperative photographic anthropometry. This study comprised of fifty cases of the unilateral complete cleft lip. At the time of surgery, the patient age ranged from 3-9 months. The surgeries, performed by a single surgeon, employed the standard Millard technique, incorporating Mohler modifications of lip repair. Anthropometric analysis revealed that the preoperative mean difference between the normal side and the cleft side was 0.2056 with a standard deviation of 0.133. In the postoperative analysis, the mean difference was reduced to 0.0174 with a standard deviation of 0.141. The paired t-test showed that the p-value is alar base symmetry during primary surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Simplifying cleft surgery by presurgical nasoalveolar molding (PNAM) for infant born with unilateral cleft lip, alveolus, and palate: a clinical report.

    Science.gov (United States)

    Kamble, Vaibhav D; Parkhedkar, Rambhau D; Sarin, Soumil P; Patil, Pravinkumar G; Kothari, Bhavesh

    2013-07-01

    A 2-day-old female infant with complete unilateral cleft lip, alveolus, and palate (left side) was presented to the Department of Prosthodontics, Government Dental College and Hospital, Nagpur for evaluation and treatment with presurgical nasoalveolar molding (PNAM) prior to surgical intervention. The alignment of the alveolar segments creates the foundation upon which excellent results of primary lip and nasal surgery are dependent in the repair of the cleft lip, alveolus, and palate patient. Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. One of the problems that the traditional approach failed to address was the deformity of the nasal cartilages and the deficiency of columella tissue in infants with unilateral and bilateral cleft lip and palate. The purpose of this article is to illustrate the step-by-step fabrication process of the PNAM prosthesis used to direct growth of the alveolar segments, lips, and nose in the presurgical treatment of cleft lip and palate. As a result, the primary surgical repair of the lip and nose heals under minimal tension, thereby reducing scar formation and improving the esthetic result. Frequent surgical intervention to achieve the desired esthetic results can be avoided by PNAM. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  3. [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.

  4. 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.

  5. Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Darvann, Tron A; Kreiborg, Sven

    Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)......Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)...

  6. Dental age in children with a complete unilateral cleft lip and palate.

    NARCIS (Netherlands)

    Huyskens, R.W.F.; Katsaros, C.; Hof, M.A. van 't; Kuijpers-Jagtman, A.M.

    2006-01-01

    OBJECTIVE: To assess dental age in children with a complete unilateral cleft lip and palate and to compare this with a noncleft control group. DESIGN: Two-group, mixed-longitudinal cohort study. SETTING: Cleft group from an academic center for cleft lip and palate treatment. Noncleft control group

  7. Unilateral cleft lip and palate : treatment outcome and long-term craniofacial growth

    NARCIS (Netherlands)

    Nollet, Petrus Josephus Paulinus Maria

    2006-01-01

    Treatment results of children with a complete Unilateral Cleft Lip and Palate (UCLP) from the Cleft Palate Craniofacial Unit of the Radboud University Nijmegen Medical Centre were evaluated and compared with prominent European cleft centers. Treatment outcome of the Nijmegen patients with UCLP and

  8. Dental age in children with a complete unilateral cleft lip and palate.

    NARCIS (Netherlands)

    Huyskens, R.W.F.; Katsaros, C.; Hof, M.A. van 't; Kuijpers-Jagtman, A.M.

    2006-01-01

    OBJECTIVE: To assess dental age in children with a complete unilateral cleft lip and palate and to compare this with a noncleft control group. DESIGN: Two-group, mixed-longitudinal cohort study. SETTING: Cleft group from an academic center for cleft lip and palate treatment. Noncleft control group f

  9. 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.

  10. 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

  11. 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

  12. The Burden of Care for Children With Unilateral Cleft Lip: A Systematic Review of Revision Surgery.

    Science.gov (United States)

    Sitzman, Thomas J; Coyne, Sarah M; Britto, Maria T

    2016-07-01

    To identify the average rate of revision surgery following cleft lip repair. PubMed, CINAHL, and SCOPUS were searched from database inception through March 2013 using the search terms cleft lip and surgery. Two investigators independently screened all abstracts and determined eligibility from review of full manuscripts using prespecified inclusion and exclusion criteria. Strengths and limitation of the studies were assessed, followed by qualitative synthesis. The I(2) test of homogeneity was performed to determine if meta-analysis was appropriate. The search identified 3034 articles. Of those, 45 met the inclusion criteria. Studies were primarily case series and retrospective cohort studies, with only one randomized controlled trial. One-third of studies (n = 15) did not describe how the study sample was selected. Follow-up duration was not reported in one-fourth of studies (n = 11). Nasolabial aesthetics were reported in 44% of studies (n = 20). The incidence of revision surgery ranged from 0% to 100%. Meta-analysis was precluded because of study heterogeneity (I(2) = 97%). The average incidence of cleft lip revision surgery cannot be estimated from the published literature, due to significant heterogeneity among existing reports and limited study quality. To provide valid information about the burden of care for unilateral cleft lip, a population-based or multicenter longitudinal cohort study is necessary; this study should measure the number of surgical procedures and the patient's aesthetic outcomes.

  13. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors.

    Science.gov (United States)

    Arshad, Anas Imran; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2017-09-01

    Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome. It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology. A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome. Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 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 ...

  15. Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate Improves Nasal Symmetry and Maxillary Alveolar Dimensions.

    Science.gov (United States)

    Ruíz-Escolano, María Gloria; Martínez-Plaza, Adoración; Fernández-Valadés, Ricardo; Cortés-Sánchez, Rosario; Muñoz-Miguelsanz, María Angeles; Velasco-Ortega, Eugenio; Perez-Ureña, María Bélen; Matar-Satuf, Kamel; España-López, Antonio José

    2016-11-01

    The aim of this study is to assess the esthetic and morphologic outcomes before surgery using nasoalveolar molding (NAM) therapy in children with unilateral cleft lip and palate. A prospective analysis was performed. The study was carried out in the Congenital Malformations Craniofacial and Cleft Lip and Palate Unit, Hospital Virgen de las Nieves, Andalusian Health Service, Granada (Spain). Twenty consecutively enrolled infants ranging in age from 7 to 30 days with nonsyndromic unilateral cleft lip and palate treated from 2008 to 2012. All patients were treated with NAM appliances to align the alveolar segments and reduce severity of the nasal deformity. The extraoral nasal measurements were performed on casts and nasal photographs. The measurements consisted of bialar width (BAW), columellar deviation (CD), cleft nostril height (CNH), cleft nostril width (CNW), non-CNH, non-CNW, and the deviation of the columella to the horizontal line represented by bilateral pupil line (BIA). The authors have made the measurements following Barilla method. Also 2 intraoral measurements were taken. Following NAM the extraoral records showed a statistically significant decrease in CD (P cleft gap, and improving shape of the maxillary dental arch. As a consequence of reducing the alveolar and nasal deformities before surgery, it is expected that the primary repair will be easier for the surgeon and more successful.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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

  1. 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.

  2. Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair.

    Science.gov (United States)

    Luyten, Anke; D'haeseleer, Evelien; Budolfsen, Dorte; Hodges, Andrew; Galiwango, George; Vermeersch, Hubert; Van Lierde, Kristiane

    2013-01-01

    The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 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.

  4. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  5. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  6. 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

  7. Maxillary sinus volumes of patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Erdur, Omer; Ucar, Faruk Izzet; Sekerci, Ahmet Ercan; Celikoglu, Mevlut; Buyuk, Suleyman Kutalmıs

    2015-10-01

    Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm(3). There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55±4171.44mm(3)) was statistically smaller than the control group (11,977.90±4484.93mm(3)) (Pcleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. 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....

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. A randomized controlled trial comparing two techniques for unilateral cleft lip and palate: Growth and speech outcomes during mixed dentition.

    Science.gov (United States)

    Ganesh, Praveen; Murthy, Jyotsna; Ulaghanathan, Navitha; Savitha, V H

    2015-07-01

    To study the growth and speech outcomes in children who were operated on for unilateral cleft lip and palate (UCLP) by a single surgeon using two different treatment protocols. A total of 200 consecutive patients with nonsyndromic UCLP were randomly allocated to two different treatment protocols. Of the 200 patients, 179 completed the protocol. However, only 85 patients presented for follow-up during the mixed dentition period (7-10 years of age). The following treatment protocol was followed. Protocol 1 consisted of the vomer flap (VF), whereby patients underwent primary lip nose repair and vomer flap for hard palate single-layer closure, followed by soft palate repair 6 months later; Protocol 2 consisted of the two-flap technique (TF), whereby the cleft palate (CP) was repaired by two-flap technique after primary lip and nose repair. GOSLON Yardstick scores for dental arch relation, and speech outcomes based on universal reporting parameters, were noted. A total of 40 patients in the VF group and 45 in the TF group completed the treatment protocols. The GOSLON scores showed marginally better outcomes in the VF group compared to the TF group. Statistically significant differences were found only in two speech parameters, with better outcomes in the TF group. Our results showed marginally better growth outcome in the VF group compared to the TF group. However, the speech outcomes were better in the TF group. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study.

    Science.gov (United States)

    Yew, Ching Ching; Alam, Mohammad Khursheed; Rahman, Shaifulizan Abdul

    2016-10-01

    This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis. A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis. Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome. This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general. Copyright © 2016 Elsevier Ireland Ltd. All

  16. 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.

  17. Congenital medium sternal cleft with partial ectopia cordis repair.

    Science.gov (United States)

    Sousa, Paulo Rego; Antunes, Sónia; Couto, Alexandra; Santos, Gonçalo Cassiano; Leal, Luis Gagp; Magalhães, Manuel Pedro

    2009-01-01

    Congenital sternal malformation is a rare anomaly often diagnosed as an asymptomatic condition at birth. The authors report a clinical case of a full-term female neonate with congenital sternal cleft and partial ectopia cordis. Successful surgical repair was accomplished at 6 days of age. When surgery is performed shortly after birth, the procedure is easier and better results are achieved.

  18. 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.

  19. Correction of unilateral cleft lip nose deformity using nasal alar rim flap.

    Science.gov (United States)

    Wang, Huan; Fan, Fei; You, Jianjun; Wang, Sheng

    2012-09-01

    The objective of this study was to show the use and effectiveness of nasal alar rim flap on the correction of unilateral cleft lip nasal deformity. Thirty-one patients (age range, 10-29 years; mean, 15.1 years; 14 male and 17 female patients) with unilateral cleft lip underwent rhinoplasty surgery using alar rim flap. The excessive skin of nasal alar was marked, then a skin flap was raised. This flap can be transferred medially (type 1) or laterally (type 2) to narrow the nostril or to augment the nasal sill and, of course, to correct the alar web deformity. Preoperative and postoperative photographs were measured for photogrammetric analysis in 16 patients. The alar rim flap used in patients with unilateral cleft lip made the nostrils more symmetrical. The nostril sill was augmented with flap type 1. The alar base width was narrowed with flap type 2 (P = 0.03). The alar web deformity was corrected. The alar rim flap could be an ideal treatment option for correction of alar web deformity in patients of unilateral cleft lip.

  20. Oral strength in subjects with a unilateral cleft lip and palate.

    Science.gov (United States)

    Van Lierde, Kristiane M; Bettens, Kim; Luyten, Anke; Plettinck, Janne; Bonte, Katrien; Vermeersch, Hubert; Roche, Nathalie

    2014-08-01

    Facial appearance and speech outcome may affect psychosocial functioning in girls and boys. Several studies reported dissatisfaction with facial appearance and more specifically the lip and mouth profile in children with cleft lip and palate (CLP). The purpose of this controlled study was to measure the tongue and lip strength and endurance in boys and girls with CLP. Twenty-five subjects (mean age: 10.6 years) with a unilateral CLP and a gender- and age- matched control group were selected. All subjects with an unilateral CLP consulted the same craniofacial team and had undergone an identical surgical procedure. Surgical procedure of the lip was performed using a modified Millard technique without primary nose correction at an average age of 5.5 months. The Iowa Oral Performance instrument was used to measure lip and tongue strength and tongue endurance. The results of the Iowa Oral Performance measurement showed no significant differences between the subjects with an unilateral cleft lip and palate and the age and gender matched control group without a cleft lip and palate. There is no significant differences regarding oral strength more specifically the lip and tongue strength and endurance between subjects with and without an unilateral cleft lip and palate. ENT specialists and speech pathologists must be aware of this aspect of the normal lip and tongue functions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Reference photographs for nasolabial appearance rating in unilateral cleft lip and palate

    NARCIS (Netherlands)

    Kuijpers-Jagtman, A.M.; Nollet, P.J.P.M.; Semb, G.; Bronkhorst, E.M.; Shaw, W.C.; Katsaros, C.

    2009-01-01

    A popular method for nasolabial rating in unilateral cleft lip and palate (UCLP) is the Asher-McDade system consisting of a 5-point ordinal scale assessing nasal form, nasal symmetry, nasal profile, and vermilion border. The aim of the current study was to identify reference photographs illustrating

  2. Evaluation of unilateral cleft lip and palate using anthropometry measurements post-alveolar bone grafting

    Science.gov (United States)

    Simorangkir, H. J.; Hak, M. S.; Tofani, I.

    2017-08-01

    Rehabilitation of patients with unilateral cleft lip and palate (UCLP) requires multiple steps and coordination of multidisciplinary sciences to produce optimal results. Alveolar bone-grafting (ABG) is an important procedure in the treatment of such patients because it influences the eruption of teeth and stabilizes the maxilla. To evaluate the effect and suitability of alveolar bone grafting procedure at Cleft Center Harapan Kita Maternal and Child Hospital on nasal deformity from anthropometry with photogrammetry and aesthetic proportional in patients with unilateral cleft lip and palate with UCLP. Patients with UCLP were evaluated post-ABG using anthropometry and photogrammetry to investigate the results anteriorly, laterally, and basally. Anthropometric measurements taken photogrammetrically used 14 points and 11 distance items. Evaluations were made of upper lip length, upper lip projection, and nostril sill elevation for both the cleft and non-cleft sides of patients’ faces. A t-test showed that the values for upper lip length and projection were significantly increased, and a correction test using a Fisher exam gave a value of 1. The ABG treatment protocol for patients with UCLP at the Cleft Lip and Palate Unit at Harapan Kita Maternal and Child Hospital is suitable to be performed; it aesthetically satisfies patients and their families.

  3. Craniofacial morphology of children with complete unilateral cleft lip and palate following labioplasty and palatoplasty

    Directory of Open Access Journals (Sweden)

    Sigit Handoko Utomo

    2012-06-01

    Full Text Available Background: A complete unilateral cleft lip and palate generally results in asymmetry of the midface. The lack of continuity in the perilabial musculature through the midline contributes to a malpositioning of the underlying osseus structures which are often underdeveloped. Purpose: The purpose of this study was to determine whether there are differences in the craniofacial morphology among children with complete unilateral cleft lip and palate following labioplasty and palatoplasty as compared with children without cleft lip and palate at the same pubertal age. Methods: A series of 14 consecutively treated subjects with complete unilateral cleft lip and palate following labioplasty and palatoplasty were compared with 14 pubertal stage-matched controls with normal craniofacial structure. Pubertal stage was determined with cervical vertebral maturation (CVM method improved by Baccetti et al, 2002. Lateral cephalograms were used for comparison. An unpaired t-test was run for 14 subjects with complete unilateral cleft lip and palate and 14 normal subjects. Results: There were significant cephalometric differences in anterior cranial base length (p = .002, cranial base length (p = .001, maxillary length (p = .000, mandibular length (p = .000, mandibular ramus height (p = .000, mandibular body length (p = .002, and upper anterior face height (p = .004. There was no significant cephalometric difference in posterior cranial base length (p = .051, lower anterior face height (p = .206, posterior face height (p = .865, growth pattern/ facial type (p = .202. Conclusion: There were craniofacial morphology differences between children with complete unilateral cleft lip and palate post labioplasty and palatoplasty and children without cleft lip and palate at the age of pubertal. Children with complete unilateral cleft lip and palate post labioplasty and palatoplasty had shorter length of the anterior cranial base, cranial base, maxilla, mandible, mandibular

  4. Unilateral Cleft Lip: Principles and Practice of Surgical Management

    Science.gov (United States)

    Tse, Raymond

    2012-01-01

    Management of cleft lip and palate requires a unique understanding of the various dimensions of care to optimize outcomes of surgery. The breadth of treatment spans multiple disciplines and the length of treatment spans infancy to adulthood. Although the focus of reconstruction is on form and function, changes occur with growth and development. This review focuses on the surgical management of the primary cleft lip and nasal deformity. In addition to surgical treatment, the anatomy, clinical spectrum, preoperative care, and postoperative care are discussed. Principles of surgery are emphasized and controversies are highlighted. PMID:24179447

  5. 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...

  6. Early hard palate closure using a vomer flap in unilateral cleft lip and palate: effects on cleft width.

    Science.gov (United States)

    de Jong, Johanna P; Breugem, Corstiaan C

    2014-05-01

    Although no universal consensus exists on treatment of cleft palates, early hard palate closure is commonly performed. The aim of the present study was to determine the influence of a vomer flap for early hard palate closure on residual palatal cleft width in patients with a unilateral complete cleft lip and palate (UCLP). Forty-seven UCLP patients were retrospectively divided into two groups. Group A consisted of 25 patients who underwent early lip closure and simultaneous hard palate closure using a vomer flap. Group B included 22 patients who had lip closure only at first surgery. Palatal cleft widths of both groups were measured at two time points and were compared using the Mann-Whitney U test to examine the influence of vomerplasty in this very early stage. No significant difference of baseline characteristics between the groups was found, and comparison of age at the time of surgeries was not significantly different. Mean age at the time of vomerplasty was 4.0 months. After the first surgery, a significantly greater total cleft width reduction of 5.0 mm average was found in group A compared to only 1.5 mm reduction in group B. This reduction took place after an average of 7.1 and 7.0 months, respectively. Lip closure accompanied by early hard palate closure using a vomer flap is associated with a significant postoperative reduction of the residual cleft when compared to lip closure only. This study shows another great advantage of performing early hard palate closure using a vomer flap.

  7. 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.

  8. 旋转推进法单侧唇裂修复术中鼻底切口设计与缝合的改进%A new modified Millard method of unilateral cleft lip repair by improvement of nasal floor incision and suture point design

    Institute of Scientific and Technical Information of China (English)

    刘丰; 杨汉林

    2015-01-01

    Objective Millard's rotation advancement technique has long been considered as principal of unilateral cleft lip repair.However,this method owe a constant postoperative effect,we introduce a modified technique to better design the C flap and the suture point. Methods We present a retrospective review of 25 cases of unilateral cleft lip patients,average age 5.2 months, referred to the department of oral and maxillofacial surgery of Hunan provincial people's hospital from March to December of 2012.A back-cut was designed to end at the lip-columellar junction and the C-flap is used to both fill the columellar defect and abut the rotated lip segment, and outline of the peak of C flap was arc rather than angular.The skin point 7 sutured with point 5,point 6 sutured with point 6'. Results The Cupid's bow and the lip height were symmetry, the scar below the columella decreased significantly,the patient family satisfaction was high. Conclusion These results suggested that modified the C flap and suture point can be achieved using our technique.%目的:介绍一种改进瓣尖设计与缝合位点的术式。方法:患侧推进瓣瓣尖设计成弧形,缝合时弧形顶点第7点与健侧鼻小柱下第5点缝合,第6点与6'点缝合。结果:整个上唇唇弓自然,唇高双侧对称,鼻小柱下方瘢痕明显减少,患者家属满意度高。结论:微调整Millard切口设计及缝合方式,可获得良好的唇裂修复效果,提高单侧唇裂患者家属的满意度。

  9. Comparison of two treatment protocols in children with unilateral complete cleft lip and palate: Tridimensional evaluation of the maxillary dental arch.

    Science.gov (United States)

    Jorge, Paula Karine; Gnoinski, Wanda; Vaz Laskos, Karine; Felício Carvalho Carrara, Cleide; Gamba Garib, Daniela; Okada Ozawa, Terumi; Andrade Moreira Machado, Maria Aparecida; Pinelli Valarelli, Fabrício; Oliveira, Thais Marchini

    2016-09-01

    The aim of this study was to evaluate the dimensional alterations of the maxillary dental arches after lip repair in children with unilateral complete cleft lip and palate of two different protocols. The sample was composed of 94 digital models and divided in two groups: Group I - 23 children, (protocol 1) - with presurgical orthopedic intervention: Hotz plate; Group II - 24 children, (protocol 2) - without presurgical orthopedic intervention. The three dimensional images of the maxillary arch were obtained before lip repair (stage 1) and at approximately 1 year of age (stage 2). Interstages changes for each group were evaluated using dependent t test and Wilcoxon test, and in the intergroup were used independent t test, and Mann-Whitney test. The comparison of the dimensional alterations of dental arches between the two protocols exhibited differences: in the stage 1, the intercanine was smaller in Group II; in the stage 2, the anterior cleft width, the intercanine and the anteroposterior cleft were smaller in Group II. The results reported here suggest that the use of infant orthopedic plate as applied in protocol 1 may favor correct arch form establishment in infants with unilateral complete cleft lip and palate. Copyright © 2016. Published by Elsevier Ltd.

  10. Breastfeeding After Early Repair of Cleft Lip in Newborns With Cleft Lip or Cleft Lip and Palate in a Baby-Friendly Designated Hospital.

    Science.gov (United States)

    Burianova, Iva; Kulihova, Katarina; Vitkova, Veronika; Janota, Jan

    2017-08-01

    Goals of treatment of orofacial cleft are to improve feeding, speech, hearing, and facial appearance. Early surgery brings faster healing, better cosmetic effect, and fewer complications. Breastfeeding rates after early surgery are unknown. Early repair of the cleft lip may influence breastfeeding rates. Research aim: The aim of this study was to evaluate breastfeeding after early repair of the cleft lip in a Baby-Friendly designated hospital. The rate of breastfeeding in newborns with cleft lip was compared to cleft lip and palate. This was a retrospective cohort study. The study group included infants with cleft lip and cleft lip and palate operated on in the first 2 weeks of life. Newborns and their mothers were supported by a team promoting breastfeeding. One hundred four infants (70 boys and 34 girls) were included. Isolated cleft lip was present in 56 (53.8%) infants, and cleft lip and palate in 48 (46.2%). Forty-four (78.6%) of the infants with a cleft lip were breastfed, 3 (5.4%) received human milk via bottle or syringe, and 9 (16.0%) were formula fed. Three (6.2%) of the infants with a cleft lip and palate were breastfed, 31 (64.6%) received human milk via bottle or Haberman feeder, and 14 (29.2%) were formula fed. The rate of breastfeeding in patients following early surgery of the cleft lip was high and comparable to the general population. The rate of breastfeeding in babies with cleft lip and palate after early repair of the cleft lip remained low.

  11. The Cleft Aesthetic Rating Scale for 18-Year-Old Unilateral Cleft Lip and Palate Patients: A Tool for Nasolabial Aesthetics Assessment.

    Science.gov (United States)

    Mulder, F J; Mosmuller, D G M; de Vet, H C W; Mouës, C M; Breugem, C C; van der Molen, A B Mink; Griot, J P W Don

    2016-12-20

      To develop a reliable and easy-to-use method to assess the nasolabial appearance of 18-year-old patients with unilateral cleft lip and palate (CLP).   Retrospective analysis of nasolabial aesthetics using a 5-point ordinal scale and newly developed photographic reference scale: the Cleft Aesthetic Rating Scale (CARS). Three cleft surgeons and 20 medical students scored the nasolabial appearance on standardized frontal photographs.   Medical Center X.   Inclusion criteria: 18-year-old patients, unilateral cleft lip and palate, available photograph of the frontal view. history of facial trauma, congenital syndromes affecting facial appearance. Eighty photographs were available for scoring.   The interobserver and intraobserver reliability of the CARS for 18-year-old patients when used by cleft surgeons and medical students.   The interobserver reliability for the nose and lip together was 0.64 for the cleft surgeons and 0.61 for the medical students. There was an intraobserver reliability of 0.75 and 0.78 from the surgeons and students, respectively, on the nose and lip together. No significant difference was found between the cleft surgeons and medical students in the way they scored the nose (P = 0.22) and lip (P = 0.72).   The Cleft Aesthetic Rating Scale for 18-year-old patients has a substantial overall estimated reliability when the average score is taken from three or more cleft surgeons or medical students assessing the nasolabial aesthetics of CLP patients.

  12. Simple Technique Overcoming a Persistent Problem in Cleft Palate Repair.

    Science.gov (United States)

    Kotrashetti, S M; Dube, Gunjan; Thakkar, Bhushan; Ahuja, Manav

    2016-12-01

    Cleft palate repair mandates use of a mouth gag and Dingmans moth gag is the most commonly used for the same; but the use of Dingmans mouth gag may have the demerit of the suture getting tethered at various places of the instrument during cleft palate closure particularly in the hands of the beginner surgeon. This article discusses about a simple technique of using a rubber dam sheet to cover the frame of the mouth gag. The technique discussed in this article is simple, cost effective method to overcome the potential disadvantage of suture adherence during repair of palatal tissue. The technique also has the potential to reduce the total operative time which needs a further study to validate the same.

  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. Effect of infant orthopedics on facial appearance of toddlers with complete unilateral cleft lip and palate (Dutchcleft).

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Prahl-Andersen, B.; Bronkhorst, E.M.; Spauwen, P.H.M.; Mulder, J.W.; Vaandrager, J.M.; Kuijpers-Jagtman, A.M.

    2008-01-01

    OBJECTIVE: To evaluate the effect of infant orthopedics (IO) on facial appearance of 54 patients with unilateral cleft lip and palate (UCLP), aged 4 and 6 years. DESIGN: Prospective two-arm randomized controlled clinical trial in three Cleft Palate Centers in the Netherlands (Dutchcleft-trial).

  15. Effect of infant orthopedics on facial appearance of toddlers with complete unilateral cleft lip and palate (Dutchcleft)

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Prahl-Andersen, B.; Bronkhorst, E.M.; Spauwen, P.H.M.; Mulder, J.W.; Vaandrager, J.M.; Kuijpers-Jagtman, A.M.

    2008-01-01

    Objective: To evaluate the effect of infant orthopedics (IO) on facial appearance of 54 patients with unilateral cleft lip and palate (UCLP), aged 4 and 6 years. Design: Prospective two-arm randomized controlled clinical trial in three Cleft Palate Centers in the Netherlands (Dutchcleft-trial).

  16. The Impact of Early Infant Jaw-Orthopaedics on Early Speech Production in Toddlers with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Lohmander, Anette; Lillvik, Malin; Friede, Hans

    2004-01-01

    The purpose of study was to investigate the impact of pre-surgical Infant Orthopaedics (IO) on consonant production at 18 months of age in children with Unilateral Cleft Lip and Palate (UCLP) and to compare the consonant production to that of age-matched children without clefts. The first ten children in a consecutive series of 20 with UCLP…

  17. The Impact of Early Infant Jaw-Orthopaedics on Early Speech Production in Toddlers with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Lohmander, Anette; Lillvik, Malin; Friede, Hans

    2004-01-01

    The purpose of study was to investigate the impact of pre-surgical Infant Orthopaedics (IO) on consonant production at 18 months of age in children with Unilateral Cleft Lip and Palate (UCLP) and to compare the consonant production to that of age-matched children without clefts. The first ten children in a consecutive series of 20 with UCLP…

  18. Speech outcome in complete unilateral cleft lip and palate - a comparison of three methods of the hard palate closure

    NARCIS (Netherlands)

    Hortis-Dzierzbicka, M.; Radkowska, E.; Stecko, E.; Dudzinski, L.; Fudalej, P.S.

    2014-01-01

    The aim of this study was to compare the speech in subjects with cleft lip and palate, in whom three methods of the hard palate closure were used. One hundred and thirty-seven children (96 boys, 41 girls; mean age = 12 years, SD = 1.2) with complete unilateral cleft lip and palate (CUCLP) operated b

  19. Limited Chances of Speech Improvement After Late Cleft Palate Repair.

    Science.gov (United States)

    Schönmeyr, Björn; Wendby, Lisa; Sharma, Mitali; Raud-Westberg, Liisi; Restrepo, Carolina; Campbell, Alex

    2015-06-01

    Late primary palatal repair is a common phenomenon, and many patients across the world will be operated on at a far later age than is suggested for normal speech development. Nevertheless, little is known about the speech outcomes after these procedures and conflicting results exist among the few studies performed. In this study, blinded preoperative and postoperative speech recordings from 31 patients operated on at Guwahati Comprehensive Cleft Care Center in Assam, India, older than 7 years were evaluated. Six non-Indian speech and language pathologists evaluated hypernasal resonance and articulation, and 4 local laymen evaluated the speech intelligibility/acceptability of the samples. In 25 of 31 cases, the evaluators could not detect any speech improvement in the postoperative recordings. A clear trend of postoperative improvement was only found in 6 of the 31 patients. Among these 6 patients, lesser clefts were overrepresented. Our findings together with previous studies suggest that late palate repairs have the potential to improve speech, but the probability for improvement and degree of improvement is low, especially in older adolescents and adults with complete clefts.

  20. Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate.

    Science.gov (United States)

    Tengroth, Birgitta; Hederstierna, Christina; Neovius, Erik; Flynn, Traci

    2017-06-01

    Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT treatments) during childhood in a group of children with cleft lip and palate. A retrospective medical chart review of 33 children (25 boys and 8 girls) born with unilateral cleft lip and palate (UCLP) was completed. Audiological data (results of hearing sensitivity tests, the total number of hearing tests, and number of VT treatments) were extracted from medical records from when the children were 4-7 and >7-10 years of age. The hearing thresholds in the speech frequencies improved with age (p 7-10 years of age. There were no significant correlations between number of VT treatments and hearing thresholds at >7-10 years. Four of the 33 children presented with complications: two children exhibited perforations of the ear drum (6.1%) and two children developed unilateral cholesteatoma (6.1%). In the current study, the hearing sensitivity of children with cleft lip and palate improved with age. However, this improvement was not seen in the higher frequencies. Twelve percent of the children experienced complications following VT treatments. Due to these complications, it is recommended that all children with cleft palate should have routine follow-ups by an ENT doctor and audiologist. As part of the routine follow-up care, hearing assessments should be performed before and after VT treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 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.

  2. Comperative analysis of unilateral cleft lip closure using absorbable and nonabsorbable sutures: a randomised clinical study

    Directory of Open Access Journals (Sweden)

    Abhay Nilkanth Datarkar

    2014-09-01

    Full Text Available Aim: Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members. Young patients often require sedation or general anesthesia (GA for suture removal on a sensitive area to prevent disruption of the repair. In this study, we compared absorbable and nonabsorbable sutures for primary cleft lip repair. Methods: Patients with cleft lip who presented to Smile Train Unit, Child Hospital and Research Institute, Nagpur, India, were randomly assigned to two groups and underwent surgical repair using either Vicryl Rapid suture (Group 1 or Prolene suture (Group 2. Patients were followed up at 1 month, 6 months, and 1 year. Photographs of the patients were obtained at these visits and rated using a validated 100-mm cosmesis visual analogue scale (VAS by three people (social worker, surgeon, and patient's mother. A VAS score of 15 mm or greater was considered as clinically important difference. Results: A total of 60 patients were enrolled in this study, and they were equally divided into two groups. There was no difference in age, race, sex, wound length, number of sutures, and layered repair rates between the groups. The average age of the patient was 3 months. There was no significant difference in the rates of infection which was 6% in this study, wound dehiscence, and hypertrophic scar formation. No significant difference was found in cosmetic outcome in both the mean VAS score of 90.3 in Group 1 and 91.7 in Group 2. Conclusion: Absorbable sutures are a viable alternative to nonabsorbable sutures in the repair of primary cleft lip repair. We prefer absorbable sutures because they do not require removal under GA or sedation.

  3. Histological comparison of the alar nasal cartilages in unilateral cleft lip

    Directory of Open Access Journals (Sweden)

    Modolin Miguel

    2002-01-01

    Full Text Available Patients with unilateral cleft lip display characteristic nasal changes that are independent of the degree of deformity. Defenders of the intrinsic theory consider these deformities to be due to embryogenic alterations of the alar nasal cartilages. Those that propose the extrinsic theory defend the thesis that the deformity is due to disorganization of the perioral muscles deformed by the cleft. The purpose of this study is to contribute histological evidence to help clarify the issue. PATIENTS AND METHODS: Specimens of the lateral portion of both the healthy and the cleft side of the alar cartilages were obtained from 18 patients. These uniformly cut specimens were stained by hematoxylin and eosin. Samples from 2 patients were excluded due to imperfections. The same pathologist examined all the slides. He was unaware of the origins of the specimens; he counted the number of chondrocytes and quantified the cartilage matrixes. RESULTS: All data was analyzed statistically, and no significant statistical differences were apparent, either in the number of chondrocytes or the cartilage matrix between the healthy side and the cleft side. DISCUSSION: These results apparently support the group that defend the extrinsic theory; nevertheless, the doubt about the composition of the cartilage matrix remains, not only concerning the glycosaminoglycans that compose them, but also regarding elastin and collagen and its linkages that can cause different degrees of collagen consistency.

  4. Minor modification of Millard's surgical technique for correction of complete unilateral cleft lip

    Directory of Open Access Journals (Sweden)

    Coen Pramono D

    2010-12-01

    Full Text Available Background: A surgical technique for correction of complete unilateral cleft lip was done using a minor modification of Millard’s surgical technique. The purpose of this modification is to achieve a good anatomical form of columelia, nostril cill and the position of nasal tip. Purpose: This article presents the correction of the complete cleft lip which was done initially by correction of the slanted columella followed by correction of the nostril sill which was done before the sequence of closing the lip crevice. Case: Correction of a case with complete unilateral cleft lip on a fifteen year old girl using modification of Millard’s surgical technique is presented. Case Management: Rotation incision in the philtrum region was made as introduced by Millard to make a triangular flap. The triangular flap was contralaterally rotated and pulled into the direction of cleft to achieve a normal position of the columella and nasal tip. The lateral side of the ala was incised in circular form down to the alar base and straight through to the direction of cleft formed an alar flap which consisted of ala, clefted and slanted nasal base tissue. The tip of the triangular flap was trimmed and approximated to the alar flap to form a new the nostril sill. Adjustment of the size of the nostrill sill size was achieved during the approximation of those two flaps. The nasal base was built during approximation of the lateral and the medial segment flap or philtrum region and the base of new nostril sill. Surgical correction of the complete unilateral cleft lip including correction of the nostrill sill using approximation of triangular flap and the alar flap was achieved. Conclusion: This surgical technique with minor modification of Millard’s surgical technique can be used for correction of the complete unilateral cleft lip with extremely slanted columella and nasal tip to form thenostril sill.Latar belakang: Koreksi celah bibir komplit satu sisi telah

  5. Skoog Primary Periosteoplasty versus Secondary Alveolar Bone Grafting in Unilateral Cleft Lip and Alveolus: Long-Term Effects on Alveolar Bone Formation and Maxillary Growth.

    Science.gov (United States)

    Jabbari, Fatima; Hakelius, Malin M; Thor, Andreas L I; Reiser, Erika A; Skoog, Valdemar T; Nowinski, Daniel J

    2017-01-01

    Clefts involving the alveolus are treated using one of two strategies: primary periosteoplasty at the time of lip repair or secondary alveolar bone grafting at mixed dentition. Most teams favor secondary alveolar bone grafting because of its high success rate, and concerns have been raised that primary periosteoplasty may interfere with maxillary growth. However, primary periosteoplasty may obviate the need for future bone grafting and is still practiced in some centers. Few studies compare the long-term outcomes of these two strategies. Fifty-seven consecutive patients born with unilateral cleft lip and alveolus were studied retrospectively. All patients underwent primary lip repair using Skoog's method; 28 patients underwent primary periosteoplasty at the time of lip repair and the remaining 29 underwent secondary alveolar bone grafting at mixed dentition. Occlusal radiographs obtained at ages 10 and 16 years were analyzed for alveolar bone height. Cephalometric analysis assessed growth at ages 5, 10, and 18 years. Seventeen of 28 patients treated using primary periosteoplasty required later secondary bone grafting, and the bone height at age 16 years was lower in the primary periosteoplasty group (p < 0.0001). There was a more pronounced decrease in maxillary protrusion from ages 5 to 10 years in the primary periosteoplasty group (p < 0.03). However, at age 18 there was no significant difference in maxillary growth between the two groups. Primary periosteoplasty did not seem to inhibit long-term maxillary growth but was ineffective as a method of reconstructing the alveolar cleft. Therapeutic, III.

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

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    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.

  7. 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.

  8. CORRECTION OF ALVEOLAR ARCH MALALIGNMENT AFTER TOTAL CORRECTION IN UNILATERAL AND BILATERAL GR III CLEFTS

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    Mohana Rao

    2015-06-01

    Full Text Available AIMS AND OBJECTIVES: Aim of this study is to document and analyse the pre - operative and postoperative alveolar arch impressions . MATERIALS AND METHODS: 20 cases of both unilateral and bilateral GR III clefts selected for this study. These pati ents were operated at the age of not less than 9 months, preferably below the age of 18 months. Below the age of 9 months general condition of these children may not cope up the duration of general anesthesia and amount of surgical trauma. After intubating the patient preoperatively, with the help of custom made metal arch plates, at first, Medical grade Alginate material with optimal hydration used to get negative impression, from these , positive impressions were obtained by the use of optimally hydrated m edical grade stone powder routinely used by dental surgeons. These positive impressions along with negative impression s and metal plates allowed to settle down for 10 hours undisturbed, after that positive impressions retrieved carefully without breaking a nd stored for analysis. Similarly postoperative impressions were taken after a gap of 2 years in the same manner like that of pre - operative ones under general anesthesia. Both impressions w ere compared and analysis was done regarding alveolar arch malalign ment, asymmetry and arch collapse correction. RESULTS & CONCLUSION: The status of the alveolar arch after single stage operation for cleft lip and palate in the unilateral cleft was much improved and there was considerable correction of the arch collapse a s well; in the bilateral cleft the correction of the premaxillary protrusion was better appreciated than the degree of correction of the alveolar gap.

  9. 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

    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

  10. 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

  11. 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

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

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    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.

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

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    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.

  14. A Multivariate Analysis of Unilateral Cleft Lip and Palate Facial Skeletal Morphology.

    Science.gov (United States)

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-07-01

    Unilateral cleft lip and palate (UCLP) occurs when the maxillary and nasal facial prominences fail to fuse correctly during development, resulting in a palatal cleft and clefted soft and hard tissues of the dentoalveolus. The UCLP deformity may compromise an individual's ability to eat, chew, and speak. In this retrospective cross-sectional study, cone beam computed tomography (CBCT) images of 7-17-year-old individuals born with UCLP (n = 24) and age- and sex-matched controls (n = 24) were assessed. Coordinate values of three-dimensional anatomical landmarks (n = 32) were recorded from each CBCT image. Data were evaluated using principal coordinates analysis (PCOORD) and Euclidean distance matrix analysis (EDMA). Approximately 40% of morphometric variation is captured by PCOORD axes 1-3, and the negative and positive ends of each axis are associated with specific patterns of morphological differences. Approximately 36% of facial skeletal measures significantly differ by confidence interval testing (α = 0.10) between samples. Although significant form differences occur across the facial skeleton, strong patterns of morphological differences were localized to the lateral and superioinferior aspects of the nasal aperture, particularly on the clefted side of the face. The UCLP deformity strongly influences facial skeletal morphology of the midface and oronasal facial regions, and to a lesser extent the upper and lower facial skeletons. The pattern of strong morphological differences in the oronasal region combined with differences across the facial complex suggests that craniofacial bones are integrated and covary, despite influences from the congenital cleft.

  15. A Subcutaneous Alar Base (SCAB) flap to restore symmetry of the ala in primary cleft-lip nose repair.

    Science.gov (United States)

    Sherif, Mahmoud Magdi

    2014-12-01

    Primary surgical correction of cleft-lip nose deformity is now well accepted. Despite various surgical techniques proposed, perfect nasal symmetry has not been persistently attained. The main reason is that the maxillary deficiency is frequently overlooked.This paper presents 62 cases of unilateral cleft lip repaired over the last 20 years by using the author's modification of the Millard primary lip nose repair. Each of these patients had a minimum follow-up of 1 year (range 1-12 years).The technique consists of raising a small subcutaneous alar base flap (SCAB) from the nasolabial region. The flap is turned over like a book page to add bulk to the deficient maxilla and to elevate the depressed ala. It also controls alar rotation and permits its permanent fixation to the anterior nasal spine.The results show that this modification has improved the alar contour and symmetry in patients undergoing primary cleft-lip nasal repair. There was minimal increase in the operating time and the final scar is similar to the original Millard technique.

  16. Infant orthopedics has no effect on maxillary arch dimensions in the deciduous dentition of children with complete unilateral cleft lip and palate (Dutchcleft).

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Hof, M.A. van 't; Prahl-Andersen, B.; Dirks, I.V.; Kuijpers-Jagtman, A.M.

    2006-01-01

    OBJECTIVE: Evaluation of the effect of infant orthopedics on maxillary arch dimensions in the deciduous dentition in patients with unilateral cleft lip and palate. DESIGN: Prospective two-arm randomized controlled clinical trial with three participating cleft palate centers. SETTING: Cleft palate

  17. 伴隐性唇裂双侧不对称性唇裂的手术修复效果初探%Surgical repair of the asymmetrical bilateral cleft lip accompanied by the recessive cleft lip

    Institute of Scientific and Technical Information of China (English)

    朱镇森; 廖晓丽; 唐世杰; 柯昌能; 舒申友

    2012-01-01

    目的 探讨伴有隐性唇裂的双侧不对称性唇裂的手术修复方式.方法 自2007年9月至2011年9月,我中心共完成了125例双侧唇裂修复,从中筛选出18例双侧不对称性唇裂,其中有6例伴有隐性唇裂.6例中有3例行一次性手术,即将两侧裂隙分别按照单侧唇裂来修复,先修复裂隙较大的,再修复隐性唇裂.有2例则按照双侧完全性唇裂的方法来修复.有1例则只修复裂隙较大一侧,隐性唇裂未予以修复.结果 3例按照单侧唇裂分侧修复者,在术后1个月及3个月的随访中,红唇及人中嵴的外观均得到满意的效果,2例按照双侧完全性唇裂修复者,上唇组织较紧,白唇瘢痕明显,组织量缺失较多.1例只修复裂隙较大的一侧,隐性唇裂仍存在畸形,需二期手术修复.结论 伴有隐性唇裂的双侧不对称性唇裂,采用单侧唇裂分侧修复一期完成,可达到较好的效果.%Objective To explore the surgical repair techniques of the asymmetrical bilateral cleft lip accompanied by recessive cleft lip. Methods Our center had performed 125 cases of the bilateral cleft lip repair from Sep 2007 to Sep 2011. Eighteen cases found with asymmetrical bilateral cleft lip were chosen, of which 6 were accompanied by recessive cleft lip. Among the 6 cases, 3 cases were repaired in only one operation, using the technique of unilateral cleft lip repair to fix both sides of the clefts respectively. First the greater side was repaired and then the contralateral side with the recessive cleft lip was repaired. Two cases were repaired by using the technique of bilateral complete cleft lip repair, and one case was repaired only on the greater side and left the recessive side undone. Results The 3 cases achieved satisfactory results by showing good postoperative appearances of the vermillion and philtrum after one to three months' follow-up. The 2 cases showed a tight upper lip with an obvious scar formation on the labial region and a

  18. 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.

  19. 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。

  20. 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.

  1. 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.

  2. Nasal airway and septal variation in unilateral and bilateral cleft lip and palate.

    Science.gov (United States)

    Starbuck, John M; Friel, Michael T; Ghoneima, Ahmed; Flores, Roberto L; Tholpady, Sunil; Kula, Katherine

    2014-10-01

    Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n = 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MANOVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P = 0.007) and CLP type (P ≤ 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P ≤ 0.001), whereas septal deviation patterns are significantly affected by CLP type (P ≤ 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity.

  3. The Development of the Cleft Aesthetic Rating Scale: A New Rating Scale for the Assessment of Nasolabial Appearance in Complete Unilateral Cleft Lip and Palate Patients.

    Science.gov (United States)

    Mosmuller, David G M; Mennes, Lisette M; Prahl, Charlotte; Kramer, Gem J C; Disse, Melissa A; van Couwelaar, Gijs M; Niessen, Frank B; Griot, J P W Don

    2017-09-01

      The development of the Cleft Aesthetic Rating Scale, a simple and reliable photographic reference scale for the assessment of nasolabial appearance in complete unilateral cleft lip and palate patients.   A blind retrospective analysis of photographs of cleft lip and palate patients was performed with this new rating scale.   VU Medical Center Amsterdam and the Academic Center for Dentistry of Amsterdam.   Complete unilateral cleft lip and palate patients at the age of 6 years.   Photographs that showed the highest interobserver agreement in earlier assessments were selected for the photographic reference scale. Rules were attached to the rating scale to provide a guideline for the assessment and improve interobserver reliability. Cropped photographs revealing only the nasolabial area were assessed by six observers using this new Cleft Aesthetic Rating Scale in two different sessions.   Photographs of 62 children (6 years of age, 44 boys and 18 girls) were assessed. The interobserver reliability for the nose and lip together was 0.62, obtained with the intraclass correlation coefficient. To measure the internal consistency, a Cronbach alpha of .91 was calculated. The estimated reliability for three observers was .84, obtained with the Spearman Brown formula.   A new, easy to use, and reliable scoring system with a photographic reference scale is presented in this study.

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

    Science.gov (United States)

    Shi, Bing; Losee, Joseph E

    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. PMID:25394591

  5. 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.

  6. Nasalance Scores of Children with Repaired Cleft Palate Who Exhibit Normal Velopharyngeal Closure during Aerodynamic Testing

    Science.gov (United States)

    Zajac, David J.

    2013-01-01

    Purpose: To determine if children with repaired cleft palate and normal velopharyngeal (VP) closure as determined by aerodynamic testing exhibit greater acoustic nasalance than control children without cleft palate. Method: Pressure-flow procedures were used to identify 2 groups of children based on VP closure during the production of /p/ in the…

  7. 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

  8. One-Stage Cleft Lip and Palate Repair in an Older Population.

    Science.gov (United States)

    Guneren, Ethem; Canter, Halil Ibrahim; Yildiz, Kemalettin; Kayan, Resit Burak; Ozpur, Mustafa Aykut; Baygol, Emre Gonenc; Sagir, Haci Omer; Kuzu, Ismail Melih; Akman, Onur; Arslan, Serap

    2015-07-01

    In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients. A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique. The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents' and patients' expectations. The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors' experience.

  9. The effects of infant orthopaedics on speech and language development in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Konst, Emmy Maria

    2002-01-01

    This thesis describes an investigation into the effects of infant orthopaedics (IO) on speech and language development in children with unilateral cleft lip and palate (UCLP). The study was performed within the framework of the three-centre prospective randomised clinical trial 'Dutchcleft'. Two gro

  10. Language skills of young children with unilateral cleft lip and palate following infant orthopedics: a randomized clinical trial.

    NARCIS (Netherlands)

    Konst, E.M.; Rietveld, T.; Peters, H.F.M.; Kuijpers-Jagtman, A.M.

    2003-01-01

    OBJECTIVE: To investigate the effects of infant orthopedics (IO) on the language skills of children with complete unilateral cleft lip and palate (UCLP). DESIGN: In a prospective randomized clinical trial (Dutchcleft), two groups of children with complete UCLP were followed up longitudinally: one

  11. Language skills of young children with unilateral cleft lip and palate following infant orthopedics: a randomized clinical trial.

    NARCIS (Netherlands)

    Konst, E.M.; Rietveld, T.; Peters, H.F.M.; Kuijpers-Jagtman, A.M.

    2003-01-01

    OBJECTIVE: To investigate the effects of infant orthopedics (IO) on the language skills of children with complete unilateral cleft lip and palate (UCLP). DESIGN: In a prospective randomized clinical trial (Dutchcleft), two groups of children with complete UCLP were followed up longitudinally: one gr

  12. Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study.

    Science.gov (United States)

    Kulewicz, M; Dudkiewicz, Z

    2010-02-01

    This study compared craniofacial morphology between three groups of children with complete unilateral cleft lip and palate, treated with different surgical protocols. The study included 66 10-year-old children (42 boys and 20 girls) with a complete unilateral cleft lip and palate (22 patients in each of the three groups). Children aged 7 months underwent one-stage surgery, performed by a single surgeon. During surgery, the soft and hard palate and the lip underwent correction. The difference between the groups depended on the hard palate closure. Group I patients had the mucoperiosteal flap elevated on both sides of the cleft. Group II patients had the mucoperiosteal flap elevated on the non-cleft side, and had only a minimal 2-3mm mucoperiosteal flap elevated on the cleft side. Group III patients had mucoperiostium elevated from the septum vomer to create a single-layered caudally pedicled flap, and had only a minimal 2-3mm palatal flap elevated on the cleft side. Craniofacial morphology was defined using lateral cephalometric analysis. Significant craniofacial morphological differences were identified between groups I, II and III. Group III demonstrated the most favourable morphology. This indicates that the technique of hard palate closure has significant influence on craniofacial growth and development. Copyright 2009 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Quantification of negative aesthetic ratings in primary unrepaired unilateral cleft lip infants by modified paired comparison method.

    Science.gov (United States)

    Uchiyama, Takeshi; Kitamura, Nobutaka; Watanabe, Akira; Suga, Ken-Ichiro; Nakano, Yoko; Hitoshi, Ohhata; Takagiwa, Mutsumi

    2014-01-01

    To quantify negative aesthetic ratings in primary unrepaired cleft lip infants by further refining our previously reported paired comparison method. The Thurstone paired comparison method was used to quantify negative aesthetic ratings of plaster facial models selected and ordered according to a table of paired random numbers. A total of 30 facial models of unrepaired incomplete unilateral cleft lip infants were used in this study. Raters comprised 20 oral surgeons and anesthesiologists. Quantification of aesthetic ratings for the 30 face models of unrepaired incomplete unilateral cleft lip infants was obtained. The ratings ranged from 0 to 5.08. Quantification of the aesthetic ratings for the 30 face models will be used as objective variables in a multivariate analysis in the third stage of this ongoing study.

  14. A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate

    Science.gov (United States)

    Subramanian, Chitravelu Siva; Prasad, N. K. K. Koteswara; Chitharanjan, Arun B.; Liou, Eric Jein Wein

    2016-01-01

    Nasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application. PMID:27403068

  15. Microvascular density and mode of angiogenesis in upper lip scar after surgical repair for unilateral complete cleft lip%单侧完全性唇裂矫治术后上唇部瘢痕的血管密度及生成模式研究

    Institute of Scientific and Technical Information of China (English)

    郑云龙; 吕洪; 刘洪全; 孙坤; 关振群; 王瑞春; 李爱群

    2015-01-01

    Objective To explore the differences between normotrophic and hypertrophic scars of lip after the surgical repair of the unilateral complete cleft lip in density of microvessels and the pattern of angiogenesis.Methods Hypertrophic scars (n=11) and normotrophic scars (n=20) were collected after correction of deformity of the unilateral complete cleft lip,and the tissues were stained with haematoxylin and eosin,and immunostained with anti-CD34 antibody.The structure of scar was observed and the microvessels were counted according to the CD34 expression.Using ImageJ software,the capillary density and length of the major and minor axes were measured,and the major:minor axes ratio was calculated.Results By statistical analysis of the capillary density,the length of the major and minor axes and the major:minor axes ratio were measured;we clarified that there were more capillaries in hypertrophic scars (87.91 ± 5.95)/mm2 than in normotrophic scars (49.84 ± 7.05)/mm2,(P<0.01),and the length of the major and minor axes of hypertrophic scars (38.36± 26.36)and (17.33±10.45) μm were longer than the normotrophic scars (13.77±9.56)and (9.00± 5.14) μm,(P<0.05.) The major:minor axes ratio of hypertrophic scars (2.85±0.57) was higher than the normotrophic scars (2.85 ± 0.57) (P<0.01).Conclusions The significant increase in the density of microvessels and the variation in the pattern and morphology of angiogenesis are related to the formation and development of scar after operation of upper lip.%目的 探讨单侧完全性唇裂矫治术后上唇部增生及正常性瘢痕在微血管密度及血管生成模式的差异.方法 2012-2014年,收集单侧完全性唇裂矫治术后上唇部增生性瘢痕标本11例(A组)、正常性瘢痕标本20例(B组),对收集标本进行常规苏木精-伊红(HE)染色和CD34免疫组织化学染色,对上唇部瘢痕内部结构进行观察,并根据CD34表达对微血管观察计数后计算瘢痕内微血管密度,用Image J

  16. Phonology in Swedish-speaking 3-year-olds born with unilateral cleft lip and palate treated with palatal closure in one or two stages.

    Science.gov (United States)

    Klintö, Kristina; Lohmander, Anette

    2017-04-01

    Phonological disorders are common in 3-year-olds born with cleft palate compared to non-cleft peers. However, published results have been based on small samples. The purpose was to expand the knowledge on phonology of Swedish-speaking 3-year-olds with unilateral cleft lip and palate (UCLP), treated with primary palatal closure in one or two stages. The phonology of 26 children with UCLP was assessed with percentage consonants correct adjusted for age (PCC-A) and number of consistent phonological simplification processes (NCP) at age 3. Fifteen of the children were treated with minimal incision technique in one stage (OS) at 13 months and 11 with a two-stage closure (TS) with soft palate repair at 4 months and hard palate repair at 12 months. Their results were compared and then merged with previously obtained data from 10 children treated with OS and nine children treated with TS. Finally, the merged results were compared with those of 20 peers without UCLP. No significant differences between the first two groups were found. In the merged results, NCP in the OS group was significantly lower than in the TS group. The UCLP group displayed significantly poorer results on PCC-A and NCP than peers without UCLP. Surgical procedure did not have a clear impact on phonology at age 3 years. Since children with UCLP are at risk of having impaired phonology at age 3, the results confirm the necessity of having both a phonological and articulatory approach when assessing and treating children born with cleft palate.

  17. Subcutaneous C Shape Muscular Flap for Correcting the Depression of Alar Base in Affected Side in Patients With Unilateral Complete Cleft Lip/Palate During Primary Surgery.

    Science.gov (United States)

    Wu, Dandan; Wang, Guomin; Ouyang, Ningjuan; Lin, Yuhen; Chen, Yang; Dai, Jiewen

    2017-06-01

    The depression of alar base in affected side in patients with unilateral complete cleft lip/palate (CL/P) is one of common clinical features. In this study, the authors try to explore the effect of subcutaneous C shape muscular flap for correcting the depression of alar base in affected side in patients with unilateral complete CL/P during primary surgery. A total of 30 patients with unilateral complete CL/P who received primary correction of the lip nose deformity were included in this study. The C flap was used to drop and lengthen the height of upper lip in unaffected side, and the subcutaneous muscular flap was dissected from the C flap and positioned at the alar base in the affected side of upper lip to correct the depression. Then the surgical effect was evaluated based on clinical examination during follow-up. Alar base symmetry was obtained in 26 patients of this case series, and 4 patients showed slight improvement in alar base symmetry. No major complications such as flap necrosis, infection, or hypertrophic scars were observed during surgery and follow-up. No additional incisions and operative time were necessary. The subcutaneous C shape muscular flap described in this article could offer enough muscular support and markedly correct the depression of nostril and alar base in affected side in primary lip nose repair with no additional incisions and operative time for patients with unilateral complete CL/P.

  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. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Lohmander, Anette; Persson, Christina

    2017-01-01

    for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. DESIGN: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark......, Finland, Norway, Sweden, and the UK. METHODS: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available...... and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments. RESULTS: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p = .045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82...

  20. 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.

  1. 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.

  2. Aesthetic Evaluation of the Nasolabial Region in Children with Unilateral Cleft Lip and Palate Comparing Expert versus Nonexperience Health Professionals

    Directory of Open Access Journals (Sweden)

    Tatiana Saito Paiva

    2014-01-01

    Full Text Available Esthetic evaluation of cleft lip and palate rehabilitation outcomes may assist in the determination of new surgical interventions and aid in reevaluation of treatment protocols. Our objective was to compare esthetics assessments of the nasolabial region in children with a unilateral cleft lip and palate between healthcare professionals who were experienced in the treatment of cleft lip and palate and those who were inexperienced. The study group included 55 patients between 6 and 12 years of age who had already undergone primary reconstructive surgery for unilateral cleft lip. Standardized digital photographs were obtained, and the esthetic features of the nose, lip, and nasolabial region were evaluated. We used only cropped photographic images in the assessments of healthcare professionals with and without experience in cleft lip and palate. Interrater analysis revealed highly reliable assessments made by both the experienced and inexperienced professionals. There was no statistically significant difference in the esthetic attractiveness of the lip and nose between the experienced and inexperienced professionals. Compared with the inexperienced professionals, the experienced professional evaluators showed higher satisfaction with the esthetic appearance of the nasolabial region; however, no difference was observed in the analysis of the lip or nose alone.

  3. 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.

  4. The use of SymNose for quantitative assessment of lip symmetry following repair of complete bilateral cleft lip and palate.

    Science.gov (United States)

    Russell, James H B; Kiddy, Harriet C; Mercer, Nigel S

    2014-07-01

    The SymNose computer program has been proposed as an objective method for the quantitative assessment of lip symmetry following unilateral cleft lip repair. This study aims to demonstrate the use of SymNose in patients with complete bilateral cleft lip and palate (BCLP), a group previously excluded from computer-based analysis. A retrospective cohort study compared several parameters of lip symmetry between BCLP cases and non-cleft controls. 15 BCLP cases aged 10 (±1 year) who had undergone primary repair were recruited from the patient database at the South West Cleft Unit, Frenchay Hospital. Frontal facial photographs were selected for measurement. 15 age-matched controls were recruited from a local school. Lip symmetry was expressed as: percentage mismatch of left vermillion border and upper lip area over the right, horizontal lip tilt and lateral deviation of the lip. A significant increase in lip asymmetry was found in the BCLP group expressed as upper vermillion border mismatch across computer-defined and user-defined midlines (mean difference was 16.4% (p lip asymmetry remains in BCLP patients even after primary repair. This challenges previous assumptions that those with bilateral defects would be relatively symmetrical. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols

    NARCIS (Netherlands)

    Fudalej, P.S.; Katsaros, C.; Bongaarts, C.; Dudkiewicz, Z.; Kuijpers-Jagtman, A.M.

    2011-01-01

    The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft

  6. The effect of infant orthopedics on the occlusion of the deciduous dentition in children with complete unilateral cleft lip and palate (Dutchcleft).

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Prahl-Andersen, B.

    2004-01-01

    OBJECTIVE: Evaluation of the effect of infant orthopedics (IO) on the occlusion of the deciduous dentition in patients with unilateral cleft lip and palate (UCLP). DESIGN: Prospective, two-arm, randomized, controlled clinical trial with three participating cleft palate centers (Dutchcleft). SETTING:

  7. Cone-Beam Computed Tomography Analysis of the Nasopharyngeal Airway in Nonsyndromic Cleft Lip and Palate Subjects.

    Science.gov (United States)

    Al-Fahdawi, Mahmood Abd; Farid, Mary Medhat; El-Fotouh, Mona Abou; El-Kassaby, Marwa Abdelwahab

    2017-03-01

      To assess the nasopharyngeal airway volume, cross-sectional area, and depth in previously repaired nonsyndromic unilateral cleft lip and palate versus bilateral cleft lip and palate patients compared with noncleft controls using cone-beam computed tomography with the ultimate goal of finding whether cleft lip and palate patients are more liable to nasopharyngeal airway obstruction.   A retrospective analysis comparing bilateral cleft lip and palate, unilateral cleft lip and palate, and control subjects. Significance at P ≤ .05.   Cleft Care Center and the outpatient clinic that are both affiliated with our faculty.   Cone-beam computed tomography data were selected of 58 individuals aged 9 to 12 years: 14 with bilateral cleft lip and palate and 20 with unilateral cleft lip and palate as well as 24 age- and gender-matched noncleft controls.   Volume, depth, and cross-sectional area of nasopharyngeal airway were measured.   Patients with bilateral cleft lip and palate showed significantly larger nasopharyngeal airway volume than controls and patients with unilateral cleft lip and palate (P cleft lip and palate showed significantly larger cross-sectional area than those with unilateral cleft lip and palate (P .05). Patients with bilateral cleft lip and palate showed significantly larger depth than controls and those with unilateral cleft lip and palate (P cleft lip and palate showed insignificant nasopharyngeal airway volume, cross-sectional area, and depth compared with controls (P > .05).   Unilateral and bilateral cleft lip and palate patients did not show significantly less volume, cross-sectional area, or depth of nasopharyngeal airway than controls. From the results of this study we conclude that unilateral and bilateral cleft lip and palate patients at the studied age and stage of repaired clefts are not more prone to nasopharyngeal airway obstruction than controls.

  8. Nasal Outcomes of Presurgical Nasal Molding in Complete Unilateral Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Emily M. Williams

    2012-01-01

    Full Text Available Objective. Short-term nasal forms following primary lip repair were compared between presurgical nasal molding and control groups. Aim. To compare nasal symmetry between patients that had nasal molding and lip repair with those that had only lip repair. Design. Retrospective case-control study Patients. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1 initial (2 postsurgical. 28 nasal molding patients and 14 control patients were included. Intervention. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Hypothesis. Nasal molding combined with lip surgery repair according to the Millard procedure provides superior nasal symmetry than surgery alone for nostril height-width ratios and alar groove ratios. Statistics. Shapiro-Wilk test of normality and Student’s -tests. Results. A statistically significant difference was found for postsurgical nostril height-width ratio (<.05. No other statistically significant differences were found. Conclusions. Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding.

  9. 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.

  10. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Karsten, Agneta; Marcusson, Agneta; Hurmerinta, Kirsti

    2017-01-01

    controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total......BACKGROUND AND AIM: Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised......- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6...

  11. Volumetric nasal cavity analysis in children with unilateral and bilateral cleft lip and palate.

    Science.gov (United States)

    Farzal, Zainab; Walsh, Jonathan; Lopes de Rezende Barbosa, Gabriella; Zdanski, Carlton J; Davis, Stephanie D; Superfine, Richard; Pimenta, Luiz A; Kimbell, Julia S; Drake, Amelia Fischer

    2016-06-01

    Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls. Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions. We analyzed 20 subjects (age range = 7-12 years) with UCLP and BCLP from a regional craniofacial center who underwent cone beam computed tomography (CT) prior to alveolar grafting. Ten multislice CT images from age-matched controls were also analyzed. Mimics software (Materialise, Plymouth, MI) was used to create 3D reconstructions of the main nasal cavity and compute total and side-specific nasal volumes. Subjects imaged during active nasal cycling phases were excluded. There was no statistically significant difference in affected:unaffected side volume ratios in UCLP (P = .48) or left:right ratios in BCLP (P = .25) when compared to left:right ratios in controls. Mean overall nasal volumes were 9,932 ± 1,807, 7,097 ± 2,596, and 6,715 ± 2,115 mm(3) for control, UCLP, and BCLP patients, respectively, with statistically significant volume decreases for both UCLP and BCLP subjects from controls (P < .05). This is the first study to analyze total nasal volumes in BCLP patients. Overall nasal volume is compromised in UCLP and BCLP by approximately 30%. Additionally, our finding of no major difference in side:side ratios in UCLP and BCLP compared to controls conflicts with pre-existing literature, likely due to exclusion of actively cycling scans and our measurement of the functional nasal cavity. 3b. Laryngoscope, 126:1475-1480, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  12. 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.

  13. 自体髂骨与胶原-羟基磷灰石复合重组人骨形成蛋白2修复大鼠单侧腭裂%Autogenous iliac boneversuscollagen/hydroxyapatite/recombinant human bone morphogenetic protein-2 composite material for repair of unilateral cleft palate in rats

    Institute of Scientific and Technical Information of China (English)

    沈悦; 马海英; 张彦升; 王娟; 时炳正

    2015-01-01

      结果与结论:随时间的推移,碱性磷酸酶活性逐渐升高,抗酒石酸酸性磷酸酶活性逐渐降低,实验组碱性磷酸酶活性始终高于对照组(P OBJECTIVE:To detect the healing effect of autologous bone graft versus colagen/hydroxyapatite/recombinant human bone morphogenetic protein-2 composite graft in a rat model of unilateral complete cleft palate. METHODS: Firstly, we established the artificial unilateral complete cleft palate models in 32 Sprague-Dawley rats, and then the established animal models were randomly divided into control group and experimental group. The autologous iliac bone was transplanted into the fissures of control group, and the experimental group received colagen/hydroxyapatite/recombinant human bone morphogenetic protein-2 composite graft. After that, the activities of serum alkaline phosphatase and tartrate-resistant acid phosphatase, bone mineral densities in the neonatal palate, expressions of osteocalcin, osteoprotegerin, core binding factor, and osteoclast differentiation factor were detected at 1, 2, 3, 4 weeks after treatment. RESULTS AND CONCLUSION: Over time, the alkaline phosphatase activity increased gradualy, while tartrate-resistant acid phosphatase activity decreased. Compared with the control group, the alkaline phosphatase activity was always higher (P < 0.05,P < 0.01) but the tartrate-resistant acid phosphatase activity was lower in the experimental group (P < 0.05,P < 0.01); the bone mineral density increased in both groups, but it was always higher in the experimental group than the control group (P < 0.01). The expression levels of osteocalcin, osteoprotegerin, and core-binding factor gene gradualy rose in both groups, but they were always higher in the experimental group than the control group; in contrast, the expression of osteoclast differentiation factor was decreased in both groups, and it was lower in the experimental group than the control group. These findings indicate that

  14. Bone-anchored maxillary protraction therapy in patients with unilateral complete cleft lip and palate: 3-dimensional assessment of maxillary effects.

    Science.gov (United States)

    Yatabe, Marília; Garib, Daniela Gamba; Faco, Renato André de Souza; de Clerck, Hugo; Janson, Guilherme; Nguyen, Tung; Cevidanes, Lucia Helena Soares; Ruellas, Antonio Carlos

    2017-09-01

    The aim of this study was to 3-dimensionally assess the treatment outcomes of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate. The cleft group comprised 24 patients with unilateral cleft lip and palate and Class III malocclusion with mean initial and final ages of 11.8 and 13.2 years, respectively. The noncleft group comprised 24 noncleft patients with Class III malocclusion with mean initial and final ages of 11.9 and 12.9 years, respectively. Cone-beam computed tomography examinations were performed before and after BAMP therapy in both groups and superimposed at the cranial base. Three-dimensional displacements of maxillary landmarks were quantified and visualized with color-coded maps and semitransparent superimpositions. The t test corrected for multiple testing (Holm-Bonferroni method), and the paired t test was used for statistical comparison between groups and sides, respectively (P cleft group with no significant differences compared with the noncleft group. The maxillary first molars of the cleft group showed significantly greater medial displacement than did those in the noncleft group. The zygoma showed significantly greater lateral displacement at the cleft side compared with the noncleft side. BAMP caused similar amounts of maxillary protraction in patients with and without unilateral cleft lip and palatem with discrete differences between the cleft side and the noncleft side. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  15. 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...

  16. 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

  17. Comparative Evaluation of the Pharyngeal Airways and Related Soft Tissues of Unilateral and Bilateral Cleft Lip and Palate Patients With the Noncleft Individuals.

    Science.gov (United States)

    Aras, Isil; Dogan, Servet

    2017-01-01

      This study is a comparison of pharyngeal airways and associated soft tissues of unilateral and bilateral cleft lip and palate patients with the noncleft individuals.   Twenty-four unilateral cleft lip and palate patients (UCLP), 21 bilateral cleft lip and palate patients (BCLP), and 26 noncleft patients (NC) between ages 15 to 17 were included in the study. Eleven linear, 1 angular, and 1 proportional measurements were carried out on pretreatment lateral cephalometric head films of these individuals.   The nasopharyngeal depths were markedly reduced in BCLP when compared with the NC (P clefts, BCLP showed significant (P cleft groups compared to the controls. Similarly, the hyoid bone was positioned in a significantly (P cleft patients. Comparison of the mean ratio of velar length to nasopharyngeal depth of the three groups revealed significant (P cleft patients with significantly (P cleft patients show serious inadequacies compared to controls, with significant diversities among cleft types pertaining to some of the parameters investigated. It should be kept in mind that these variations can influence function in terms of respiration and phonation.

  18. Presurgical Nasoalveolar Molding Therapy Using Figueroa's NAM Technique in Unilateral Cleft Lip and Palate Patients: A Preliminary Study.

    Science.gov (United States)

    Koya, Shafees; Shetty, Sandeep; Husain, Akhter; Khader, Mustafa

    The objective of the study was to evaluate the results of nasoalveolar molding (NAM) in the treatment of patients with unilateral cleft lip and palate using a modified technique in a South Indian population. The design was a prospective study with blinded measurements. The sample constituted 10 complete unilateral cleft lip and palate (UCLP) patients who underwent NAM therapy by the same operator. Direct extra and intra oral anthropometric measurements were done using a digital vernier caliper before and after NAM therapy. A photographic evaluation was also done to rate the nasal deformity post NAM therapy. The differences between measurements were statistically analyzed using paired t tests. The extra oral measurements revealed a statistically significant increase in bi-alar width, columellar length and width. The intraoral measurements demonstrated a statistically significant reduction in anterior alveolar cleft width. There was also a significant increase in arch width and greater and lesser segments length. All cases were rated as improved by the surgeons in photographic analysis. The study has quantitatively shown that the modified NAM therapy improved nasal asymmetry by columellar lengthening and effectively molded the maxillary alveolar arch.

  19. A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.

    Science.gov (United States)

    Semb, Gunvor; Enemark, Hans; Friede, Hans; Paulin, Gunnar; Lilja, Jan; Rautio, Jorma; Andersen, Mikael; Åbyholm, Frank; Lohmander, Anette; Shaw, William; Mølsted, Kirsten; Heliövaara, Arja; Bolund, Stig; Hukki, Jyri; Vindenes, Hallvard; Davenport, Peter; Arctander, Kjartan; Larson, Ola; Berggren, Anders; Whitby, David; Leonard, Alan; Neovius, Erik; Elander, Anna; Willadsen, Elisabeth; Bannister, R Patricia; Bradbury, Eileen; Henningsson, Gunilla; Persson, Christina; Eyres, Philip; Emborg, Berit; Kisling-Møller, Mia; Küseler, Annelise; Granhof Black, Birthe; Schöps, Antje; Bau, Anja; Boers, Maria; Andersen, Helene Søgaard; Jeppesen, Karin; Marxen, Dorte; Paaso, Marjukka; Hölttä, Elina; Alaluusua, Suvi; Turunen, Leena; Humerinta, Kirsti; Elfving-Little, Ulla; Tørdal, Inger Beate; Kjøll, Lillian; Aukner, Ragnhild; Hide, Øydis; Feragen, Kristin Billaud; Rønning, Elisabeth; Skaare, Pål; Brinck, Eli; Semmingsen, Ann-Magritt; Lindberg, Nina; Bowden, Melanie; Davies, Julie; Mooney, Jeanette; Bellardie, Haydn; Schofield, Nina; Nyberg, Jill; Lundberg, Maria; Karsten, Agneta Linder-Aronson; Larson, Margareta; Holmefjord, Anders; Reisæter, Sigvor; Pedersen, Nina-Helen; Rasmussen, Therese; Tindlund, Rolf; Sæle, Paul; Blomhoff, Reidunn; Jacobsen, Gry; Havstam, Christina; Rizell, Sara; Enocson, Lars; Hagberg, Catharina; Najar Chalien, Midia; Paganini, Anna; Lundeborg, Inger; Marcusson, Agneta; Mjönes, Anna-Britta; Gustavsson, Annica; Hayden, Christine; McAleer, Eilish; Slevan, Emma; Gregg, Terry; Worthington, Helen

    2017-02-01

    Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project. Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes. Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years. The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series. ISRCTN29932826.

  20. Congenital superior sternal cleft repair using our modified Sally technique: A case report

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kuwata

    2014-12-01

    Full Text Available We report the case of an 8-month-old male neonate who underwent reconstructive surgery for a congenital superior sternal cleft to decrease the risk of commotio cordis. With regard to use of the Sally technique for the repair of a relatively wide cleft (4 × 4 cm, we were concerned about respiratory problems caused by compression following closure of the sternal halves. By closing the sternal halves imperfectly, elevation of intrapleural pressure can be avoided to some extent. By bridging the surplus resected cartilage from the lower sternum over the gap of the upper sternum, the heart is protected by more rigid material. We recommend our modified Sally technique because it is both flexible and effective for sternal cleft repair.

  1. 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.

  2. Hearing sensitivity in adults with a unilateral cleft lip and palate after two-stage palatoplasty.

    Science.gov (United States)

    Kappen, I F P M; Schreinemakers, J B S; Oomen, K P Q; Bittermann, D; Kon, M; Breugem, C C; Mink van der Molen, A B

    2017-03-01

    To evaluate long-term hearing and middle ear status in patients treated for a unilateral complete cleft lip and palate (UCLP) by two-stage palatoplasty. Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a multidisciplinary long-term follow-up of their treatment at a tertiary center for craniofacial surgery in the Netherlands. ENT assessment included tympanometry and pure-tone audiometry. Medical files were searched for medical and surgical history. In total, 19.4% of the patients had significant long-term hearing loss (PTA > 20 dB), comprising conductive hearing loss in 21.5% of the patients. In the majority (70%), this hearing loss was more pronounced at higher frequencies. In 25% the high fletcher index showed hearing thresholds above 20 dB. Ventilation tubes were placed at least once in 78.7% of the patients. The frequency of tube insertion was positively correlated with the incidence of reduced tympanic compliance (tympanogram type B) and the need for a pharyngoplasty. The present study reports long-term hearing outcomes in UCLP patients with hard palate closure at 3 years of age. Persistent hearing loss was observed in 19.4% of our patients (PTA > 20 dB), mainly at the higher frequencies. Ventilation tube placement was associated with reduced tympanic compliance and higher risk on hearing loss (PTA air conduction). Our high incidence of velopharyngeal incompetence during early childhood, which is likely associated with Eustachian tube dysfunction, might have contributed to these results. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Speech Analysis of Bengali Speaking Children with Repaired Cleft Lip & Palate

    Science.gov (United States)

    Chakrabarty, Madhushree; Kumar, Suman; Chatterjee, Indranil; Maheshwari, Neha

    2012-01-01

    The present study aims at analyzing speech samples of four Bengali speaking children with repaired cleft palates with a view to differentiate between the misarticulations arising out of a deficit in linguistic skills and structural or motoric limitations. Spontaneous speech samples were collected and subjected to a number of linguistic analyses…

  4. Speech Analysis of Bengali Speaking Children with Repaired Cleft Lip & Palate

    Science.gov (United States)

    Chakrabarty, Madhushree; Kumar, Suman; Chatterjee, Indranil; Maheshwari, Neha

    2012-01-01

    The present study aims at analyzing speech samples of four Bengali speaking children with repaired cleft palates with a view to differentiate between the misarticulations arising out of a deficit in linguistic skills and structural or motoric limitations. Spontaneous speech samples were collected and subjected to a number of linguistic analyses…

  5. Tratamiento ortopédico con moldeador nasoalveolar prequirúrgico en la fisura labiopalatina unilateral Orthopaedic treatment with presurgical nasoalveolar moulding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Antonio José España-López

    2012-12-01

    Full Text Available Se describen 2 casos de niños con fisura labiopalatina unilateral total con gran separación de procesos alveolares, remitidos a nuestra unidad. Tras valoración por el equipo multidisciplinar se procede a realizar tratamiento ortopédico mediante moldeamiento nasoalveolar prequirúrgico durante 3,5 meses en un caso y 2 meses en el otro. A los 9 meses se mantiene la coalescencia de ambos procesos alveolares y la simetría nasal en ambos pacientes, existiendo una buena proyección de la punta nasal y longitud de la columela.We present two cases of children with total unilateral cleft lip and palate with a marked separation of alveolar segments. After evaluation by a multidisciplinart team, he children were treated with a presurgical nasoalveolar moulding for 2 months in one of them and 3.5 months in the other. At 9 months after the presurgical nasoalveolar moulding treatment, there was improved dental arch form, the cleft edges moved closer to each other, and improved symmetry of the nose in width, height, and columella lengths in both patients.

  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. 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.

  8. Primary treatment for cleft lip and/or cleft palate in children in Japan.

    Science.gov (United States)

    Uchiyama, Takeshi; Yamashita, Yukari; Susami, Takafumi; Kochi, Shoko; Suzuki, Shigehiko; Takagi, Ritsuo; Tachimura, Takashi; Nakano, Yoko; Shibui, Takeo; Michi, Ken-ichi; Nishio, Juntaro; Hata, Yuiro

    2012-05-01

    To investigate current trends in primary treatment for children with cleft lip and/or cleft palate in Japan. Nationwide, retrospective study under the direction of the Academic Survey Committee of the Japanese Cleft Palate Association based on analysis of data obtained via a booklet-style questionnaire completed by institutions providing primary treatment for cleft lip and/or palate patients. PARTICIPANTS, PATIENTS: Patients were 4349 children undergoing primary repair for cleft lip and/or palate at 107 participating institutions between 1996 and 2000. Cleft type, laterality; use of infant palatal plate; and timing and technique of primary repair for cleft lip and/or palate were evaluated by cleft surgeons at 107 participating institutions. Of a total of 2874 patients with cleft lip and palate or cleft palate only, infant palatal plates were used with 1087 (37.8%) and were not used with 1787 (62.2%). Primary unilateral lip repair was performed at the age of 2 to 6 months in more than 90% of patients. Bilateral cleft lip was treated by one-stage repair in 285 patients (44.5%) and by two-stage repair in 258 (40.2%). Primary one-stage palatal repair was performed in 2212 (76.9%) and two-stage palatal repair in 262 (9.1%) cleft palate patients. Information on treatment of the remaining 400 (14%) patients was unavailable. This investigation clarified current trends in primary treatment for cleft lip and/or palate in Japan. The results suggest the need for an increase in regional core hospitals and greater variation in treatment options.

  9. 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.

  10. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes.

    Science.gov (United States)

    Kappen, Isabelle Francisca Petronella Maria; Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom Fjmc; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-05-01

    No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (Ppalate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  11. Assessing an avoidable and dispensable reoperative entity: Self-referred flawed cleft lip and palate repair.

    Science.gov (United States)

    Foroglou, Pericles; Tsimponis, Antonis; Goula, Olga-Christina; Demiri, Efterpi

    2015-01-01

    aesthetically improved outcome. Indications for surgery include widened scars, lip contour deformities, shortened lips, poorly defined and flattened nasal tip, short columella and irregularities of the nostrils (narrow or high-riding) and cartilages. Wound dehiscence, contractures, vermilion notching, white roll malalignment and orovestibular fistulas are possible unfavourable results after cleft lip repair. The psychological status of children and adults with repaired cleft lip and palate has been the subject of extensive research especially regarding the way of their evaluation facial appearance, satisfaction and need for secondary corrective surgical procedures in the hope of increasing their self-esteem and self-confidence. The aim of this study was to assess secondary CLP deformity management in an accredited present-day tertiary hospital facility with an existing infrastructure of a specialist teams however not formed in a multidisciplinary group. Equally, to answer questions of specific operation indications and choice as related to prior surgeries, hospitalization time and cost, provision of adequate preoperative information, correlation between paediatric and plastic surgeons and effect of post-plastic surgical care on patients' health and well-being. It also aims at presenting, beyond our current primary cleft lip and palate repair approach, appropriate indications and timing of secondary repair and achieved results.

  12. 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.

  13. Self-esteem, coping styles, and quality of life in polish adolescents and young adults with unilateral cleft lip and palate.

    Science.gov (United States)

    Pisula, Ewa; Lukowska, Ewa; Fudalej, Piotr S

    2014-05-01

    Objectives : To evaluate self-esteem, coping styles, and health-related quality of life and their relationships in Polish adolescents and young adults with unilateral complete cleft lip and palate and related sex differences. Design and Participants : Self-report questionnaires measuring self-esteem (Multidimensional Self-Esteem Inventory), coping styles (Coping Inventory for Stressful Situations), and health-related quality of life (WHOQOL-BREF) were completed by 48 participants with cleft lip and palate (age, 16 to 23 years; 31 males, 17 females) and 48 controls without cleft lip and palate (age, 16 to 23 years; 28 males, 20 females) matched for age, place of residence, and socioeconomic status. Results : Regarding self-esteem, individuals with cleft lip and palate scored higher on body functioning (P cleft lip and palate scored higher than controls, but males did not differ between groups (P cleft lip and palate scored lower than controls in personal power but higher in body functioning (P cleft lip and palate differed little in terms of psychological adjustment measures. The higher scores in defensive self-enhancement of individuals with cleft lip and palate suggest the need for instruments measuring social approval in psychosocial adjustment research involving this group.

  14. 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)

    Rader, Erik P.; Cederna, Paul S.; McClellan, William T.; Caterson, Stephanie A.; Panter, Kip E.; Yu, Deborah; Buchman, Steven R.; Larkin, Lisa M.; Faulkner, John A.; Weinzweig, Jeffrey

    2009-01-01

    Objective 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-resistant type 1 fibers. As an initial step to determining the validity of this theory, we tested the hypothesis that, in most cases, repair induces the transformation to type 1 fibers, thus diminishing susceptibility to injury. Interventions Single permeabilized levator veli palatini muscle fibers were obtained from normal palates and nonrepaired congenitally-clefted palates of young (2 months old) and adult (14 to 15 months old) goats and from repaired palates of adult goats (8 months old). Repair was done at 2 months of age using a modified von Langenbeck technique. Main Outcome Measures Fiber type was determined by contractile properties and susceptibility to injury was assessed by force deficit, the decrease in maximum force following a lengthening contraction protocol expressed as a percentage of initial force. Results For normal palates and cleft palates of young goats, the majority of the fibers were type 2 with force deficits of ~40%. Following repair, 80% of the fibers were type 1 with force deficits of 20% ± 2%; these deficits were 45% of those for nonrepaired cleft palates of adult goats (p < .0001). Conclusion The decrease in the percentage of type 2 fibers and susceptibility to injury may be important for the development of a functional levator veli palatini muscle postrepair. PMID:18333646

  15. 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.

  16. 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.

  17. Fifteen-Year Follow-Up Results of Presurgical Orthopedics Followed by Primary Correction for Unilateral Cleft Lip Nose in Program SEHATI in Indonesia.

    Science.gov (United States)

    Sulaiman, Farida Kamil; Haryanto, Inge Gustiningsih; Hak, Syafrudin; Nakamura, Norifumi; Sasaguri, Masaaki; Ohishi, Masamichi

    2013-03-01

    Objective : To assess long-term effects of nasal correction in infancy on nasal form and growth in patients with unilateral cleft lip, alveolus, and palate (UCLP). Design : Retrospective longitudinal study. Patients : Seventeen patients with complete UCLP treated in Program SEHATI in Harapan Kita Children and Maternity Hospital, Indonesia, and followed for approximately 15 years were enrolled. Interventions : Subjects received presurgical orthopedics using a Hotz's plate and simultaneous primary lip and nose repair in which the lower lateral cartilage was repositioned through a reverse-U incision. Main Outcome Measures : Preoperative and postoperative nasal forms, including the nostril height and width ratio, the ratio of the height of the top of the alar groove, and the ratio of nostril surface areas were analyzed using color photos taken serially. One-way analysis of variance was used for statistical analyses. Results : The nostril height and width ratio and the height of the alar groove were significantly improved postoperatively and maintained for 15 years. The mean ratio of nostril surface areas was 1.01 ± 0.12 fifteen years postoperatively, and there was no significant difference from the ratio 1 year postoperatively. The major persistent deformities were septal deviation and a small skin web on the nostril rim. Conclusions : Our primary cleft lip nose correction has provided an acceptable nose form and absence of disturbance of the nasal growth in patients with UCLP. However, the repositioning of the nasal cartilage at infancy might not eliminate the need for secondary correction after puberty.

  18. Rating dental arch relationships and palatal morphology with the EUROCRAN index on three different formats of dental casts in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Sabelis, A.J.; Kuijpers, M.A.; Nada, R.M.; Chiu, Y.T.; Bronkhorst, E.M.; Kuijpers-Jagtman, A.M.; Fudalej, P.S.

    2016-01-01

    BACKGROUND: The EUROCRAN index has been used in inter-center studies to assess dental arch relationship (DAR) and palatal morphology (PM) in children with unilateral cleft lip and palate (UCLP). For this type of inter-center research, a scoring method that could be performed over the internet would

  19. Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age

    NARCIS (Netherlands)

    Offert, B.; Janiszewska-Olszowska, J.; Dudkiewicz, Z.; Brudnicki, A.; Katsaros, C.; Fudalej, P.S.

    2013-01-01

    OBJECTIVES: To evaluate facial esthetics in patients with unilateral cleft lip and palate (UCLP) after alveolar bone grafting combined with rhinoplasty between 2 and 4 years of age. DESIGN: Retrospective case-control study. SETTING: The Department of Pediatric Surgery, Institute of Mother and Child,

  20. Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age.

    NARCIS (Netherlands)

    Offert, B.; Janiszewska-Olszowska, J.; Dudkiewicz, Z.; Brudnicki, A.; Katsaros, C.; Fudalej, P.S.

    2013-01-01

    OBJECTIVES: To evaluate facial esthetics in patients with unilateral cleft lip and palate (UCLP) after alveolar bone grafting combined with rhinoplasty between 2 and 4 years of age. DESIGN: Retrospective case-control study. SETTING: The Department of Pediatric Surgery, Institute of Mother and Child,

  1. Self-esteem, coping styles, and quality of life in polish adolescents and young adults with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Pisula, E.; Lukowska, E.; Fudalej, P.S.

    2014-01-01

    Objectives : To evaluate self-esteem, coping styles, and health-related quality of life and their relationships in Polish adolescents and young adults with unilateral complete cleft lip and palate and related sex differences. Design and Participants : Self-report questionnaires measuring self-esteem

  2. Phonological development of toddlers with unilateral cleft lip and palate who were treated with and without infant orthopedics: a randomized clinical trial.

    NARCIS (Netherlands)

    Konst, E.M.; Rietveld, T.; Peters, H.F.M.; Prahl-Andersen, B.

    2003-01-01

    OBJECTIVE: To investigate the phonological development of toddlers from 2 to 3 years of age with complete unilateral cleft lip and palate (UCLP) treated during the first year of life with and without infant orthopedics (IO). DESIGN: In a randomized clinical trial (Dutchcleft), two groups of children

  3. 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.

  4. Is Early Nasal Shaping With a Limited Alar Base Incision Possible in the Repair of Cleft Lips?

    Science.gov (United States)

    Kapi, Emin; Bozkurt, Mehmet; Ozer, Torun; Celik, Mehmet Yusuf

    2016-05-01

    The repair of cleft lips has an important place in plastic and reconstructive surgery. In the treatment of these deformities, the aim was to restore the normal lip morphology in the cleft area as well as repairing any coexisting nasal deformities. Various methods are in use for this purpose. One of the most commonly employed surgical methods is Millard repair. However, this method may lead to additional scarring in the alar base on the cleft side subsequent to the incision. In this study, the results obtained from a group who have been applied alar base incisions during the modified Millard repair are compared to a group who have undergone intranasal wide dissections.The patients enrolled in the study were randomized into 2 groups. The first group were applied the modified Millard repair. In the second group, the rotation, advancement, and C-flaps were prepared according to Millard surgical repair technique; however, instead of an alar base and nasofacial groove incision on the cleft side, a nasal and maxillary supraperiosteal wide dissection was made through the incision in the mucosa of the nostril.The intranasal dissection performed during the study was observed to provide the targeted outcome and a more satisfactory cosmetic result through the modified Millard repair. In conclusion, the authors are of the opinion that the limited alar base incision and the wide supraperiosteal dissection performed in patients with cleft lips is an alternative method that can be employed in a wide range of patients.

  5. 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

  6. 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...

  7. Severe hemolytic anemia after repair of primum septal defect and cleft mitral valve.

    Science.gov (United States)

    Alehan, D; Doğan, R; Ozkutlu, S; Elshershari, H; Gümrük, F

    2001-01-01

    Two cases are described in which severe mechanical hemolytic anemia developed after surgical repair of primum atrial septal defect (ASD) and cleft mitral valve. In both cases there was residual mitral regurgitation after repair. Moderate mitral regurgitation and collision of the regurgitant jet with the teflon patch used for repair of the primum ASD were detected by color-Doppler echocardiography imaging. Laboratory tests showed normochromic normocytic anemia, increased indirect serum bilirubin, decreased plasma haptoglobin and hemoglobinuria. The peripheral blood smear contained numerous fragmented red cells. Following another surgical correction of the mitral valve (repair or mitral valve replacement), there was no more hemolysis. The two presented cases show that foreign materials in association with localized intracardiac turbulence may cause severe hemolysis.

  8. Postoperative analgesia for cleft lip and palate repair in children

    Directory of Open Access Journals (Sweden)

    Reena

    2016-01-01

    Full Text Available Acute pain such as postoperative pain during infancy was ignored approximately three decades ago due to biases and misconceptions regarding the maturity of the infant′s developing nervous system, their inability to verbally report pain, and their perceived inability to remember pain. More recently, these misconceptions are rarely acknowledged due to enhanced understanding of the developmental neurobiology of infant pain pathways and supraspinal processing. Cleft lip and palate is one of the most common congenital abnormalities requiring surgical treatment in children and is associated with intense postoperative pain. The pain management gets further complicated due to association with postsurgical difficult airway and other congenital anomalies. Orofacial blocks like infraorbital, external nasal, greater/lesser palatine, and nasopalatine nerve blocks have been successively used either alone or in combinations to reduce the postoperative pain. Since in pediatric population, regional anesthesia is essentially performed under general anesthesia, association of these two techniques has dramatically cut down the risks of both procedures particularly those associated with the use of opioids and nonsteroidal anti-inflammatory drugs. Definitive guidelines for postoperative pain management in these patients have not yet been developed. Incorporation of multimodal approach as an institutional protocol can help minimize the confusion around this topic.

  9. 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.

  10. The Effect of Cleft Lip and Palate, and the Timing of Lip Repair on Mother-Infant Interactions and Infant Development

    Science.gov (United States)

    Murray, Lynne; Hentges, Francoise; Hill, Jonathan; Karpf, Janne; Mistry, Beejal; Kreutz, Marianne; Woodall, Peter; Moss, Tony; Goodacre, Tim

    2008-01-01

    Background: Children with cleft lip and palate are at risk for psychological problems. Difficulties in mother-child interactions may be relevant, and could be affected by the timing of lip repair. Method: We assessed cognitive development, behaviour problems, and attachment in 94 infants with cleft lip (with and without cleft palate) and 96…

  11. The Effect of Cleft Lip and Palate, and the Timing of Lip Repair on Mother-Infant Interactions and Infant Development

    Science.gov (United States)

    Murray, Lynne; Hentges, Francoise; Hill, Jonathan; Karpf, Janne; Mistry, Beejal; Kreutz, Marianne; Woodall, Peter; Moss, Tony; Goodacre, Tim

    2008-01-01

    Background: Children with cleft lip and palate are at risk for psychological problems. Difficulties in mother-child interactions may be relevant, and could be affected by the timing of lip repair. Method: We assessed cognitive development, behaviour problems, and attachment in 94 infants with cleft lip (with and without cleft palate) and 96…

  12. 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.

  13. Prevalence of abnormalities in dental structure, position, and eruption pattern in a population of unilateral and bilateral cleft lip and palate patients.

    Science.gov (United States)

    Tortora, Chiara; Meazzini, Maria C; Garattini, Giovanna; Brusati, Roberto

    2008-03-01

    To evaluate the dental characteristics of patients subjected to a protocol that included early secondary gingivoalveoloplasty (ESGAP). Panoramic radiographs of 87 patients with unilateral cleft lip and palate (UCLP) and 29 with bilateral cleft lip and palate (BCLP) were evaluated. Missing and supernumerary teeth were also quantified on the cleft and noncleft side and in the maxilla and mandible. Crown and root malformations and tooth rotations were quantified. A subsample in permanent dentition was extrapolated to analyze canine eruption patterns. A total of 48.8% of the UCLP patients presented with missing permanent lateral incisors in the cleft area and 6.1% contralaterally. A total of 4.9% presented with missing second maxillary premolars on the cleft site and 1.2% contralaterally. A total of 7.3% presented with supernumerary lateral incisors, and 45% of the BCLP cleft sites presented with missing lateral incisors, while 25% of the cleft sites presented second maxillary premolars agenesis. Five percent of the cleft sites presented with supernumerary lateral incisors. Evaluation of the subsample in permanent dentition showed that 15.5% had a canine retention and 4.4% of the canines had to be surgically exposed. A significant association was observed between canine inclination and retention but not with absence of the lateral incisor. The frequency of dental anomalies in this sample was similar to other cleft populations. As surgical trauma has been suggested to damage forming teeth, the results of this study indicated that ESGAP has no detrimental influence on subsequent dental development.

  14. 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.

  15. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Pedersen, Kirsten Mølsted; Humerinta, Kirsti; Küseler, Annelise

    2017-01-01

    BACKGROUND AND AIM: Facial appearance is one of the most relevant measures of success in cleft lip and palate treatment. The aim was to assess nasolabial appearance at 5 years of age in all children in the project. In this part of the project the local protocol for lip closure continued to be used...... the three trials. CONCLUSION: The Millard procedure combined with McComb technique had been used in the majority of the cases in all three trials. There were statistically significant differences between the three trials concerning upper lip, nasal form, and cleft side profile. TRIAL REGISTRATION: ISRCTN...... because the primary lip and nose operations were not part of the randomisation. The great majority of the surgeons used Millard's technique together with McComb's technique for the nose. One center used Tennison-Randalls technique and in one center the centers own technique as well as nose plugs were used...

  16. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje

    2017-01-01

    BACKGROUND: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. AIMS: To assess the influence of different timing of hard palate closure in a two-stage procedure...... on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery...

  17. The effect of muscle repair on postoperative facial skeletal growth in children with bilateral cleft lip and palate.

    Science.gov (United States)

    Nagase, T; Januszkiewicz, J S; Keall, H J; de Geus, J J

    1998-12-01

    The effect of orbicularis muscle repair on postoperative facial skeletal growth in bilateral cleft lip and palate patients was studied by analysis of cephalometric radiographs and dental casts. Sixty-two patients operated on between 1961-1989 were selected for the study. They were divided into three groups, group 1a (muscle repair; n = 12), group 1b (failed attempt at muscle repair; n = 5), and group 2 (no attempt at muscle repair; n = 45). Comparison of the morphological measurements among these three groups showed that there was a trend towards crossbite in the muscle repair group, but this difference was not significant. Mechanisms by which muscle repair might influence maxillofacial skeletal growth include the possibility that the area around the nasal septum might be the growth centre. The choice of operative technique in bilateral cleft lip and palate should be important.

  18. Speech outcome in children born with cleft lip and palate treated with one-stage palate repair : aspects of function and environment

    OpenAIRE

    Nyberg, Jill

    2016-01-01

    Introduction and aims: This project focused on speech outcomes at 5 and 10 years of age after two different surgical protocols and on peer perceptions of speech in children born with cleft palate. The aim was to gain knowledge about speech outcome in children born with unilateral cleft lip and palate (UCLP) or cleft palate only (CPO), treated with one-stage palatoplasty at approximately 12 months of age, according to two different surgical protocols: minimal incision technique (MIT) and minim...

  19. 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.

  20. 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.

  1. Relationship between chin deviation and the position and morphology of the mandible in individuals with a unilateral cleft lip and palate

    OpenAIRE

    Kim, Kyung-Seon; Son, Woo-Sung; Park, Soo-Byung; Kim, Seong-Sik; Kim, Yong-il

    2013-01-01

    Objective In this study, we aimed to examine the relationship between chin deviation and the positional and morphological features of the mandible and to determine the factors that contributed to chin deviation in individuals with a unilateral cleft lip and palate (UCLP). Methods Cone-beam computed tomography (CBCT) images of 28 adults with UCLP were analyzed in this study. Segmented three-dimensional temporomandibular fossa and mandible images were reconstructed, and angular, linear, and vol...

  2. Maxillary Expansion and Midline Correction by Asymmetric Transverse Distraction Osteogenesis in a Patient With Unilateral Cleft Lip/Palate: A Case Report.

    Science.gov (United States)

    Shintaku, Yuko; Tanikawa, Chihiro; Iida, Seiji; Aikawa, Tomonao; Kogo, Mikihiko; Yamashiro, Takashi

    2015-09-01

    This case report presents the management of a female patient with unilateral cleft lip and palate presenting with skeletal Class III malocclusion and a narrow upper dental arch with a midline deviation. The treatment plan involved asymmetric transverse distraction osteogenesis of the maxilla to make the upper dental midline coincident with the facial midline. After the treatment, a good facial profile and a close intercuspation of teeth were achieved. Occlusion remained stable with normal overjet and overbite after 2-year retention.

  3. Dental arch relationships on three-dimensional digital study models and conventional plaster study models for patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Asquith, J A; McIntyre, G T

    2012-09-01

    To determine if three-dimensional (3D) digital study models could replace plaster study models for the evaluation of dental arch relationships for patients with unilateral cleft lip and palate. Observational study involving plaster study models from a records archive. U.K. National Health Service. Thirty sets of study models of 5-year-old patients with unilateral cleft lip and palate were identified and scanned to produce 3D digital study models by ESM Digital Solutions Ltd. (Swords, Co. Dublin, Ireland) using an R250 Orthodontic Study Model Scanner (3Shape A/S, Copenhagen, Denmark). None. The plaster and 3D digital study models were scored using the 5-year-olds' and modified Huddart Bodenham indices and analyzed using the Friedman test (p plaster and 3D digital models. Intra-observer and interobserver reproducibility were good (0.62 to 0.83 and 0.64 to 0.78, respectively). There were no statistically significant differences between the scores for the 3D digital study models when compared to the plaster study models for either the 5-year-olds' index (p  =  .12) or for the modified Huddart Bodenham index (p  =  .506). Three-dimensional digital models are a valid alternative to traditional plaster study models for the evaluation of dental arch relationships in patients with unilateral cleft lip and palate.

  4. [Medial proximal tibia donor site: contribution to alveolar cleft repair in children].

    Science.gov (United States)

    Corre, P; Khonsari, R H; Laure, B; Cordova Jara, L; Bonnet, R; Mercier, J-M

    2011-11-01

    Cancellous bone is the best material for alveolar cleft repair (or secondary alveolar cleft repair). It is usually harvested from the iliac bone but morbidity of this donor site is high. Among the other possible donor sites the tibial harvesting procedure seems safe with lower morbidity. The authors assessed the medio-proximal tibial harvesting procedure on a consecutive series of 55 children having undergone secondary alveoloplasty. An individual questionnaire was used to assess retrospectively the intensity and duration of postoperative pain, functional impotence, possible late complications, and scar length. Postoperative tibial in frontal and profile radiographs were used to assess corticotomy diameter, the distance between corticotomy and growth plate, and local complications. The mean patient age was nine years. No complications were reported. Sixty nine percent of patients complained of postoperative pain with an average intensity of four out of 10 for a period of 17 days. Sixty five percent of patients complained of discomfort in walking for an average of 12 days. The average scar length was 10 mm. Two patients (3.6%) presented with sequels two years after surgery, residual scar pain for one, and painless ectopic tibial ossification next to the sampling site for the other. The medio-proximal tibial site bone harvesting morbidity is low. The surgical procedure is easy, rapid, and safe. The amount of cancellous bone collected is sufficient for two simultaneous alveolar defect grafts. This site seems especially well adapted for secondary alveoloplasty in children. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  5. Herpes simplex 1 stomatitis after cleft palate repair: a case report and guidelines for management.

    Science.gov (United States)

    Evangelista, Maristella S; Tracy, Lauren; Wells, James H

    2015-05-01

    Herpes simplex virus (HSV) primary infection and reactivation has been associated with the inflammation and transient decrease in immunocompetence after surgery and local trauma. In addition, HSV infection is known to impair wound healing, increase risk of scarring, and impede connective tissue graft transplantation. To our knowledge, this is the first case of HSV infection complicating cleft palate repair presented in literature. In this report, we present a case of primary HSV infection occurring in a healthy 26-month-old patient after repair of the secondary cleft palate with mucoperichondrial flaps and V-Y pushback. The patient developed high fever on postoperative day 1, which was followed by perioral vesicular lesions and multiple intraoral ulcerations involving the lips, palate, and posterior pharynx. Unknown to the surgeons, the patient was exposed to HSV before surgery by a sibling with orolabial HSV infection. The infective cause was ascertained via polymerase chain reaction for HSV-1 DNA, and the infection was treated with topical and intravenous acyclovir for 1 week. The patient recovered well with adequate flap healing, good aesthetic outcome, and no complications on 1-month follow-up. This report underscores the importance of prompt recognition of herpetic infections in the patient with craniofacial surgery and reviews the association and complications of HSV infection in surgical healing. Early identification with prompt antiviral therapy and meticulous wound care are essential to ameliorate the scarring and delayed wound healing associated with HSV infection.

  6. 单侧完全性唇腭裂胎儿颌面部血供的应用解剖%Applied anatomy of the maxillofacial region's blood supply in unilateral complete cleft lip and palate fetus

    Institute of Scientific and Technical Information of China (English)

    黄海龙; 邓健全; 陈丽娟; 钟卫娟; 梁恩来

    2013-01-01

    Objective To provide anatomic basis of intrauterine surgical repair in unilateral complete cleft lip and palate fetus. Methods The head and neck vascular cast specimens of 21-32 weeks normal and unilateral complete cleft lip and palate were made and observed, which maxillofacial region's blood supply source and arterial anastomosis were compared. Results ①For the normal fetus, the maxillofacial region' s blood supply mainly came from facial artery, submental artery, inferior labial artery, superior labial artery, lower edge nasal alar artery, nasal alar artery, lateral nasal artery, dorsal nasal artery, infraorbiatal artery and transverse facial artery, which to build the rich vascular network. ②For the fetus with unilateral complete cleft lip and palate, the affected side of superior labial artery walked along cleft border up to the anastomosis with lower edge nasal alar artery by the basis of nasal alar artery. The affected side of greater palatine artery and nasal vessel were formd in the anastomosis by bone stump. Conclusion When the intrauterine surgical repair of unilateral complete cleft lip and palate is performed, the emphasis of blood supply are on the nose and upper lip region, which are mainly in superior labial artery, lower edge nasal alar artery and greater palatine artery.%目的 为单侧完全性唇腭裂胎儿宫内手术修复提供解剖学基础.方法 制作和观察21~32周正常和单侧完全性唇腭裂胎儿头颈部血管铸型标本,比较它们颌面部血供的来源及吻合情况.结果 ①正常胎儿颌面部血供主要来源于面动脉、颏下动脉、下唇动脉、上唇动脉、鼻翼下缘动脉、鼻翼动脉、鼻外侧动脉、鼻背动脉、眶下动脉及面横动脉等,这些动脉及其分支构筑颌面部组织丰富的血管网;②单侧完全性唇腭裂胎儿患侧上唇动脉沿裂缘向上至鼻翼基底部与鼻翼下缘动脉等相吻合,患侧部分腭骨缺损暴露的腭大动脉穿过骨残端

  7. Crecimiento maxilar según severidad de hendidura labial, alveolar y palatina unilateral Maxillary growth according to the severity of unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    M.C. Navas-Aparicio

    2012-12-01

    ón de crecimiento anterior del maxilar. Como conclusión, la asimetría transversal del arco maxilar fue el hallazgo más importante en este estudio. Se debe realizar un nueva investigación con respecto a la dimensión transversal del maxilar en niños con labio y paladar hendido, ya que existe una alteración de la misma. La posición anterior del maxilar y la longitud del maxilar no estuvieron influenciadas por la severidad de la hendidura. Es importante considerar que el crecimiento maxilar puede estar afectado por factores individuales, tales como el patrón facial genético. De igual manera, deberá efectuarse también un nueva medición hasta que el crecimiento de la cara haya finalizado.The inhibition of the growth and development resulting of a surgical treatment in patients with cleft lip and palate is a widely discussed topic in the world. According to literature, tissue deficiency, probably due to the cleft width and position of the alveolar segments, is a considerable variable that affects the growth of the maxilla, which is also influenced by the surgical correction of the lip, the nose and the palate by scarring, types of surgical treatment, time of the surgery, surgeon skills and pre-surgical orthopedics. The purpose of this study was to determine the possible associations between the severity of cleft and maxillary growth in patients with non-syndromic unilateral cleft lip and palate, who were born in 2001 and treated at the Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social, San José, Costa Rica. The study was retrospective and descriptive, based on data obtained from medical records, initial maxillary study casts of the newborn child, cephalometric radiograph and the present study casts of the child at the age of 5 years. The study sample comprised of 13 patients. The maxillary transverse arch of 12 cases was asymmetric, indicating an alteration of growth in this direction. There is a statistically

  8. Clinical studies of presurgical nasoalveolar molding in unilateral complete cleft lip and palate preoperative correction%鼻-牙槽骨塑形器在婴儿单侧完全性唇腭裂术前矫治的临床研究

    Institute of Scientific and Technical Information of China (English)

    付雪飞; 徐卫华; 吴睿

    2014-01-01

    Objective: To explore the application value of presurgical nasoalveolar molding in unilateral complete cleft lip and palate preoperative correction. Methods: 13 cases with unilateral complete cleft lip and palate underwent early simultaneous lip-nose-alveolar repair following presurgical nasoalveolar molding (PNAM), the changes were observed before and after treatment. Results: After PNAM therapy, the measurement indexes differences were statistically significant as compared with that before treatment (p<0.05). Conclusions: Presurgical nasoalveolar molding showed significant effect on treating unilateral complete cleft lip and palate.%目的:探讨鼻-牙槽骨塑形器在婴儿期单侧完全性唇腭裂术前矫治中的应用价值。方法采用鼻-牙槽骨塑形器(PNAM)对13例单侧完全性唇腭裂患儿进行术前矫治,比较PNAM治疗前后的变化。结果 PNAM术前矫形治疗后各测量指标与治疗前相比,差异均有统计学意义(P<0.05)。结论 PNAM治疗对于婴儿单侧完全性唇腭裂术前矫治疗效显著。

  9. Three-dimensional analysis of maxillary development in patients with unilateral cleft lip and palate during the first six years of life.

    Science.gov (United States)

    Stancheva, Nadezhda; Dannhauer, Karl-Heinz; Hemprich, Alexander; Krey, Karl-Friedrich

    2015-09-01

    The purpose of this work was to analyse early upper-jaw development in patients with unilateral cleft lip and palate (UCLP) treated using two different concepts and to compare shape and size developments between these two groups and a group of noncleft patients. A total of 204 maxillary casts available for this study from 50 UCLP patients were analyzed for upper-jaw development based on three-dimensional measurements performed with a Reflex Microscope from birth up to 71 months of age. Thirty-five of these 50 patients were part of an early treatment group (two-stage cleft closure with single-stage palatoplasty at an age of 10-14 months) and 15 were part of a late treatment group (two-stage cleft closure with palatoplasty at an age of 4-7 years). The control group included 39 casts of 17 noncleft patients. Analysis of shape and size between the patients in the three groups yielded statistically significant differences between the cleft and the noncleft patients. In both treatment groups, we made observations typically associated with cleft formation like lateralization, asymmetry of the greater and lesser cleft segments, and pronounced vertical deviations of the segments. Viewed in all dimensions, however, the patients in the early treatment group approached the control group more closely, although a statistically significant difference was still observed. Our results suggest that the timing of hard-palate closure is not a decisive factor for upper-jaw development. Intrinsic factors (initial cleft width, presence of tooth buds) and the surgeon's skills appear to have a much more defining role.

  10. Unilateral cleft lip and palate. Relationship between morphology of the dentition and functional parameters of the tongue.

    Science.gov (United States)

    Opitz, C; Hochmuth, M; Rabe, H; Subklew, D

    1997-01-01

    The relationship between orthodontic and logopedic findings was evaluated with statistical contingency analysis. The investigation was focused on selected dentomorphologic parameters and oral function/malfunction of 100 patients between 3 and 7 years of age with unilateral cleft lip and palate. For further classification into contingency tables "normal" and "abnormal" attributes were defined. Interdependencies between observed findings and their probable frequencies were calculated and represented in diagrams by means of statistical parameters such as the contingency coefficient. Scatterplots of the calculated coefficients showed a characteristic pattern corresponding to clinical experience. While overjet and transversal occlusion are strongly associated with oral functions, overbite tends not to be associated with oral functions. The contingency coefficient calculated from sagittal and transversal orthodontically relevant conditions of occlusion and incorrect tongue position as well as incorrect swallowing tends to be stronger than that of "abnormal" morphologic parameters and an incorrect tongue position during speech. The longitudinal study of lip position and the 3 investigated morphologic parameters revealed strongly associated contingency coefficients.

  11. Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment.

    Science.gov (United States)

    Hoffmannova, Eva; Bejdová, Šárka; Borský, Jiri; Dupej, Ján; Cagáňová, Veronika; Velemínská, Jana

    2016-11-01

    A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3) the development of these dimensions compared with published data on noncleft controls and on cUCLP patients operated using later operation protocol (LOP; 6 months of age). Sixty-six virtual dental models of 33 longitudinally evaluated cUCLP patients were analysed using metric analysis, a dense correspondence model, and multivariate statistics. We compared the palatal surfaces before neonatal cheiloplasty (mean age, 4 days) and before palatoplasty (mean age, 10 months). The palatal form variability of 10-month-old children was considerably reduced during the observed period thanks to their undisturbed growth, that is, the palate underwent the same growth changes following neonatal cheiloplasty. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. The maxilla of cUCLP patients after neonatal cheiloplasty had a growth tendency similar to noncleft controls (unlike LOP). Both methodological approaches showed that early neonatal cheiloplasty in cUCLP patients did not prevent forward growth of the upper jaw segments and did not reduce either the length or width of the maxilla during the first 10 months of life. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. 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.

  13. A case of single atrium and single ventricle physiology with bilateral cleft lip and palate for lip repair surgery

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2012-01-01

    Full Text Available Bilateral cleft lip and palate may occasionally be associated with complex congenital cyanotic heart disease. An infant with common atrium and single ventricle with infundibular pulmonary stenosis (Blalock-Taussig shunt done recently presented for lip repair surgery. Balanced general anesthesia was administered using sevoflurane along with a regional nerve block to maintain optimal pulmonary and systemic vascular resistance.

  14. “改良Barsky”法在唇裂二期上唇畸形修复中的应用%Application of modified Barsky method in the secondary repair of upper lip deformity of cleft lip

    Institute of Scientific and Technical Information of China (English)

    常冬青; 祝贺; 李蠡; 杨蓉娅; 谷廷敏

    2012-01-01

    Objective To sum up the experiences of secondary repair of upper lip deformity of cleft lip by modified Barsky method. Methods Designed the incision and scar excision according to the basic Barsky method. All incisions were corrected to straight line which similar to the "Z flap" incision. Results Twenty five cleft lip patients healed well, the bilateral lip peak and vermilion tubercle appearance was near normal, and the degree of symmetry of upper lip increased. Conclusion Application of the modified Barsky method to repair upper lip deformity after the primary repair of cleft lip can extend the length of the white-lipped of upper lip, improve the shape of the cupid bow. Due to the symmetry of the method, it can be applied to the late repair of unilateral or bilateral cleft lip.%目的 总结应H改良Barsky法修复单侧或双侧唇裂二期畸形的经验.方法 依照Barsky法根据Barsky法的基本原则设计固定方向的切口及瘢痕切除范围,所有切口均矫正为直线,切开后形成类似“Z皮瓣”的切口,美容缝合.结果 应用本方法修复后的25例患者愈合良好,双侧唇峰和唇珠外观接近正常,上唇对称度增加.结论 应用改良Barsky法修复唇裂修复后期上唇畸形,可以较好的延长号唇白唇长度,改善唇弓形态.由于该方法具有对称性,可以同时应用于单侧或双侧唇裂后期修复.

  15. Pre-operative haematological investigations in paediatric orofacial cleft repair: Any relevance to management outcome?

    Directory of Open Access Journals (Sweden)

    Anthony T Adenekan

    2012-01-01

    Full Text Available Aim and Objectives: To determine the value of routine pre-operative haematologic investigations in children undergoing orofacial cleft repair. Background: Although routine pre-operative laboratory screening tests are carried out traditionally, some studies suggest that they are not absolutely necessary in the management of elective surgical patients. Materials and Methods: This is a prospective cohort study carried out at a tertiary health facility located in Nigeria. A review of the laboratory investigations in 116 paediatric orofacial cleft patients undergoing surgery during a 6-year period was undertaken. Pre-operative laboratory investigations and peri-operative transfusion records were analysed for the frequency and impact of abnormal results on treatment plan and outcome using the Statistical Packages for the Social Scientists 16.0. Results: All the children had pre-operative packed cell volume (PCV check on admission for surgery. The PCV ranged from 23% to 43%, mean was 32.9 (±3.7%. Twenty-two children (18.6% had sub-optimal PCV (<30%. Patients with the lowest PCV values (23% and 26% were transfused pre-operatively. The lowest post-operative PCV was 23%, mean 30.8 (±3.3%. There was no occasion of post-operative blood transfusion. Eighty-six patients (72.9% had full or partial serum electrolyte and urea analysis. Screening for sickle-cell disease was rarely done. Fourteen intra- and post-operative complications were recorded. None of these were predictable by the results of pre-operative screening tests carried out. All the children were discharged home in satisfactory condition. Conclusions: Routine laboratory testing has minimal impact on management and outcome of orofacial cleft surgeries. However, haematocrit screening may be appropriate, particularly in clinically pale patients.

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

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    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.

  17. 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.

  18. Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate

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    Cerom, Jaqueline Lourenço

    2013-04-01

    Full Text Available Introduction: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. Aim: To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. Methods: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. Results: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26 nor between the complaint and hearing loss (p = 0.83. Conclusion: This study showed no association between the hearing complaint and the conventional audiologic assessment.

  19. Transverse dental arch relationship at 9 and 12 years in children with unilateral cleft lip and palate treated with infant orthopedics: a randomized clinical trial (DUTCHCLEFT).

    Science.gov (United States)

    Noverraz, R L M; Disse, M A; Ongkosuwito, E M; Kuijpers-Jagtman, A M; Prahl, C

    2015-12-01

    A long-term evaluation to assess the transverse dental arch relationships at 9 and 12 years of age in unilateral cleft lip and palate treated with or without infant orthopedics (IO). The hypothesis is that IO has no effect on the transverse dental arch relationship. A prospective two-arm randomized controlled trial (DUTCHCLEFT) in three academic cleft palate centers (Amsterdam, Nijmegen and Rotterdam, the Netherlands). Fifty-four children with complete unilateral cleft lip and palate and no other malformations were enrolled in this evaluation. One group wore passive maxillary plates (IO+) during the first year of life, and the other group did not (IO-). Until the age of 1.5, all other interventions were the same. Hard palate was closed simultaneously with bone grafting according to protocol of all teams. Orthodontic treatment was performed when indicated. The transverse dental arch relationship was assessed on dental casts using the modified Huddart/Bodenham score to measure the maxillary arch constriction at 9 and 12 years of age. No significant differences were found between the IO+ and IO- groups. Differences between the centers increased from 9 to 12 years of age. Transverse dental arch relationships at 9 and 12 years of age do not differ between children with UCLP treated with or without IO. There is no orthodontic need to perform IO as applied in this study in children with UCLP.

  20. Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair

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    Yoon Seok Lee

    2015-11-01

    Full Text Available BackgroundVarious techniques for lengthening short columellae have been used for bilateral cleft nose repair. However, previous methods have not yielded satisfactory results. We performed a full-thickness skin graft to lengthen short columellae during secondary cleft nose repair in adult patients.MethodsTen bilateral cleft lip and nose patients underwent secondary cheiloplasty with open rhinoplasty between July 2008 and August 2014. The patients underwent a full-thickness skin graft on the medial crura to elongate the columella. The average age of the patients at the time of surgery was 22.2 years. Nasal profiles were evaluated before and after the operation using the photogrammetric method.ResultsThe nasal profiles were improved in all patients, and all skin grafts were well taken, with the exception of one patient. Columellar height, nostril height, and columella-lip angle increased, and nasal width decreased significantly. The ratios of columellar height to nasal height, columellar height to nasal width, and nasal height to nasal width increased to a statistically significant extent.ConclusionsColumella lengthening with a full-thickness skin graft is a simple and effective method for the repair of severely short columellae in bilateral cleft nose patients. We had satisfactory outcomes, with good color matching and aesthetically pleasing contours.

  1. Post-surgical dentofacial deformities and dental treatment needs in cleft-lip-palate children: A clinical study

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    V Krishna Priya

    2011-01-01

    Full Text Available Background: Cleft lip and palate is a common congenital defect. It is one of the most common facial deformities occurring in major racial and ethnic groups. Aims: The aim of the present study was to record the post-surgical dentofacial deformities in operated cleft lip and palate children, as well as to assess the multitude and magnitude of their dental and other related problems so as to formulate an appropriate treatment plan for complete oral rehabilitation of these children. Materials and Methods: The present in vivo study was conducted on 50 operated cleft lip and palate children (23 males and 27 females ranging from 3 to 14 years of age in an attempt to evaluate the post-surgical dentofacial abnormalities in these children. Results and Conclusions: The study revealed that the distribution of cleft deformity is shown out of 23 male children, 11 children with unilateral cleft lip, 9 children with bilateral cleft lip palate, and remaining 3 children were with cleft palate. Out of 27 female children, 19 children with unilateral cleft lip palate, 3 children with bilateral cleft lip palate, and 5 children with cleft palate. This study showed a wide range of surgical, dental, and functional problems in all operated cleft lip and palate patients. Hence, the study concluded that the effect of timing of the cleft repair on the overall development of facio skeletal-dental structures showed insignificant differences among the various operated cleft-lip-palate children.

  2. 毛发游离移植治疗唇裂修复术后上唇瘢痕%Treatment of upper lip scar with hair transplantation after cleft lip repaired

    Institute of Scientific and Technical Information of China (English)

    亓发芝; 顾建英; 施越冬; 张学军

    2001-01-01

    目的应用毛发游离移植胡须再造,治疗唇裂修复术后遗留的上唇瘢痕。方法切取枕部头皮,分割成含单一毛囊的皮条,供区缝合,应用崔式植毛器移植到上唇瘢痕。结果临床应用4例,单侧唇裂3例,双侧唇裂1例,移植毛发生长良好,效果满意。结论毛发游移植治疗唇裂修复术后上唇瘢痕是一种切实可行的方法。%Objective To treat the upper lip scar with hair transplantation after cleft lip repair. Methods  Excise an elliptical occipital scalp,get the hair ready, and then transplant it into the upper lip scar using Chui-type transplanter. Results Such surgery was performed on 4 patients (3 unilateral and 1 bilateral cleft lip),and the transplantation were successful with satisfactory effects. Conclusion Single hair transplantation is an effective way to treat the upper lip scar after cleft lip repair.

  3. Comparison of dental arch dimensions in models of preschool children with cleft lip/palate repaired by means of surgery alone versus controls.

    Science.gov (United States)

    Burhan, Ahmad S; Nawaya, Fehmieh R

    2016-09-01

    Cleft lip and palate (CLP) anomaly is one of the most prevalent congenital defects causing disturbances of dental arch dimensions. This study aimed at investigating differences in these dimensions between preschool children with cleft lip/palate and a matched control group representing healthy individuals with normal occlusion (NO). The sample of this cross-sectional analytical study consisted of 108 plaster models of children aged from 4 to 5.5 years. They were divided into five groups: the cleft lip group, the cleft palate (CP) group, the unilateral cleft lip and palate group, the bilateral cleft lip and palate group, and the NO group. The NO group was used as a control group. All cleft-affected children were treated only with surgery. Dental arch length and widths were measured. The dental arch dimensions of the cleft lip group were nearly similar to those in the controls. Moreover, the mandibular transverse widths of the CP group were close to those in the controls. However, the mandibular arch length and all maxillary dimensions of the CP group were smaller than those in the controls. In the unilateral cleft lip and palate group, the arch lengths in both jaws and the maxillary transverse widths were smaller than those in the controls, whereas the mandibular transverse widths were similar to those in the controls. In the bilateral cleft lip and palate group, the arch lengths in both jaws were close to those in the controls, but both arches were narrower than those in the controls. The various types of CLP were found to be associated with differences in most maxillary and some mandibular arch dimensions. These data can be used for cleft patient counseling and treatment planning.

  4. 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...

  5. Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

    Directory of Open Access Journals (Sweden)

    M. Elsonbaty

    2017-01-01

    Conclusion: Co-administration of intravenous magnesium sulphate or dexamethasone with to sevoflurane anesthesia during primary cleft palate repair provides more vital hemodynamic state and decrease in postoperative vomiting and delirium when compared with control group.

  6. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.

    LENUS (Irish Health Repository)

    O'Reilly, Elma A

    2012-05-01

    Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached.

  7. Reconstruction of the Vermilion with Healthy Labial Margin Flap in Cleft Lip Repair%唇缘红唇瓣在单侧唇裂红唇整复中的临床观察

    Institute of Scientific and Technical Information of China (English)

    王占; 孔金聪; 杨晓丹

    2011-01-01

    Objective: To summarize the clinical practice of vermilion reconstruction with healthy labial margin flap in cleft lip repair. Methods: 25 cases in unilateral cleft lip repair were retrospectively reviewed. The labial tubercle and lip peak reconstruction consisted of bringing down the medial side of the cleft as a large rotation-advancement flap, and using the vermilion tissue on the lateral side to fill the defect high in the lip. Its effects were evaluated by three professional doctors at the end of seventh day after this operation. The ratio of the line length and the angle (RLA) on the healthy side to the correspondence on the cleft side were calculated for objective evaluation. Results: After operation, the labial bow of each side was intensively found to be symmetrical. In a smiling and static state, patients were satisfactory. RLA was evaluated between 0.91 to 1.10. Conclusion: The anatomical structures of the vermilion of unilateral cleft lip were repaired by using this rotation teehnicque.%目的:探求一种实用的修复单侧唇裂唇峰及唇珠的手术方法.方法:25例单侧唇裂患者应用旋转健侧唇缘红唇瓣重建唇峰唇珠.在术后第7天,由3名专科医师进行主观和客观评价.结果:所有患者健、患侧唇峰对称,唇红饱满,唇珠明显,干湿线(红线)恢复整齐.对称性的客观评价数值大多数在0.91~1.10之间,接近正常人群.结论:旋转健侧唇缘红唇瓣,能够较好地恢复单侧唇裂的红唇解剖结构.术式设计简单,定点明确具体,手术效果良好,是一种可靠实用的单侧唇裂红唇修复术式.

  8. Limited Evidence for the Effect of Presurgical Nasoalveolar Molding in Unilateral Cleft on Nasal Symmetry : A Call for Unified Research

    NARCIS (Netherlands)

    van der Heijden, P.; Dijkstra, P.U.; Stellingsma, C.; van der Laan, B.F.; Korsten-Meijer, A.G.W.; Goorhuis-Brouwer, S.M.

    Background: In the past two decades, presurgical nasoalveolar molding has been applied increasingly in the care of patients with a cleft to improve nasal symmetry and facilitate closure of the lip and secondary rhinoplasty. Many cleft centers do not apply presurgical molding, because its effect is

  9. A cross-sectional survey of 5-year-old children with non-syndromic unilateral cleft lip and palate: the Cleft Care UK study. Part 1: background and methodology

    Science.gov (United States)

    Persson, M; Sandy, J R; Waylen, A; Wills, A K; Al-Ghatam, R; Ireland, A J; Hall, A J; Hollingworth, W; Jones, T; Peters, T J; Preston, R; Sell, D; Smallridge, J; Worthington, H; Ness, A R

    2015-01-01

    Structured Abstract Objectives We describe the methodology for a major study investigating the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after an initial survey, detailed in the Clinical Standards Advisory Group (CSAG) report in 1998, had informed government recommendations on centralization. Setting and Sample Population This is a UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Children born between 1 April 2005 and 31 March 2007 were seen in cleft centre audit clinics. Materials and Methods Consent was obtained for the collection of routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) and anthropometric measures (height, weight, head circumference). The methodology for each clinical measure followed those of the earlier survey as closely as possible. Results We identified 359 eligible children and recruited 268 (74.7%) to the study. Eleven separate records for each child were collected at the audit clinics. In total, 2666 (90.4%) were collected from a potential 2948 records. The response rates for the self-reported questionnaires, completed at home, were 52.6% for the Health and Lifestyle Questionnaire and 52.2% for the Satisfaction with Service Questionnaire. Conclusions Response rates and measures were similar to those achieved in the previous survey. There are practical, administrative and methodological challenges in repeating cross-sectional surveys 15 years apart and producing comparable data. PMID:26567851

  10. Paravertebral block can be an alternative to unilateral spinal anaesthesia for inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    M C Mandal

    2011-01-01

    Full Text Available Background: Inguinal hernia repair can be performed under satisfactory anaesthetic conditions using general, regional and peripheral nerve block anaesthesia. Unilateral spinal anaesthesia provides optimal anaesthesia, with stable haemodynamics and minimal adverse events. The paravertebral block, being segmental in nature, can be expected to produce some advantages regarding haemodynamic stability and early ambulation and may be a viable alternative. Methods: Fifty-four consenting male patients posted for inguinal hernia repair were randomized into two groups, to receive either the two-segment paravertebral block (group-P, n=26 at T10 and L1 or unilateral spinal anaesthesia (group-S, n=28, respectively. The time to ambulation (primary outcome, time to the first analgesic, total rescue analgesic consumption in the first 24-hour period and adverse events were noted. Results: Block performance time and time to reach surgical anaesthesia were significantly higher in the patients of group-P (P<0.001. Time to ambulation was significantly shorter in group-P compared to group-S (P<0.001, while postoperative sensory block was prolonged in patients of group-S; P<0.001. A significantly higher number of patients could bypass the recovery room in group-P compared to group-S, (45% versus 0%, respectively, P<0.001. No statistically significant difference in adverse outcomes was recorded. Conclusion: Both the paravertebral block and unilateral spinal anaesthesia are effective anaesthetic techniques for uncomplicated inguinal hernia repair. However, the paravertebral block can be an attractive alternative as it provides early ambulation and prolonged postoperative analgesia with minimal adverse events.

  11. Effects of early and late cheiloplasty on anterior part of maxillary dental arch development in infants with unilateral complete cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Silvia Valentová-Strenáčiková

    2016-02-01

    Full Text Available Objectives. The objective of this study is to compare the impact of early and late reconstruction of complete unilateral cleft lip and palate on the growth and development of the front of the dentoalveolar arch. Methods. This study was carried out in the years 2012–2015 at the Clinic of Plastic, Reconstructive and Aesthetic Surgery in Banska Bystrica. Infants with unilateral complete cleft lip and palate were divided into 2 groups according to the timing of lip reconstruction. Group A consisted of infants with early lip reconstruction–realised in the first 14 days of life. Group B consisted of infants with later lip reconstruction–realised in the third month of age. Maxillary dental casts were obtained for each child in four periods–in the first 14 days of life, in the third month, in the sixth month and in the age of one year. These were followed by the identification, measurement and evaluation of anthropometric parameters. Results. Significant differences were occurred after the reconstruction of the lips in linear and angle measurements between infants in the A and B groups. Conclusion. The early surgical reconstruction of the lips in the first 14 days of life has a positive effect on the growth and development of the anterior segment of the dentoalveolar arch. Early lip reconstruction forms a continuous pressure on the frontal segment, resulting in the earlier remedy of anatomical properties and creates appropriate conditions for the best development of this area.

  12. 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

  13. Factors contributing to hearing impairment in patients with cleft lip/palate in Malaysia: A prospective study of 346 ears.

    Science.gov (United States)

    Cheong, Jack Pein; Soo, Siew Shuin; Manuel, Anura Michelle

    2016-09-01

    To determine the factors contributing towards hearing impairment in patients with cleft lip/palate. A prospective analysis was conducted on 173 patients (346 ears) with cleft lip and palate (CL/P) who presented to the combined cleft clinic at University Malaya Medical Centre (UMMC) over 12 months. The patients' hearing status was determined using otoacoustic emission (OAE), pure tone audiometry (PTA) and auditory brainstem response (ABR). These results were analysed against several parameters, which included age, gender, race, types of cleft pathology, impact and timing of repair surgery. The patients' age ranged from 1-26 years old. They comprised 30% with unilateral cleft lip and palate (UCLP), 28% with bilateral cleft lip and palate (BCLP), 28% with isolated cleft palate (ICP) and 14% with isolated cleft lip (ICL). Majority of the patients (68.2%) had normal otoscopic findings. Out of the 346 ears, 241 ears (70%) ears had passed the hearing tests. There was no significant relationship between patients' gender and ethnicity with their hearing status. The types of cleft pathology significantly influenced the outcome of PTA and ABR screening results (p cleft groups and the outcome of hearing tests. However, hearing improvement occurred when palatal repair was performed at the age of cleft patients had normal hearing (70%). Hearing threshold varied significantly between the different types of cleft pathology. Surgery conferred no significant impact on the hearing outcome unless surgery was performed at the age of <1 year old. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Repair of a submucous cleft palate by W-pushback and levator repositioning without incision to the nasal mucosa.

    Science.gov (United States)

    Hwang, Kun

    2012-03-01

    The author created an innovative method of W-pushback and levator repositioning without having to make an incision to the nasal mucosa for submucous cleft palate repair.The W-shaped mucoperiosteal flap is outlined where the 2 peaks of W are the alveolar processes of both canine teeth and the midpoint of W is the anterior limit of the cleft notch of the hard palate. A short incision, medial to and behind the maxillary tuberosity and curved forward onto the palate and extended forward just medial to the alveolar process, is joined by a second incision from the apex of the cleft to the region of the canine tooth. The W-shaped mucoperiosteal flap is raised until the midline notch of the hard palate is exposed. The nasal mucosa and abnormally inserted levator veli palatini muscle to the posterior border of the hard palate bone are detached. By leaving the nasal mucosa intact, the detached levator veli palatini muscle is approximated at the midline and so the zona pellucida is obliterated. The cleft uvulas are cut in half and closed. The approximated W-flap is joined to the small anterior flap by 1 or more sutures (the W-pushback).Three patients were operated on with this technique without serious complications.The author believes that this method can make the levator sling and increase the length of the soft palate without making an incision to the nasal mucosa.

  15. 152例幼儿期腭裂手术治疗的临床探讨%Clinical Analysis of Treatment of Cleft Palate Repair in Infancy

    Institute of Scientific and Technical Information of China (English)

    阿依努尔·达吾提; 艾克拜尔·阿合买提; 韩洁; 莫红

    2013-01-01

    目的 探讨基层医院在幼儿期开展早期腭裂修复手术的可行性、安全性和成功率等.方法 分析新疆民政康复医院于2009年1月-2011年12月收治152例先天性腭裂患者的临床资料,所有患者术前常规及辅助检查后均行早期腭裂修复手术.手术年龄11个月~4岁,手术方法单侧完全性腭裂采用两大瓣后推术,双侧完全性腭裂采用犁骨瓣加两大瓣后推术,不完全腭裂采用兰氏术式.手术后给予全身抗炎治疗,局部每日漱口清洁,术后第2日给予0.9%氯化钠注射液20 ml、地塞米松注射液3 mg、庆大霉素注射液2ml雾化吸入,预防术后喉头水肿和切口感染.结果 152例先天性腭裂患者中,治愈149例(98.03%),穿孔3例(1.97%)所有病例均一期愈合出院,腭部愈合好,悬雍垂重建良好,语言功能有不同程度改善,患儿家长均感满意.结论 先天性唇腭裂患儿饮食困难,体质差,手术惠儿普遍年龄小在具备可靠的手术麻醉与护理条件的医院收治腭裂患儿是可行的和安全的.在幼儿期开展早期腭裂修复术为临床上腭裂手术的最佳时机.%Objective To investigate feasibility, safety and achievement ratio of early cleft palate repair in early childhood development in basic hospital. Methods Analysis on Xinjiang home rehabilitation hospital between January 2009 and admitted to 152 cases of congenital cleft palate patients with clinical data,all General and after the auxiliary examination before operation in patients with early surgical repair of cleft palate. Surgery 11 months up to 4 years of age,of unilateral complete cleft palate surgery method uses two push the big flap,double cleft palate with Vomer flap and two great after a flap operation,incomplete cleft palate using Orchid' s operation. Systemic anti-inflammatory therapy after the operation,a local daily mouthwash clean,after second day of 0.9% sodium chloride injection 20ml 3mg 2ml aerosol inhalation of

  16. 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.

  17. Rapid maxillary expansion in alveolar cleft repaired with a tissue-engineered bone in a canine model.

    Science.gov (United States)

    Huang, Jialiang; Tian, Bo; Chu, Fengting; Yang, Chenjie; Zhao, Jun; Jiang, Xinquan; Qian, Yufen

    2015-08-01

    This study aims to investigate the effects of orthodontic expansion on graft area of a tissue-engineered bone (TEB) BMSCs/β-TCP, and to find an alternative strategy for the therapy of alveolar cleft. A unilateral alveolar cleft canine model was established and then treated with BMSCs/β-TCP under rapid maxillary expansion (RME). Sequential fluorescent labeling, radiography and helical computed tomography were used to evaluate new bone formation and mineralization in the graft area. Hematoxylin-eosin staining and Van Gieson׳s picro fuchsin staining were performed for histological and histomorphometric observation. ALP activity, mineralization and the expression of osteogenic differentiation related genes of BMSCs that grew on the β-TCP scaffold were promoted by their cultivation in osteogenic medium. Based on fact, TEB was constructed. After 8 weeks of treatment with BMSCs/β-TCP followed by RME, new bone formation and mineralization of the dogs were markedly accelerated, and bone resorption was significantly reduced, compared with the untreated dogs, or those only treated with autogenous iliac bone. The treatment with both TEB and RME evidently made the bone trabecula more abundant and the area of bone formation larger. What is more, there were no significant differences between BMSCs/β-TCP group and the group treated with autogenous bone and RME. This study further revealed that TEB was not only a feasible clinical approach for patients with alveolar cleft, but also a potential substituent of autogenous bone, and its combination with RME might be an alternative strategy for the therapy of alveolar cleft.

  18. 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.

  19. Centre-level variation of treatment and outcome in 5-year-old children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 1: Methodology and results for dento-facial outcomes.

    Science.gov (United States)

    Wills, A K; Mahmoud, O; Hall, A; Sell, D; Smallridge, J; Southby, L; Toms, S; Waylen, A; Wren, Y; Ness, A R; Sandy, J R

    2017-06-01

    Outline methods used to describe centre-level variation in treatment and outcome in children in the Cleft Care UK (CCUK) study. Report centre-level variation in dento-facial outcomes. Two hundred and sixty-eight five-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP). Between January 2011 and December 2012, data were collected on a comprehensive range of outcomes. Child facial appearance and symmetry were assessed using photographic pictures. Dental arch relationships were assessed from standardized dental study models. Hierarchical statistical models were used to predict overall means and the variance partition coefficient (VPC)-a measure of amount of variation in treatment or outcome explained by the centre. Data on dento-alveolar arch relationships and facial appearance were available on 197 and 252 children, respectively. The median age of the children was 5.5 years, and 68% were boys. Variation was described across 13 centres. There was no evidence of centre-level variation in good or poor dento-alveolar arch relationships with a VPC of 4% and 3%, respectively. Similarly, there was no evidence of centre-level variation in good or poor facial appearance with a VPC of 2% and 5%, respectively. There was no evidence of centre-level variation for dento-facial outcomes although this study only had the power to detect large variation between sites. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Acute liver failure following cleft palate repair: a case of therapeutic acetaminophen toxicity.

    Science.gov (United States)

    Iorio, Matthew L; Cheerharan, Meera; Kaufman, Stuart S; Reece-Stremtan, Sarah; Boyajian, Michael

    2013-11-01

    Background : Acetaminophen is a widely used analgesic and antipyretic agent in the pediatric population. While the hepatotoxic effects of the drug have been well recognized in cases of acute overdose and chronic supratherapeutic doses, the toxic effects of acetaminophen are rarely documented in cases where therapeutic guidelines are followed. Case : An 8-month-old boy underwent cleft palate repair and placement of bilateral myringotomy tubes. His anesthetic course was uneventful, consisting of maintenance with desflurane and fentanyl. He received acetaminophen for routine postoperative pain management and was tolerating liquids and discharged home on postoperative day 1. On day 3, the child was profoundly lethargic with multiple episodes of emesis and was taken to the emergency department. He suffered a 45-second tonic-clonic seizure in transport to the regional children's medical center, and initial laboratory results demonstrated acute hepatitis with AST 24,424 U/L, ALT 12,885 U/L, total bilirubin 3.1 mg/dL, and a serum acetaminophen level of 83 μg/mL. Aggressive supportive measures including blood products and periprocedural fresh frozen plasma, piperacillin/tazobactam, and intravenous infusions of N-acetylcysteine, sodium phenylacetate and sodium benzoate, carnitine, and citrulline were administered. His metabolic acidosis and acute hepatitis began to correct by day 4, and he was discharged home without further surgical intervention on day 15. Conclusion : Although acetaminophen is an effective and commonly used analgesic in pediatric practice, hepatotoxicity is a potentially devastating complication. This report challenges the appropriateness of existing guidelines for acetaminophen administration and emphasizes the importance of close follow-up and hydration after even relatively minor surgery.

  1. 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

  2. Three-dimensional comparison between the palatal forms in infants with complete unilateral cleft lip, alveolus, and palate (UCLP) with and without Hotz's plate.

    Science.gov (United States)

    Mishima, K; Sugahara, T; Mori, Y; Sakuda, M

    1996-05-01

    A three-dimensional measuring system was developed to analyze changes in palatal forms of UCLP infants. This system quantified the change of the curved surface on a palate by automatically superimposing two wireframe models obtained from casts at different stages of growth. It also analyzed the curvature of the palatal surface. This system was used to study the palates of 20 infants with unilateral cleft lip and palate (UCLP), from the first to fourth months after birth (12 with Hotz's plate and 8 without, selected at random). Both major and lesser maxillary segments without Hotz's plate remained anterior and lateral although those with Hotz's plate moved mesially during the fourth month after birth. In addition, the degrees of curvature on the palatal surfaces with Hotz's plate were less than those without Hotz's plate.

  3. The correction of alar-columella web deformities in unilateral cleft-lip nasal deformities with web graft technique.

    Science.gov (United States)

    Go, Ju Young; Mun, Goo-Hyun; Bang, Sa Ik; Oh, Kap Sung; Lim, So Young

    2014-10-01

    Among the many secondary deformities in cleft-lip nose, the alar-columella web is unsightly and is a recurrent deformity. The purpose of this article is to revisit the correction of alar web deformity in patients with cleft-lip nasal deformities and to introduce our web graft technique. Thirteen patients with alar webbing underwent surgery between June 2012 and February 2013. The age range of the patients at the time of surgery was 14-29 years. An open rhinoplasty incision, including a reverse-U incision, was made and cartilage work was performed. After the cleft side was equalized with the dome angle of the healthy side, we used contralateral alar or auricular cartilage grafts as a stiff batten to stabilize the converted web skin. The web graft was fixed to the cleft-side web skin's inner side with at least three sutures to maintain the tucking of the vestibular skin. The follow-up period ranged from 1 to 20 months. The postoperative frontal and basal views showed that the nostrils and columella had better shape. Most patients demonstrated correction of the drooping alar rim and satisfactory symmetry of the nostrils. A web graft supports the vestibular lining of the reverse-U incision and increases the strength of the new concavity of the tucked skin. We expect that a long-lasting concave web contour could be achieved with this technique.

  4. 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.

  5. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate.

    Science.gov (United States)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje; Kisling-Møller, Mia; Nielsen, Joan Bogh; Jørgensen, Line Dahl; Andersen, Mikael; Bolund, Stig; Andersen, Helene Søgaard

    2017-07-25

    Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two-stage procedure was tested in a cohort of 126 Danish-speaking children born with non-syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p cleft speech characteristics than children with EHPC (p treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables. © 2017 Royal College of Speech and Language Therapists.

  6. 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.

  7. 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.

  8. Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency.

    Science.gov (United States)

    Reddy, R R; Reddy, S G; Banala, B; Bronkhorst, E; Kummer, A W; Kuijpers-Jagtman, A M; Bergé, S J

    2016-02-01

    Cleft palate repair is done to allow for normal speech by separating the oral and nasal cavities and creating a functioning velopharyngeal valve. However, despite cleft palate repair, some patients demonstrate velopharyngeal insufficiency (VPI). An attempt was made to determine the effectiveness of a modified secondary Furlow Z-plasty in improving VPI. Fifty-five children aged between 12 and 15 years, with postoperative VPI following primary palatoplasty, were included in the study. These children underwent a modified Furlow Z-plasty. Nasometry was done to determine the change in velopharyngeal function due to the secondary Furlow Z-plasty by comparing the preoperative with the 1-year postoperative nasalance scores. A test-retest study was performed to determine the reliability of the nasometric measures. Reliability measurements of the nasometer passages revealed good reliability for 18 out of the 25 speech passages. There was a statistically significant reduction in VPI at 1 year postoperative in patients who were treated with the modified Furlow Z-plasty, with a P-value of nasalance scores at 1 year postoperative, indicating significantly improved velopharyngeal function.

  9. 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.

  10. 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.

  11. Does crossover innervation really affect the clinical outcome? A comparison of outcome between unilateral and bilateral digital nerve repair.

    Science.gov (United States)

    Oruç, Melike; Ozer, Kadri; Çolak, Özlem; Kankaya, Yüksel; Koçer, Uğur

    2016-09-01

    Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the injured side occurs after digital nerve injuries is sustained, one could argue that this concept might even result in the overestimation of the outcome of the digital nerve repair. With this knowledge in mind, this study aimed to present novel, pure, focused and valuable clinical data by comparing the outcomes of bilateral and unilateral digital nerve repair. A retrospective review of 28 fingers with unilateral or bilateral digital nerve repair using end-to-end technique in 19 patients within 2 years was performed. Weber's two-point discrimination, sharp/dull discrimination, warm/cold sensation and Visual Analog Scale scoring were measured at final 12-month follow ups in all patients. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Though there is crossover innervation microscopically, it is not important in the clinical evaluation period. According to clinical findings from this study, crossover innervations appear to be negligible in the estimation of outcomes of digital neurorrhaphy.

  12. Does crossover innervation really affect the clinical outcome? A comparison of outcome between unilateral and bilateral digital nerve repair

    Institute of Scientific and Technical Information of China (English)

    Melike Oru; Kadri Ozer; zlem olak; Yksel Kankaya; Uur Koer

    2016-01-01

    Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the in-jured side occurs after digital nerve injuries is sustained, one could argue that this concept might even result in the overestimation of the outcome of the digital nerve repair. With this knowledge in mind, this study aimed to present novel, pure, focused and valuable clinical data by comparing the outcomes of bilateral and unilateral digital nerve repair. A retrospective review of 28 ifngers with unilateral or bilateral digital nerve repair using end-to-end technique in 19 patients within 2 years was performed. Weber’s two-point discrimination, sharp/dull discrimination, warm/cold sensation and Visual Analog Scale scoring were measured at final 12-month follow ups in all patients. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Though there is crossover innervation microscopically, it is not important in the clinical evaluation period. According to clinical ifndings from this study, crossover innervations appear to be negligible in the estimation of outcomes of digital neurorrhaphy.

  13. Abrupt laryngeal engagement during stop plosive-vowel transitions in children with repaired cleft palate and adequate velopharyngeal closure: aerodynamic and sound pressure level evidence.

    Science.gov (United States)

    Zajac, David J; Milholland, Sarah

    2014-01-01

    To determine whether children with repaired cleft palate and adequate velopharyngeal closure exhibit abrupt laryngeal engagement during stop plosive-vowel transitions as compared with children without cleft palate. A prospective group design was used with convenience sampling of patients at a university craniofacial center. PARTICIPANTS were 25 children (15 boys, 10 girls) with repaired cleft palate (mean age = 10.9 years, standard deviation = 1.5 years) and 20 children (10 boys, 10 girls) without cleft palate (mean age = 10.8 years, standard deviation = 1.8 years). All children with cleft palate had adequate velopharyngeal closure as determined by aerodynamic testing. (1) Peak oral airflow was determined during the release of /t/ in the word "two" during a counting task. (2) An index of laryngeal engagement defined as the ratio of the maximum oral airflow declination to peak oral airflow was calculated during the release of /t/. (3) Sound pressure level was determined during the vowel of the word "two." Children with cleft palate exhibited significantly more negative laryngeal engagement ratios (i.e., more abrupt adduction) (P = .002) and greater sound pressure level (P = .049) than controls. There was a significant negative relationship between laryngeal engagement and sound pressure level for all children (r = -.428, P = .003). Children with repaired cleft palate and adequate velopharyngeal function appear to use a strategy of abrupt laryngeal adduction during stop plosive-vowel transitions. This strategy-perhaps learned even prior to palate surgery-may help to achieve either adequate sound pressure level and/or velopharyngeal closure.

  14. Roberts-SC syndrome, a rare syndrome and cleft palate repair

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2008-01-01

    Full Text Available Roberts SC syndrome is a rare syndrome with only 17 previously recognized patients reported in medical literature. The syndrome is characterized by multiple malformations, particularly, symmetrical limb reduction, craniofacial anomalies such as bilateral cleft lip and palate, micrognathia, and severe growth and mental retardation. Our patient, a young child of five years having Roberts-SC, was successfully operated for cleft palate under general anesthesia. The main features of the syndrome and the technical problems of anesthesia and surgery are discussed in this report.

  15. Receptive and expressive language performance in children with and without Cleft Lip and Palate.

    Science.gov (United States)

    Lamônica, Dionísia Aparecida Cusin; Silva-Mori, Mariana Jales Felix da; Ribeiro, Camila da Costa; Maximino, Luciana Paula

    2016-01-01

    To compare the performance in the abilities of receptive and expressive language of children with cleft lip and palate with that of children without cleft lip and palate with typical 12 to 36-month chronological development. The sample consisted of 60 children aged 12 and 36 months: 30 with cleft lip and palate diagnosis and 30 without cleft lip and palate diagnosis with typical development. The groups were paired according to gender, age (in months), and socioeconomic level. The procedures consisted of analysis of medical records, anamnesis with family members, and valuation of the Early Language Milestone Scale (ELMS). The chart analysis showed 63.34% of the children with unilateral cleft lip and palate, 16.66% with bilateral incisive transforamen cleft, and 20% with post-foramen cleft. Children with cleft lip and palate underwent surgeries (lip repair and/or palatoplasty) at the recommended ages and participated in early intervention programs; 40% presented recurrent otitis history, and 50% attended schools. Statistical analysis included the use of the Mann Whitney test with significance level of p cleft lip and palate showed statistically significant low performance in receptive and expressive language compared with children without cleft lip and palate.

  16. Clinical outcome of tooth-supported fixed partial dentures in unilateral cleft lip and palate patients: A case series

    Directory of Open Access Journals (Sweden)

    Sudhir Bhandari

    2017-01-01

    Discussion: CLP patients undergo a lot of treatment; therefore understanding their opinions, expectations, and perspectives towards the prosthodontic intervention was given due importance. The provisional phase was utilized to educate the patients on the achievable treatment outcome and its limitation. In the present case series, out of three failed FPDs, only one restoration failed relatively early due to functional factors. Re-treatment was successfully achieved without change in the original material and extent of the FPDs. Conclusion: The outcome accomplished endorses the integral role of T-FPDs in the overall cleft care and it will remain a viable treatment alternative in select few patients in meeting their esthetic and functional desires.

  17. 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

  18. [Construction and validation of a three-dimensional finite element model of cranio-maxillary complex with sutures in unilateral cleft lip and palate patient].

    Science.gov (United States)

    Wu, Zhi-fang; Lei, Yong-hua; Li, Wen-jie; Liao, Sheng-hui; Zhao, Zi-jin

    2013-02-01

    To explore an effective method to construct and validate a finite element model of the unilateral cleft lip and palate(UCLP) craniomaxillary complex with sutures, which could be applied in further three-dimensional finite element analysis (FEA). One male patient aged 9 with left complete lip and palate cleft was selected and CT scan was taken at 0.75mm intervals on the skull. The CT data was saved in Dicom format, which was, afterwards, imported into Software Mimics 10.0 to generate a three-dimensional anatomic model. Then Software Geomagic Studio 12.0 was used to match, smoothen and transfer the anatomic model into a CAD model with NURBS patches. Then, 12 circum-maxillary sutures were integrated into the CAD model by Solidworks (2011 version). Finally meshing by E-feature Biomedical Modeler was done and a three-dimensional finite element model with sutures was obtained. A maxillary protraction force (500 g per side, 20° downward and forward from the occlusal plane) was applied. Displacement and stress distribution of some important craniofacial structures were measured and compared with the results of related researches in the literature. A three-dimensional finite element model of UCLP craniomaxillary complex with 12 sutures was established from the CT scan data. This simulation model consisted of 206 753 individual elements with 260 662 nodes, which was a more precise simulation and a better representation of human craniomaxillary complex than the formerly available FEA models. By comparison, this model was proved to be valid. It is an effective way to establish the three-dimensional finite element model of UCLP cranio-maxillary complex with sutures from CT images with the help of the following softwares: Mimics 10.0, Geomagic Studio 12.0, Solidworks and E-feature Biomedical Modeler.

  19. 改良Millard法功能性修复单侧唇裂16例%Unilateral cleft lip using Millard method:report of 16 cases

    Institute of Scientific and Technical Information of China (English)

    王怀谷; 赵永娟; 顾斌

    2013-01-01

    Objective: To improve the effects of contour and the function of cleft lip using improve Millard method. Methods:The operation of the upper lip, prismatical line and vermilion lip were designed accordiing to the method of Millard, Onizuka and Noordhoff, and oris orbicularis of contralateral side and nasal spine and base of diseased side were sutured by multi-level and place overlap. The founction of cleft lip were recovered, philtrum ridge was emerged and the recurrence of nasal feet offshoring was prevented. C flap shrink back to the bottom of nose to expand the skin of nasal columellar and bottom. Results:The equal height of bilateral lip, smooth margin of vermilion lip, natural lips bow and philtrum ridge were found without dry, staggering and ectropion vermilion lip. The upper lip movement without normal sag and distortion, the symmetry base of nasal alar to form nostrils were confirmed. The effects were good. Conclusions:The imprved Millard method is a valuable way,which can recover the founction of unilateral cleft lip.%目的:观察改良Millard法修复单侧唇裂的效果.方法:基于对Millard、Onizuka及罗慧夫术前设计的理解,在白唇、柱状线及红唇的设计上选择性地综合采用三种设计方法,同时采用患侧口轮匝肌与鼻棘、鼻底及对侧口轮匝肌多层次、多部位重叠缝合.在功能性修复唇裂的同时,使人中嵴显现,且防止鼻翼外脚外移复发.术中使C瓣自然退缩于鼻底,以增加患侧鼻小柱和鼻底的皮肤.结果:16例术后双侧唇高相等,红唇缘延续光滑,唇弓形态自然;人中嵴形态存在,无干燥红唇与湿润红唇交错,无唇外翻;上唇运动时无不正常凹陷和扭曲;双侧鼻孔、鼻翼基底基本对称,形成鼻孔槛,效果满意.结论:改良Millard法是功能性修复单侧唇裂的一种较好的方法.

  20. Analysis of Millard Ⅱ Technique and Lip Adhesion Procedure for Correcting Unilateral Complete Cleft Lip%唇粘连术与Millard Ⅱ式联合修复单侧完全性唇裂疗效分析

    Institute of Scientific and Technical Information of China (English)

    谢锋; 张正文; 李昊; 李磊

    2011-01-01

    目的:分析唇粘连术与Millard Ⅱ式手术联合矫正单侧完全性唇裂的优点与手术要点.方法:2003年3月至2009年9月对42例单侧完全性唇裂接受过唇粘连术患者采用MillardⅡ式手术矫正.结果:所有患者术后切口愈合良好,随访3~6个月,患侧鼻小柱延长,两侧鼻孔对称,人中嵴对称,唇弓形态好,无瘢痕增生.结论:唇粘连术与MillardⅡ式手术联合是矫正单侧完全性唇裂的理想术式.%Objective: To analyze the Millard Ⅱ technique and lip adhesion procedure for correcting of unilateral complete cleft lip.Methods: The Millard Ⅱ technique was used to correct unilateral complete cleft lip made correction through lip adhesion procedure in 42 patients from March of 2003 to September of 2009.Results: The postoperative follow-ups of 3-6 months revealed good results of the symmetrical nostrils and philtrums, prolonged columella nasi, good-shaped cupids bow, and invisible scar.Conclusion: The Millard Ⅱ technique and lip adhesion procedure could be an ideal method to correct unilateral complete cleft lip.

  1. 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.

  2. Outcomes of Primary Unilateral Cheiloplasty in Same-Day Surgical Settings

    Directory of Open Access Journals (Sweden)

    Mansoor Khan

    2016-05-01

    Full Text Available BackgroundFinancial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair.MethodsThis study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair.ResultsA total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5, and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation.ConclusionsMild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications.

  3. Innate lymphoid cells: a paradigm for low SSI in cleft lip repair.

    Science.gov (United States)

    Simmerman, Erika; Qin, Xu; Marshall, Brendan; Perry, Libby; Cai, Lei; Wang, Tailing; Yu, Jack; Akbari, Omid; Baban, Babak

    2016-10-01

    Cleft lip and palate reconstructions demonstrate significantly lower surgical site infection rates compared with clean-contaminated cases, prompting investigation into the pathophysiology causing this discrepancy. Recent studies have identified a new group of innate lymphocytes called innate lymphoid cells (ILCs), located in barrier surfaces of the skin, airways, and intestine. Our objectives were to explore for the first time the presence of ILCs in the vermillion of neonates and young children undergoing cleft lip reconstruction and characterize their composition by measuring the three classes of ILCs. Lip tissue samples were collected from 13 subjects undergoing vermillion resection during cleft lip reconstructive surgery. Preparative, transmission electron microscopy, and analytical flow cytometry were performed. The functionality of ILCs was tested in terms of their capacity to produce type 1 (IFN-γ/TNF-α), type 2 (IL-5/IL-13), and type 3 (IL-17/IL-22) cytokines. Data were analyzed using Student t test or the analysis of variance to establish significance (P < 0.05) among groups for all other data. All three classes of ILCs were detected and visualized in the tissue samples. In all samples, the level of ILC2 subset was significantly higher than the other two ILC subsets (P < 0.01), followed by the ILC1 subset, which was present in significantly higher levels than the ILC3 subset (P < 0.05). Our data place ILCs for the first time in the interface of oral mucosal immunity, tissue microenvironment, and homeostasis during and after tissue development, possibly explaining lower infection rates in cleft lip or palate reconstructions. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Domino Flaps for Repairing of Secondary Bilateral Cleft Lip With Severe Columella Deformity.

    Science.gov (United States)

    Wei, Jiao; Chiang, Cheng-An; Zhou, Da; Li, Qingfeng; Liu, Kai

    2017-01-01

    The patients with secondary bilateral cleft lip and nasal deformity always suffer from a serious part of the horizontal and vertical soft tissue deficiencies in the upper lip and nose, especially the columella. Normally, the Abbe flap is used to increase the soft tissue volume of upper lip. However, how to reconstruct the sever columella deficient, how to make full use of the Abbe flap and the remaining soft tissue of the upper lip, are always the problems that need to be solved by plastic surgeons. Twenty-nine patients with secondary bilateral cleft lip and severe columella deficiency were simultaneously reconstructed with several local flaps like dominos that was called "Domino sliding flaps." Six of the patients had their nasal tip and dorsum or collumella augmented and modified with autologous costal cartilage at the same time. The other 23 patients underwent the autologous auricular cartilage augmentation. The patients were followed from 15 months to 50 months. No secondary deformation occurred in any of the patients. 93.1% patients were satisfied with the aesthetics postoperatively, 89.7% patients were satisfied with the incision and donor site scar. Among them, 3 of the patients got hypertrophic scar on the upper lip and were modified 1 year after their first operations. The operational technique of the domino sliding flaps could better play the role of the Abbe flap. It also gave plastic surgeons an effective method to modify the severe deformities of bilateral cleft lip in 1 stage.

  5. 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.

  6. Unilateral pulmonary edema following acute subglottic edema.

    Science.gov (United States)

    Morisaki, H; Ochiai, R; Takeda, J; Nagano, M

    1990-01-01

    Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

  7. 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

  8. 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.

  9. Experimental study on cleft palate repair of rat using rat fetal membrane%鼠胎膜修复大鼠腭裂的实验研究

    Institute of Scientific and Technical Information of China (English)

    张驰; 娜荷雅; 张幸竹; 王丝墨; 唐喜乐; 马振宇; 肖晶; 李武伟

    2013-01-01

    目的 以鼠胎膜对腭裂进行整复手术,研究修复腭裂的效果.方法 建立腭裂动物模型实验.30只SD大鼠按照腭部裂隙大小分为3组,每组10只.a组:长7 mm×宽0.9 mm;b组:长7 mm×宽1.1 mm;c组:长7mm×宽1.3 mm.术后12周处死所有大鼠,观察裂隙变化.手术关闭裂隙实验.10只SD大鼠分为3组.A组大鼠5只,手术造腭裂并以新鲜双层胎膜关闭裂隙;B组大鼠3只,手术造腭裂,令裂隙自行生长;C组2只作为空白对照组.术后4周处死动物,大体观察;制作切片,行组织学观察.结果 腭裂动物模型成功建立,确立b组7mm×1.1 mm为临界缺损.A组大鼠腭裂得到成功修复,口鼻腔黏膜分别愈合,完全覆盖腭裂,镜下见腭裂处口腔黏膜层次清楚,存在黏膜下层,顶部有完整的鼻腔黏膜.结论 鼠胎膜对SD大鼠腭裂具有良好的修复效果.%Objective To explore the feasibility of repairing the defect in cleft palate using fetal membrane in a rat model. Methods To establish the animal model of cleft palate. Thirty SD rats were randomly divided into three groups with 10 rats in each group according to the different size of man - made cleft, group a: 7 mm × 0. 9 mm, group b: 7 mm × 1. 1 mm, group c: 7 mm × 1.3 mm. Animals were sacrificed at the end of 12 weeks and the changes of clefts were compared. Repairing experiment for cleft palate. Ten SD rats were randomly divided into three groups, group A was underwent reduction with 5 rats, group B was only performed model operation with 3 rats, group C was blank with 2 rats. All rats were sacrificed at the end of 4 weeks and the gross and histological observation was respectively carried out. Results The animal model of cleft palate was successfully established. Group b was determined to be the animal model group for critical - sized defect. Cleft palate was repaired successfully in group A with fetal membrane of rat, the structure of palate mucosa was similar to that of the group C in gross

  10. 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

  11. 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.

  12. Incidence of Cleft Lip and Palate in Uganda

    NARCIS (Netherlands)

    Dreise, Marieke; Galiwango, George; Hodges, Andrew

    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

  13. 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

  14. 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

  15. Effect of unrestricted bottle-feeding on early postoperative course after cleft palate repair.

    Science.gov (United States)

    Kim, Eun Key; Lee, Taik Jong; Chae, Soo Wook

    2009-09-01

    Although bottle-feeding after cheiloplasty is widely accepted, postoperative feeding regimen after palatoplasty is still controversial. The aim of this prospective randomized study was to evaluate the effect of bottle-feeding on early postoperative course after palatoplasty in a relatively homogeneous group of patients. Eighty-two consecutive patients with nonsyndromic cleft palate undergoing 2-flap palatoplasty by a single surgeon were randomized to feeding from a bottle with the usual nipple (G1, N = 42) or to feeding with a spoon, cup, or syringe (G2, N = 40). Complication rates, postoperative sedative use, oral intake for the first 6 days, and relative weight gain at 1 and 2 months were compared. There were no significant complications such as bleeding or respiratory problem. The overall complication rate including wound dehiscence and oronasal fistula was similar in G1 and G2 (11.9% versus 12.5%, P = 1.000) as was postoperative sedative use and mean daily oral intake for the first 5 days. Mean intake on the sixth day was significantly higher in G1. There were no significant between-group differences in relative weight gain after 1 and 2 months. In conclusion, bottle-feeding had no adverse effect on the early postoperative course after palatoplasty including complication rate, oral intake, and weight gain. These findings suggest that an unrestricted feeding regimen is appropriate immediately after palatoplasty.

  16. The philtrum in cleft lip: review of anatomy and techniques for construction.

    Science.gov (United States)

    Rogers, Carolyn R; Meara, John G; Mulliken, John B

    2014-01-01

    The philtrum is imperfectly formed in both unilateral and bilateral cleft lip. Surgical construction of this exquisite feature in the upper lip is challenging and often takes a back seat to construction of Cupid's bow and the nose. However, the philtrum is one of the defining features of a normal lip. The purpose of this review is to compile information on philtral anatomy and techniques for construction to guide the reader on his or her own quest to optimize cleft lip repair. In this article, we review the normal anatomy of the philtral dimple and ridges, with particular attention to pars peripheralis configuration. We also review methods for philtral construction during primary labial repair and secondary labial revision. For unilateral cleft lip, eversion of orbicularis oris muscle is necessary to build a philtral ridge. For bilateral cleft lip, emphasis is on proper design of the philtral flap and efforts to simulate a dimple and ridges. For secondary philtral correction, techniques include complete labial revision with various types of muscular re-repair and autologous philtral ridge augmentation. Objective methods are needed to document the efficacy of the many techniques for philtral construction and reconstruction.

  17. Open versus laparoscopic unilateral inguinal hernia repairs: defining the ideal BMI to reduce complications.

    Science.gov (United States)

    Willoughby, Ashley D; Lim, Robert B; Lustik, Michael B

    2017-01-01

    Open inguinal hernia repair is felt to be a less expensive operation than a laparoscopic one. Performing open repair on patients with an obese body mass index (BMI) results in longer operative times, longer hospital stay, and complications that will potentially impose higher cost to the facility and patient. This study aims to define the ideal BMI at which a laparoscopic inguinal hernia repair will be advantageous over open inguinal hernia repair. The NSQIP database was analyzed for (n = 64,501) complications, mortality, and operating time for open and laparoscopic inguinal hernia repairs during the time period from 2005 to 2012. Bilateral and recurrent hernias were excluded. Chi-square tests and Fisher's exact tests were used to assess associations between type of surgery and categorical variables including demographics, risk factors, and 30-day outcomes. Multivariable regression analyses were performed to determine whether odds ratios differed by level of BMI. The HCUP database was used for determining difference in cost and length of stay between open and laparoscopic procedures. There were 17,919 laparoscopic repairs and 46,582 open repairs in the study period. The overall morbidity (across all BMI categories) is statistically greater in the open repair group when compared to the laparoscopic group (p = 0.03). Postoperative complications (including wound disruption, failure to wean from the ventilator, and UTI) were greater in the open repair group across all BMI categories. Deep incisional surgical site infections (SSI) were more common in the overweight open repair group (p = 0.026). The return to the operating room across all BMI categories was statistically significant for the open repair group (n = 269) compared to the laparoscopic repair group (n = 70) with p = 0.003. There was no difference in the return to operating room between the BMI categories. The odds ratio (OR) was found to be statistically significant when comparing the obese

  18. 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

  19. THE CORRELATION BETWEEN DERIVED NASALANCE MEASURES AND PERCEIVED NASALITY IN CHILDREN WITH REPAIRED CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Attuluri Navya

    2014-04-01

    Full Text Available Context: Velopharyngeal dysfunction (VPD is one of the associated condition reported in individuals with repaired cleft lip and palate (RCLP leading to hypernasality. Nasality can be assessed by nasometer through nasalance values. But, mean nasalance values (N found to be overlapping between individuals with RCLP and normals. To overcome these limitations Nasalance Distance (ND and Nasalance Ratio (NR are derived based on nasalance range. Aims: The study is aimed to evaluate, correlate and compare acoustical (N, ND & NR and perceptual measures of nasality between the children with RCLP and control group. Settings and Design: Institutional setup and standard group comparison design Methods and Material: The study included fifteen children with RCLP ranging from 6 to 11 years and the control group consists of age and gender matched 15 typically developing children. Four point standard rating scale was used to rate the hypernasality by three speech language pathologists (SLP’s and Nasometer was used to measure the mean and derived nasalance scores for vowels and sentences in Kannada. Statistical analysis: SPSS, Cronbach’s Alpha test, multivariate analysis and Pearson’s product movement correlation were used to analyze the data. Results: Significant increase in the mean nasalance value and NR was seen in children with RCLP than the control group, whereas ND was contrary. ND was highly correlated with perceived nasality than N. The NR of sentences shows high negative correlation. Conclusions: The measures based on range of nasalance can be adapted to the routine clinical examinations for better correlation with perceived nasality.

  20. 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

  1. 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

  2. The comparative evaluation of safety and efficacy of unilateral paravertebral block with conventional spinal anaesthesia for inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Sinha

    2016-01-01

    Full Text Available Background and Aims: Unilateral paravertebral block (PVB as a sole anaesthetic technique is underutilised even in experienced hands. Hence, this study was undertaken regarding the efficacy and safety of PVB and compared with subarachnoid block (SAB for inguinal hernia repair procedures. Methods: Sixty-three consenting adult male patients scheduled for unilateral inguinal hernia repair were randomly assigned to receive either PVB or SAB (Group P: PVBs at T10–L2 levels, 5 mL of 0.5% bupivacaine at each segment; Group S: SAB at L3–L4 level with 12.5 mg 0.5% of hyperbaric bupivacaine. Primary objective was to compare duration of post-operative analgesia and time to reach discharge criteria (modified Aldrete scores and modified post-anaesthetic discharge scoring [PADS] scores. Secondary objectives were to compare the block characteristics (time required for performing the block, time to surgical anaesthesia, time to ambulation, time to the first analgesic, total rescue analgesic consumption and adverse effects. Independent Student's t-test was used for continuous data and Pearson Chi-square test for categorical data. P<0.05 was considered as statistically significant. Results: The duration of post-operative analgesia (min was 384.57 ± 38.67 in Group P and 194.27 ± 20.30 in Group S (P < 0.05. Modified PADS scores were significantly higher at 4 h and 6 h (P < 0.0001 in Group P. Time to reach the discharge criteria was early in Group P than Group S. Conclusion: PVB provides excellent post-operative analgesic conditions with lesser adverse effects and shorter time to reach the discharge criteria compared to SAB.

  3. The comparative evaluation of safety and efficacy of unilateral paravertebral block with conventional spinal anaesthesia for inguinal hernia repair

    Science.gov (United States)

    Sinha, Sunil Kumar; Brahmchari, Yudhyavir; Kaur, Manpreet; Jain, Aruna

    2016-01-01

    Background and Aims: Unilateral paravertebral block (PVB) as a sole anaesthetic technique is underutilised even in experienced hands. Hence, this study was undertaken regarding the efficacy and safety of PVB and compared with subarachnoid block (SAB) for inguinal hernia repair procedures. Methods: Sixty-three consenting adult male patients scheduled for unilateral inguinal hernia repair were randomly assigned to receive either PVB or SAB (Group P: PVBs at T10–L2 levels, 5 mL of 0.5% bupivacaine at each segment; Group S: SAB at L3–L4 level with 12.5 mg 0.5% of hyperbaric bupivacaine). Primary objective was to compare duration of post-operative analgesia and time to reach discharge criteria (modified Aldrete scores and modified post-anaesthetic discharge scoring [PADS] scores). Secondary objectives were to compare the block characteristics (time required for performing the block, time to surgical anaesthesia, time to ambulation, time to the first analgesic, total rescue analgesic consumption) and adverse effects. Independent Student's t-test was used for continuous data and Pearson Chi-square test for categorical data. P <0.05 was considered as statistically significant. Results: The duration of post-operative analgesia (min) was 384.57 ± 38.67 in Group P and 194.27 ± 20.30 in Group S (P < 0.05). Modified PADS scores were significantly higher at 4 h and 6 h (P < 0.0001) in Group P. Time to reach the discharge criteria was early in Group P than Group S. Conclusion: PVB provides excellent post-operative analgesic conditions with lesser adverse effects and shorter time to reach the discharge criteria compared to SAB. PMID:27512167

  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. Comparison of Intercanine and Intermolar Width Between Cleft Lip Palate and Normal Class I Occlusion Group.

    Science.gov (United States)

    Wahaj, Aiyesha; Ahmed, Imtiaz

    2015-11-01

    To determine the mean difference of arch dimensions (both intercanine and intermolar width) between cleft lip palate and normal class I occlusion group. Cross-sectional analytic study. Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, [Dow University of Health Sciences (DUHS)], Karachi, from March 2012 to April 2013. Group 1 consisted of 32 subjects with complete repaired, non-syndromic unilateral and bilateral cleft lip palate. Group 2 consisted of 32 subjects with normal facial morphology and class I occlusion. Exclusion criteria were cleft lip palate subjects with systemic diseases, any arch expansion procedure, incomplete repaired palate, open fistulas, developmental or acquired craniofacial muscular deformities, autoimmune conditions, syndromes, endocrine abnormalities, neurological problems, or previous history of orthodontic treatment and signs and symptoms of temporomandibular disorders, history of trauma, impacted or missing teeth, periodontally involved teeth, subdivision molar classification, skeletal base II and III with molar class I. The transverse width (intercanine and intermolar width) of dental casts was measured with the help of digital caliper. The intercanine width was measured between cusp tips of the canine while the intermolar width distance was measured between mesiobuccal cusp tips of first molars, and buccal grooves of the mandibular first molars in both cleft lip palate and normal class I occlusion group, respectively. There were 64 subjects with mean 14.7 ±6.8 years in the cleft palate and 14.7 ±6.3 years in the normal group. There was statistically significant differences found between intercanine and intermolar width in maxillary arch (p < 0.001). In mandibular arch, only intercanine width has showed significant difference (p < 0.001) between cleft and normal occlusion class I group. Maxillary and mandibular intercanine width was found to be significantly reduced in cleft lip palate group (both unilateral and bilateral) as

  6. 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.

  7. 牵引成骨在齿槽嵴裂修复中的应用%Application of Distraction Osteogenesis in the Repair of Alveolar Cleft

    Institute of Scientific and Technical Information of China (English)

    郑益略(综述); 尹宁北(审校)

    2016-01-01

    自体髂骨移植是齿槽嵴裂二期植骨修复中最常用的方法,但是对于牙槽突裂隙较大,瘢痕牵拉严重,骨段塌陷,以及缺乏健康黏骨膜以覆盖植骨组织的患者,该方法成功率较低。采用牵引成骨的方法可有效关闭牙槽裂隙,我们就牵引成骨在齿槽嵴裂修复中的应用进行综述。%[Summary] Secondary autogenous cancellous bone grafting is a widely used method for the treatment of alveolar clefts. However, failure of iliac bone grafting sometimes occurs due to inadequate covering with the surrounding soft tissue and marked scar formation, inappropriate patient age, or large clefts. For these patients, distraction osteogenesis is a useful method. In this paper, the application of distraction osteogenesis in the repair of alveolar cleft was reviewed.

  8. The Management of Iatrogenic Obstructive Sleep Apnoea Syndrome Following Bimaxillary Surgery in a Patient with Cleft Lip and Palate.

    Science.gov (United States)

    Gerbino, Giovanni; Gervasio, Fernando Carmine; Blythe, John; Bianchi, Francesca Antonella

    2016-07-01

    A 26-year-old man presented with a 6-year history of severe obstructive sleep apnoea syndrome followed a bimaxillary osteotomy procedure for a class III skeletal pattern. The patient was born with a unilateral cleft lip and palate and underwent primary lip and palate repair and later a pharyngeal flap for severe velopharyngeal insufficiency. Surgical management of obstructive sleep apnoea syndrome with conventional osteotomy, in cleft lip and palate patients, is a difficult problem. Distraction osteogenesis may provide a safer alternative. The authors describe and discuss the indications and the technical challenge of a multistage treatment protocol with distraction osteogenesis.

  9. 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)

  10. Comparison of the Effects of Laparoscopic and Open Repair Techniques on Postoperative Pain and Analgesic Consumption in Pediatric Unilateral Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Ferda Yılmaz İnal

    2014-06-01

    Full Text Available Aim: Although laparoscopic inguinal hernia (IH repair in adults is widely accepted, its advantages in pediatric age group are questionable. We aimed to compare the effects of open inguinal hernia repair and laparoscopic inguinal hernia repair on length of anaesthesia, postoperative pain and analgesic consumption in boys who underwent unilateral inguinal hernia repair. Methods: Forty patients aged between 7 and 14 years who underwent open and laparoscopic inguinal hernia repair were included in this study. The patients were randomly divided into two groups: unilateral open inguinal hernia repair group (OR n=20 and unilateral laparoscopic inguinal hernia repair group (LR n=20. All patients underwent general anesthesia. The duration of anaesthesia and the duration of surgery were recorded. The Patient Controlled Analgesia (PCA device was set at a 0.01 mg/kg bolus dose, 10 minutes lockout interval and 4 hour limit of 4 mg morphine. The patients, who received morphine PCA for 24 hours postoperatively, were monitored with continuous oximetry. The Visual Analogue Scale (VAS was used to measure pain (0 cm: no pain, 10 cm: worst possible pain. We recorded the side effects of morphine, such as respiratory depression, nausea, vomiting, urinary retention, pruritus. SpO2 level and Ramsay Sedation Scale (RSS, Numerical Rating Scale (NRS, and Visual Analogue Scale (VAS scores at intervals 1, 2, 4, 12, 24 hours as well as amount of analgesics consumed and number of requests within 24 hours postoperatively were recorded. Time to first walking was recorded. Results: In group OR, the mean duration of anaesthesia and surgery were 39.85 minutes and 28.85 minutes, respectively. In group LR, the mean duration of anaesthesia and surgery were 26.11 and 20.53 minutes, respectively. VAS scores and time to first walking were similar in both groups. There was no significant difference in amount of analgesics consumed and number of request between the two groups. In group OR

  11. Rconstruction of the Tension Balanced for Secondary Unilateral Cleft Lip Inferior Nasal Deformities.%单侧唇裂继发鼻下端畸形张力平衡的重建

    Institute of Scientific and Technical Information of China (English)

    胡黎萍; 胡勤刚; 唐恩溢; 卢明星; 杨家平

    2011-01-01

    目的:探讨单侧唇裂继发鼻下端畸形两侧张力平衡重建的手术方法及临床意义.方法:通过健侧降鼻中隔肌的处理及"C"形鼻中隔的纠正,重建鼻小柱两侧的肌张力及软骨弹性张力平衡;将鼻翼软骨外侧脚充分游离,解除鼻翼软骨周边组织的病理影响;用三点缝合二点高位悬吊法重塑外鼻下端软骨支架结构;最后施鼻翼外侧脚软组织的移位.结果:32例患者鼻下端形态恢复满意、持久.结论:用重建鼻下端两侧组织张力平衡的手术方法整复单侧唇裂继发鼻下端畸形,可获得可靠的治疗效果.%Objective: To reconstruct the tension balanced for secondary unilateral cleft lip inferior nasal deformities with a new procedure. Methods: Firstly, we remodeled the musculus depressor septi nasi (MDSN) and Cshaped nasal septum to reconstruct the muscular and cartilaginous tension equilibrium in the columella region. Secondly we dissociated lateral cartilages to eliminate the adverse effect from the surrounding structures. Thirdly the cartilage framework of the inferior of nose was reconstructed after freeing the lateral crus. Finally, the soft tissue of lateral crura was dislocated. Results: 32 patients were satisfied with the stable correction of the inferior nasal deformities. Conclusion: The method is useful to correct the secondary unilateral cleft lip inferior nasal deformities.

  12. 基于3dsmax唇裂修复多媒体平台的建立%Construction of cleft lips repairing multi-media platform based on 3dsmax

    Institute of Scientific and Technical Information of China (English)

    江静; 祁文军; 阿地力·莫明

    2011-01-01

    目的:收集并建立唇裂及唇裂修复手术三维可视化模型数据库,衍生相应的唇裂患儿模型,对模型进行虚拟修复操作,实现部分唇裂手术仿真.方法:利用三维动画软件(3D Studio MAX或3dsmax)建立相应的唇裂患儿模型,在模型的基础上建立唇裂的各种分类以实现唇裂修复过程中的的定点、划线、切开和缝合操作.结果:采用3dsmax软件仿真了唇裂修复的整个过程.结论:虚拟唇裂修复操作表明本文研究方法的可行性,为颌面外科手术提供了一种有效的三维仿真可视化平台.%Objective To collect and establish 3d visualization model database of cleft lips and cleft lips repair surgery,derivative corresponding harelip children model,have virtual repair operations on model,implement partially cleft palate surgery simulation.Methods This article established corresponding harelip children model using 3d animation software (3D Studio MAX or 3dsmax) and it established various classification of cleft lip on the basis of model to achieve noding,lineation,cuting and suture operation.Results It simulated the entire process of the cleft palate repair by using 3dsmax software.Conclusion Virtual cleft palate repairing operation shows the feasibility of the method, and provide an efficient 3d visualization simulation platform for maxillofacial surgery.

  13. 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。

  14. 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.

  15. 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...... 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...

  16. Clinical and Demographic Profile of Cases Requiring Ear Lobe Repair in North Gujarat

    Directory of Open Access Journals (Sweden)

    Ajeet K. Khilani

    2013-04-01

    Full Text Available Introduction: Wearing various types of earrings is not only an age old custom but a fashion symbol also. This demographic and clinical profile study was done on ear lobe cleft cases attending ENT OPD of a tertiary care center of North Gujarat. Methodology: The size, number of ears involved, factors leading to ear lobe cleft such as weight of earring, duration of wearing heavy rings, pull leading to tear were noted in all cases. Surgical repair was done by scar excision and suturing. The procedure was completed in 15-20 minutes and minimal post surgical complications in the form of depressed linear scar and lower border notching are seen in 2 cases. Results: Prevalence of ear lobe cleft was 2.4% of all OPD cases. 192 cases (328 ears included 187 (97.3% females and 5 males. Both ears were involved in 136 (70.8% cases while 56 cases had unilateral involvement. A partial cleft of 6 to 10 mm size (range from 3-25 mm was most common reason in females to visit for repair and total cleft was observed in 122 (37.1% ears. 42% females (age 15-45 years had bilateral clefts whereas unilateral involvement was common at young age (1-15 years. Factors leading to cleft formation were earrings weight and prolonged use (44.4% tears were due to weight 15 grams or more. Conclusion: Ear lobe cleft can be repaired by simple surgical approximation. Prevention of recurrence can be done by simple advice of avoiding the scar site for re-piercing and use of light weight earrings. [Natl J Med Res 2013; 3(2.000: 140-142

  17. 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.

  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

    2016-04-01

    The study was conducted to examine the patients with abnormalities of cleft lip and/or palate and its association with different types of malocclusion. 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 clefts patients as cleft lip (81), CP (31), and both cleft lip and palate (53). The occurrence of unilateral cleft lip (44) was maximum among the sample followed by UCLP (39), and bilateral cleft lip (31). Maximum subjects with Class II (10.7%) and Class III (4.9%) malocclusion were seen with unilateral cleft lip deformities. None of the patients with UCLP had Class III malocclusion. 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.

  19. One-staged correction of lip and nose deformities in complete unilateral cleft lip%完全性单侧唇裂鼻唇畸形的同期修复

    Institute of Scientific and Technical Information of China (English)

    王玉新; 郭家妍

    2011-01-01

    Objective To investigate the influence of timing, operative method and perioperative sequence treatment on the therapeutic effect of one-staged correction of lip and nose deformities in complete unilateral cleft lip. Methods Seventy-six patients with unilateral complete cleft lip, aged from 3 to 12 months, underwent one-staged correction of lip and nose deformities, based on the Salyer, Noordhoof method. Sequence treatment was performed before and after operation. Results The patients were followed up for 3 months to 20 years with excellent results in 39 cases ( 51. 3% ) , good in 33 patients (43. 4% ) , unsatisfied in 4 patients( 5. 3% ). Conclusions Good results can be achieved when the onestaged correction of lip and nose deformities, combined with perioperative sequence treatment, is performed. The operative technique of plastic surgeon or maxillofacial surgeon is also important for less morbidity and scar.%目的 探讨完全性单侧唇裂鼻唇畸形同期修复的时机、手术方法及围手术期的序列治疗对手术效果的影响.方法 收集完全性单侧唇裂病例76例,手术年龄为3~12个月.手术方法采用鼻唇畸形同期修复方法,参考Salyer及Noordhoof法的手术原则,并根据具体情况灵活设计,配合术前、术后的序列治疗.结果 完全性单侧唇裂鼻唇畸形同期修复术后随访时间为3个月至20年.总体鼻唇形态恢复满意.其中,优秀39例(51.3%),满意33例(43.4%),不满意4例(5.3%).结论 早期鼻唇畸形同期修复,配合围手术期的序列治疗,以及整形外科或颌面外科医师纯熟的手术技巧,尽最大可能减少损伤和瘢痕,会达到理想的修复效果.

  20. Repair of complete bilateral cleft lip with severely protruding premaxilla performing a premaxillary setback and vomerine ostectomy in one stage surgery

    Science.gov (United States)

    Sanchez-Sanchez, Marta; Iglesias-Martin, Fernando; Garcia-Perla-Garcia, Alberto; Belmonte-Caro, Rodolfo; Gonzalez-Perez, Luis-Miguel

    2015-01-01

    a single-stage surgery, a good primary lip repair at our center. Further confirmations of this surgery with follow up and anthropometric studies of these patients during childhood and adolescence are required. Key words: Protruding premaxilla, bilateral cleft lip, vomerine ostectomy, one stage surgery, Millard II technique. PMID:26034932

  1. Successful management of severe unilateral re-expansion pulmonary edema after mitral valve repair with mini-thoracotomy using extracorporeal membrane oxygenation.

    Science.gov (United States)

    Kitahara, Hiroto; Okamoto, Kazuma; Kudo, Mikihiko; Yoshitake, Akihiro; Hayashi, Kanako; Inaba, Yu; Ai, Kimiaki; Suzuki, Takeshi; Morisaki, Hiroshi; Shimizu, Hideyuki

    2017-03-01

    A 60-year-old man received mitral valve repair via right mini-thoracotomy, which was followed by unilateral re-expansion pulmonary edema on the right side and severe hemoptysis just after the surgery. Despite differential lung ventilation with unilateral high positive end expiratory pressure was initiated for the affected right lung, respiratory function did not improved and hemodynamics was collapsed in the next day. Veno-venous extracorporeal membrane oxygenation was initiated by cannulation of the right jugular and the left femoral vein. After pulmonary function recovered gradually, veno-venous extracorporeal membrane oxygenation was terminated on the fifth postoperative day. He was discharged in ambulatory condition on postoperative day 52.

  2. Number of Surgical Procedures for Patients With Cleft lip and Palate From Birth to 21 Years Old at a Single Children's Hospital.

    Science.gov (United States)

    McIntyre, Joyce K; Sethi, Harleen; Schönbrunner, Anna; Proudfoot, James; Jones, Marilyn; Gosman, Amanda

    2016-05-01

    Pediatric patients with cleft lip and palate undergo numerous surgeries throughout their childhood and early adulthood to correct the aesthetic and functional stigmata of their diagnoses. This study identifies patient and clinical factors that contribute to the number of surgeries and anesthesia events children undergo for their cleft repair. Retrospective chart review was performed using the genetic and dysmorphology database at Rady Children's Hospital San Diego. All patients with cleft lip or cleft palate diagnosis who underwent surgery at Rady Children's Hospital San Diego between 1988 and 2014 were included. A sample size of 71 patients was analyzed. Poisson regression was used to determine if there is a relationship between each variable of interest and the number of procedures. For our sample of 71 patients, the average number of surgical procedures was 8.6 (SD, 4.4). The average number of anesthesia events was 6.7 (SD, 3.3). Across and within diagnosis, race and sex were not statistically significant factors in patients' number of surgeries. Patients with bilateral cleft lip and palate (BCLP) and unilateral cleft lip and palate had, on average, 10 and 9.4 procedures, respectively. This is in contrast to patients with unilateral cleft lip and isolated cleft palate who had, on average, 5.3 and 5.9 procedures, respectively. This difference was significant (P value = 0.01). Patients were also compared based on continuity of care. Patients who had their cleft surgeries by multiple plastic surgeons affiliated with our children's hospital had significantly more surgeries (P = 0.01). A surgical outlier subset of 17 patients (24%) was identified who had more than 10 surgeries. These patients also had, on average, 11.3 (unilateral cleft lip and palate) and 11.8 (bilateral cleft lip and palate) anesthesia events; this is in contrast to the nonoutliers who had, on average, 4.1 to 8 anesthesia events. This retrospective review identifies patient and clinical factors

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Hui-Ling Chia

    2014-01-01

    Full Text Available 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.

  5. Repair of alveolar cleft defect with mesenchymal stem cells and platelet derived growth factors: a preliminary report.

    Science.gov (United States)

    Behnia, Hossein; Khojasteh, Arash; Soleimani, Masoud; Tehranchi, Azita; Atashi, Amir

    2012-01-01

    The purpose of this study was to evaluate the enhancing effect of recombinant platelet derived growth factor on human mesenchymal stem cells (hMSCs) in secondary alveoloplasty. Three patients with 4 alveolar defects were selected for this study. Mesenchymal stem cells were cultured from a posterior iliac bone aspirate. MSCs were mounted on biphasic scaffolds and combined with platelet derived growth factor (PDGF) in the operating room to make a triad of the scaffold, growth factor, and cells. The triads were placed in anterior maxillary cleft defects and closed with lateral advancement gingival flaps. The postoperative cleft bone volume was measured with cone beam computed tomography scans. A mean of 51.3% fill of the bone defect was calculated 3 months post-operation. Our data suggests the use of recombinant platelet derived growth factor with hMSCs may enhance the regeneration capacity of the cells. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

    OpenAIRE

    Simona Stoicescu; Dm Enescu

    2013-01-01

    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 closu...

  8. Bite force evaluation in subjects with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Carla Renata Sipert

    2009-04-01

    Full Text Available The purpose of this study was to evaluate the masticatory function of subjects with cleft lip and palate by analyzing the bite force developed by these individuals. Bite force was evaluated in a group of 27 individuals with repaired unilateral cleft lip and palate (14 males and 13 females - aged 18-26 years and compared to the data achieved from a group of 20 noncleft subjects (10 males and 10 females - aged 18-26 years. Measurement was achieved on three positions within the dental arch (incisors, right molars and left molars, three times at each position considering the highest value for each one. Statistical analysis was performed by ANOVA and Mann-Whitney test ( α = 5%. There was a significant deficit in bite force in male individuals with cleft lip and palate compared to the male control group (p=0.02, p=0.004, p=0.003 for incisors, right and left molars, respectively. For the female group, the difference was not statistically significant (p=0.79, p=0.06, p=0.47. In the group of individuals with clefts, 92.6% were under orthodontic treatment, which could be a reason for the present findings, since it can decrease the bite force more remarkably in males than in females. In conclusion, the bite force is significantly reduced in men when comparing the cleft group to the noncleft group. In females, this reduction was not significant in the same way. However, the main reason for this reduction and for the different behavior between genders should be further investigated.

  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. 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.

  11. Cleft lip and palate: successful management trends

    OpenAIRE

    Bedon Rodriguez, Monica; universidad de manizales; Villota Gonzales, Luis Gerardo; Univerdidad de Manizales

    2011-01-01

    Cleft and palate is one of the most common congenital malformations, represents 2 - 3 % of these and is considered the most common craniofacial anomaly. Surgical repairof a patient with a cleft lip is not an emergency. Primary repair of cleft lip is done about 3 months old, consisting of a series of elective surgeries that are performed individualizingeach case as required by the patient. The aim of this review is to address the innovative treatment alternatives that are beingused in patients...

  12. Children with repaired bilateral cleft lip/palate: effect of age at premaxillary osteotomy on facial growth.

    Science.gov (United States)

    Padwa, B L; Sonis, A; Bagheri, S; Mulliken, J B

    1999-10-01

    This study compared facial growth in three groups of patients with bilateral complete cleft lip/palate: those who had (1) no premaxillary osteotomy, (2) premaxillary osteotomy before age 8 years, and (3) premaxillary osteotomy after age 8 years. Of 24 children with bilateral complete cleft lip/palate, 7 had early premaxillary osteotomy (mean age, 6.1; range, 3.7 to 7.6 years), 10 had late osteotomy (mean age, 11.2; range, 8.3 to 20.7 years), and 7 did not require premaxillary repositioning and served as controls (mean age, 12.4; range, 6.4 to 17.8 years). Presurgical and postsurgical lateral cephalograms were digitized using the Dentofacial Planner software; most current lateral cephalograms comprised the control group. Forty-one bony and 25 soft-tissue landmarks were digitized, and 8 angles were measured: SNA, (sella-nasion-A point), SNPg (sella-nasion-pogonion), ANB (A point-nasion-B point), NAPg (nasion-A point-pogonion), ST convexity (glabella-subnasale-soft-tissue pogonion), Sn-G vertical (line perpendicular to the horizontal plane dropped from glabella and distance measured from subnasale to this vertical), Cm-Sn-Ls (columella-subnasale-abial superioris), and Sn-Gn-C (subnasale-soft-tissue gnathion-chin point). Statistical difference in mean preoperative and postoperative values were measured with analysis of variance. Tests of significance were adjusted for multiple comparisons using the Bonferroni correction. Mean age at follow-up for early, late, and control groups was 11.8, 14.0, and 12.4 years, respectively. Mean follow-up for early and late groups was 5.7 and 2.8 years. There was a significant preoperative difference among the three groups for mean SNA (p premaxillary positioning had more significant preoperative deformity; however, this group's postoperative profile was not, on average, significantly different from either the late or control groups. Our findings that the early group had more significant change with premaxillary osteotomy than the late

  13. 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.

  14. Multiple phonetically trained-listener comparisons of speech before and after articulatory intervention in two children with repaired submucous cleft palate.

    Science.gov (United States)

    Roxburgh, Zoe; Cleland, Joanne; Scobbie, James M

    2016-01-01

    Cleft Palate (CP) assessments based on phonetic transcription are the "gold standard" therapy outcome measure, despite reliability difficulties. Here we propose a novel perceptual evaluation, applied to ultrasound-visual biofeedback (U-VBF) therapy and therapy using visual articulatory models (VAMs) for two children with repaired submucous CP. Three comparisons were made: post VAM, post U-VBF and overall pre- and post-therapy. Twenty-two phonetically-trained listeners were asked to determine whether pre- or post-therapy recordings sounded "closer to the English target", using their own implicit phonological knowledge (prompted via orthographic representation). Results are compared with segment-oriented percent target consonant correct (PTCC) derived from phonetic transcriptions. Listener judgements and PTCC suggest that both children made improvements using both VAM and U-VBF. Statistical analysis showed listener agreement in each comparison, though agreement was weak. However, perceptual evaluation offers a straightforward method of evaluating the effectiveness of interventions and can be used by phonetically trained or lay listeners.

  15. 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...

  16. 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...

  17. Botulinum toxin to improve results in cleft lip repair: a double-blinded, randomized, vehicle-controlled clinical trial.

    Directory of Open Access Journals (Sweden)

    Chun-Shin Chang

    Full Text Available BACKGROUND: Most patients with facial scarring would value even a slight improvement in scar quality. Botulinum toxin A is widely used to alleviate facial dynamic rhytides but is also believed to improve scar quality by reducing wound tension during healing. The main objective was to assess the effect of Botulinum toxin on scars resultant from standardized upper lip wounds. METHODS: In this double-blinded, randomized, vehicle-controlled, prospective clinical trial, 60 consecutive consenting adults undergoing cleft lip scar revision (CLSR surgery between July 2010 and March 2012 were randomized to receive botulinum toxin A (n = 30 or vehicle (normal saline; n = 30 injections into the subjacent orbicularis oris muscle immediately after wound closure. Scars were independently assessed at 6-months follow-up in blinded fashion using: Vancouver Scar Scale (VSS, Visual Analogue Scale (VAS and photographic plus ultrasound measurements of scar widths. RESULTS: 58 patients completed the trial. All scar assessment modalities revealed statistically significantly better scars in the experimental than the vehicle-control group. CONCLUSION: Quality of surgical upper lip scars, which are oriented perpendicular to the direction of pull of the underlying orbicularis oris muscle, is significantly improved by its temporary paralysis during wound healing. TRIAL REGISTRATION: ClinicalTrials.gov NCT01429402.

  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. 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.

  20. 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...

  1. 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...

  2. 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.

  3. 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…

  4. 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…

  5. Cleft lip: a histochemical and ultrastructural analysis of lip muscles.

    Science.gov (United States)

    Raposio, E; Cella, A; Panarese, P; Renzi, M; Caregnato, P; Barabino, P; Faggioni, M; Gualdi, A; Santi, P L

    1999-10-01

    In order to evaluate the pathogenesis of cleft-lip in relation to both the anatomical and structural anomalies of the mesenchymal tissues, the authors concluded that the presence of structural anomalies in the examined tissues could not explain the malformation, but might be a consequence of it. Delayed muscular development, asymmetrical distribution of the muscular fibres and their anomalous insertion suggest that the anatomical/functional loss clinically detectable in the orbicular muscle could be the result of a perinatal dysmorphological process rather than of a simple mesenchymal hypoplasia. Schendel et al. suggested that a metabolic defect in the mitochondrial function could cause a deficiency in cell migration and proliferation responsible for the malformation in question. To establish whether the pathogenesis of the cleft-lip is associated with an alteration in mitochondrial functionality, eight patients affected by unilateral cleft-lip were subjected to a biopsy of the orbicular muscle during the course of reparative surgery. The results obtained showed: 1) a great variation in the size of muscle fibres; 2) the absence of ragged red fibres; 3) a normal oxidative function in the muscle fibres examined; 4) the absence of typologically significant groupings positive for myofibral ATPases. Furthermore, the morphology of the mitochondria was preserved in all cases and neither inclusions nor morphological or volumetric changes were detected. This preliminary data did not confirm the constant presence of mitochondrial pathology responsible for the malformation in question. In our opinion, the growth deficiency of the maxillary segment could be ascribed to the cicatrization of the surgical repair of the cleft-lip.

  6. Anatomic and functional plasty for unilateral complete deft lip%单侧完全性唇裂解剖功能修复

    Institute of Scientific and Technical Information of China (English)

    赵宇; Carstens Micheal; 陈秋思

    2009-01-01

    Objective To explore methods for one-stage repairing of nose deformity and alveolar cleft, as well as primary unilateral complete cleft lip. Methods The nose deformity and alveolar cleft were repaired by Carstens' surgical methods, rhBMP-2 was used for correction of alveolar cleft. Results From 2004 to 2008, 45 cases of cleft lip were treated in the United States and followed up for 3~5years. In 2007, 10 cases of cleft lip were treated in China and followed up for 1 year. All results were satisfactory. Conclusions Carstens' surgical methods can be applied for early correction of nose deformity and alveolar cleft in patients with complete cleft lip.%目的 研究单侧完全性唇裂修复同期矫正鼻、牙槽嵴裂畸形的方法.方法 运用唇裂胚胎发育理论与Carstens的手术设计方法.唇裂修复同时行鼻翼软骨畸形的矫正,并运用基因重组成骨蛋白(rhBMP-2)修复牙槽嵴裂.结果 2004至2008年在美国完成唇裂手术45例,随访3~5年;2007年至今在国内完成单侧唇裂手术10例,随访1年;均取得满意效果.结论 运用Carstens技术能够早期矫正完全性唇裂鼻畸形与牙槽嵴裂.

  7. Neuromechanical Modulation of the Achilles Tendon During Bilateral Hopping in Patients with Unilateral Achilles Tendon Rupture, Over 1 Year After Surgical Repair.

    Science.gov (United States)

    Oda, Hiroyuki; Sano, Kanae; Kunimasa, Yoko; Komi, Paavo V; Ishikawa, Masaki

    2017-06-01

    Patients who have had an Achilles tendon (AT) rupture repaired are potentially at higher risk for re-rupture than those without previous rupture. Little attention has been given to the neuromechanical modulation of muscle-tendon interaction and muscle activation profiles during human dynamic movements after AT rupture repair. The purpose of this study was to examine muscle-tendon behavior and muscle activation during bilateral hopping. We enrolled nine subjects who had undergone surgical repair of unilateral AT rupture within the past 1-2 years. Subjects performed bilateral hopping while we took ultrasound, kinematic, and electromyogram recordings and measurements. AT behaviors were also recorded. We then compared responses between values obtained from the ruptured AT leg (LEGATR) and non-ruptured AT leg (LEGNOR). During hopping, the AT stretching amplitudes were greater in the LEGATR than in the LEGNOR, although the peak AT force and stiffness were smaller in the LEGATR than in the LEGNOR. The AT negative mechanical work did not show any significant differences between both legs. However, positive works were significantly lower in the LEGATR than in the LEGNOR. Electromyogram patterns in both soleus and tibialis anterior muscles clearly differed after ground contact for the LEGATR and the LEGNOR. These results suggest that the repaired ruptured AT can be compliant and have insufficient Young's modulus, which can influence mechanical responses in muscle activities. The modulation of agonist-antagonist muscle activities corresponding to the different levels of stiffness between the LEGATR and the LEGNOR may not be fully functioning during the pre-activation phase.

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

    Science.gov (United States)

    Niranjane, P. Priyanka; Kamble, R. H.; Diagavane, S. Pallavi; Shrivastav, S. Sunita; Batra, Puneet; Vasudevan, S. D.; Patil, Pushkar

    2014-01-01

    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. PMID:25593413

  9. 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.

  10. Effect of pre-operative rectal diclofenac suppository on post-operative analgesic requirement in cleft palate repair: A randomised clinical trial

    Directory of Open Access Journals (Sweden)

    E S Adarsh

    2012-01-01

    Full Text Available Background: Opioid analgesics used for analgesia are associated with sedation, respiratory depression and post-operative nausea and vomiting. Non-steroidal anti-inflammatory drugs such as diclofenac are a safe and effective alternative with opioid-sparing effect. Objective: To evaluate the effectiveness of pre-operative rectal diclofenac suppository (1 mg/kg in cleft palate repair for post-operative analgesia and reduction in post-operative opioid requirements. Study Design: A randomized clinical trial. Methods: After obtaining approval from the institutional ethical committee, 60 children were allocated by a computer-generated randomisation into two groups of 30 each; group D (Diclofenac group and group C (Conventional group. Children in group D and group C were similar in all aspects except for the fact that group D children received 1 mg/kg diclofenac suppository after induction. Pain was evaluated using modification of the objective pain scale by Hannallah and colleagues for 6 h post-operatively by an anaesthesiology resident or nursing staff who was blinded to the group. If the pain score was more than 3, rescue analgesic I.V. fentanyl 0.5 μgm/kg was administered. The pain scores at different intervals, number of doses and quantity of rescue analgesic required were noted. Results: We observed that pre-operative rectal diclofenac provided effective analgesia in the immediate post-operative period, as evidenced by reduced pain scores and reduced opioid requirement (P=0.00002. There was no evidence of any increased perioperative bleeding in the diclofenac group. Conclusion: Pre-operative rectal diclofenac reduces opioid consumption and provides good post-operative analgesia.

  11. 3D analysis of effects of primary surgeries in cleft lip/palate children during the first two years of life.

    Science.gov (United States)

    Sakoda, Karine Laskos; Jorge, Paula Karine; Carrara, Cleide Felício Carvalho; Machado, Maria Aparecida de Andrade Moreira; Valarelli, Fabrício Pinelli; Pinzan, Arnaldo; Oliveira, Thais Marchini

    2017-06-05

    This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student's ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey's test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. Plip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.

  12. 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...

  13. Comparative Effectiveness of Two Ultrasound-Guided Regional Block Techniques for Surgical Anesthesia in Open Unilateral Inguinal Hernia Repair.

    Science.gov (United States)

    Steffel, Lauren; Kim, T Edward; Howard, Steven K; Ly, Daphne P; Kou, Alex; King, Robert; Mariano, Edward R

    2016-01-01

    Transversus abdominis plane (TAP) and ilioinguinal/iliohypogastric (II/IH) nerve blocks have been described as analgesic adjuncts for inguinal hernia repair, but the efficacy of these techniques in providing intraoperative anesthesia, either individually or together, is not known. We designed this retrospective cohort study to test the hypothesis that combining TAP and II/IH nerve blocks ("double TAP" technique) results in greater accordance between the preoperative anesthetic plan and actual anesthetic technique provided when compared to TAP alone. Based on this study, double TAP may be preferred for patients undergoing open inguinal hernia repair who wish to avoid general anesthesia.

  14. Effect of Self-Made Premaxilla Plate-Nasoalveolar Molding Device for Complete Unilateral Cleft Lip and Palate Complicated by Severe Premaxillary Extroversion%自制前颌托-鼻牙槽嵴塑性矫治器对双侧完全性唇腭裂并前颌突严重前突外翻的影响

    Institute of Scientific and Technical Information of China (English)

    刘淑琴; 胡仁梅; 王从; 李小林; 刘新庆

    2015-01-01

    ABSTRACT:Objective To investigate the clinical efficacy of preoperative orthodontic treatment with self-made premaxilla plate-nasoalveolar molding device for complete bilateral cleft lip and palate complicated by severe premaxillary extroversion in infants.Methods According to parents'decision,40 infants with complete unilateral cleft lip and palate complicated by severe premaxil-lary extroversion were divided into two grouops,with 20 infants in each group.The experimental group received preoperative orthodontic treatment with a self-made premaxilla plate-nasoalveolar molding device.The control group received no treatment.Bilateral nostril width,nostril height, columellar height,nasal floor cleft width,upper lip cleft width,alveolar ridge cleft width,premax-illary protrusion distance,palate cleft width,anterior palatal cleft width and middle palatal cleft width were observed before and after treatment.Results Compared with control group,preopera-tive orthodontic treatment with self-made premaxilla plate-nasoalveolar molding device decreased bilateral nostril width,nasal floor cleft width,upper lip cleft width,alveolar ridge cleft width,pre-maxillary protrusion distance,palate cleft width,anterior palatal cleft width and middle palatal cleft width,and increased nostril height and columellar height(P <0.05).Conclusion The self-made premaxilla plate-nasoalveolar molding device can improve nasal deformity,decrease premax-illary protrusion and nose,lip,alveolar ridge and palate cleft,and reduce operative difficulty in in-fants with complete unilateral cleft lip and palate complicated by severe premaxillary extrover-sion.%目的:探讨自制前颌托-鼻牙槽嵴塑性矫治器行术前正畸治疗婴儿双侧完全性唇腭裂并前颌突严重前突外翻的临床疗效。方法将40例双侧完全性唇腭裂并前颌突严重前突外翻患儿按患儿家长意愿分为试验组和对照组,每组20例。试验组采用自行设计的前颌托-鼻牙槽嵴塑性

  15. Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes.

    Science.gov (United States)

    Justin, Grant A; Brietzke, Scott E

    2017-01-01

      This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes.   The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate.   Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.   A total of 36 cases were identified, with 12 unique cases from 1981 to 2006 meeting the inclusion criteria. Six cases (50%) were decided by a jury and six by settlement. Five cases involved complications related to the specific surgery, and the other seven were associated with any surgery and perioperative care of children and adults. Cleft palate repair (50%) was the most frequently litigated surgery. Postoperative negligent supervision was the most common allegation (42%) and resulted in a payout in each case (mean = $3,126,032). Death (42%) and brain injury (25%) were the most frequent injuries reported. Financial awards were made in nine cases (after adjusting for inflation, mean = $2,470,552, range = $0 to $7,704,585). The awards were significantly larger for brain injury than other outcomes ($4,675,395 versus $1,368,131 after adjusting for inflation, P = .0101).   Malpractice litigation regarding cleft lip and palate surgery is uncommon. However, significant financial awards involving perioperative brain injury have been reported.

  16. 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.

  17. Invisible incision technology in the cleft lip repair of application%隐形切口技术在唇裂唇鼻畸形整复术中的应用

    Institute of Scientific and Technical Information of China (English)

    石冰

    2013-01-01

      在对唇裂鼻唇畸形解剖学认识的基础上,以及在对唇裂整复术中上唇皮肤解剖标志点几何学移动规律研究与应用的过程中,笔者提出了按照“由内至外”的唇鼻畸形矫治原理,开发设计了系列用于初期与鼻唇继发畸形的隐形切口技术,现已用于临床,获得了较好的临床效果。改变了传统鼻唇继发畸形矫治中“由外及内”畸形整复的原则,深化了对唇鼻畸形矫治的认识。%  This paper puts forward the principle of lip and nasal deformity correction according to the“from inside to outside” norm in the cleft lip and nasal deformity, which originates from the deep understanding of cleft lip and nasal anatomy, as well as the study and application process to of anatomical points in regularly geometri-cal movement of lip skin. The development and design of a series of technology to primary and secondary correc-tion of cleft lip and nose with invisible lip incision have been formed achieved, and they have been employed in clinical process, having good clinical effects. The traditional process of cleft lip and nose repair carried out from“the outside to the inside?” was improved now and the understanding of lip and nasal deformity correction has been more thorough.

  18. The repairing application of presurgical nasoalveolar molding used for infants with complete cleft lip and palate%鼻-牙槽塑形矫治器在完全性唇腭裂修复中的应用

    Institute of Scientific and Technical Information of China (English)

    刘颖萍; 张婧; 郭雪松; 梁惠惠; 张丽霞

    2016-01-01

    and 12 infants of unilateral,were treated with PNAM in preoperative orthopedics.The nasal columella length,width of malformed nostril,width of cleft lip and alveolar cleft were measured before and after operation of PNAM.The data were analyzed by SPSS 13.0.Results The width of malformed nostril[bilateral group:(9.01 ±1.04)mm,(8.87 ±1.62)mm;unilateral group:(12.32 ±1.91)mm], width of cleft lip[bilateral group:(9.86 ±3.05)mm,(9.45 ±2.78)mm;unilateral group:(8.76 ±2.7)mm]and alveolar cleft[bilateral group:(4.39 ±2.23)mm,(4.06 ±2.41 )mm;unilateral group:(6.49 ±1.15)mm]were remarkably decreased,and nasal columella length[bilateral group:(3.36 ±1.98)mm;unilateral group:(5.06 ± 2.03)mm]was extended after PNAM treatment compared with those before treatment[bilateral group:(12.43 ± 2.02)mm,(11.91 ±1.55)mm,(12.95 ±2.39)mm,(12.31 ±1.92)mm,(8.45 ±2.67)mm,(8.05 ±2.48)mm, (1.03 ±0.51)mm;unilateral group:(16.89 ±2.36)mm,(13.85 ±2.52)mm,(9.23 ±2.37)mm,(1.78 ±0.61)mm],in addition,changes of data were statistically significant(t value bilateral group:9.286,8.847,6.659,5.672,8.596, 6.121,6.896;unilateral group:10.537,11.497,10.001,9.391;all P <0.05).Conclusion The primary deformity of cleft lip and palate and nasal profile of complete cleft lip and palate infants could be improved by PNAMtreatment, which is favorable for first stage surgery of complete cleft lip and palate;improving functions of sucking,respiratory and language and relieving anxiety of parents who would be full of confidence in treatment.Furthermore,all these advantages will perfect the clinical effect of restoration.

  19. 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 ...

  20. Laryngotracheoesophageal clefts.

    Science.gov (United States)

    Strychowsky, Julie E; Rahbar, Reza

    2016-06-01

    Laryngotracheoesophageal clefts are rare congenital anomalies of the aerodigestive tract. Patients may present with airway and/or swallowing impairments. An approach to evaluation and management is presented. Important pearls for conservative and surgical management are discussed. Open versus endoscopic surgical techniques are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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.

  3. The Epidemiology of Cleft Lip and Palate in Canada, 1998 to 2007.

    Science.gov (United States)

    Matthews, Jennifer L K; Oddone-Paolucci, Elizabeth; Harrop, Robertston A

    2015-07-01

    To examine the birth prevalence, gender distribution, and pattern of surgical intervention for clefts in Canada (1998 to 2007). Also to highlight the difficulties associated with studying the epidemiology of clefts using the current data collection mechanisms. Epidemiologic data acquired from the Canadian Institute for Health Information. Population-based study in Canada 1998 to 2007. All live births with an International Classification of Diseases (9th or 10th revision) diagnostic code for cleft palate or for cleft lip with or without cleft palate or with a surgical intervention code for repair of cleft lip or cleft palate. Birth prevalence, gender distribution, and pattern of surgical intervention. There were 3,015,325 live births in Canada (1998 to 2007). The mean birth prevalence was 0.82 per 1000 live births for cleft lip with or without cleft palate and 0.58 per 1000 live births for cleft palate. The birth prevalence of cleft lip with or without cleft palate was significantly higher in boys, with a stable boy to girl ratio of 1.75:1. Cleft palate was significantly greater in girls; however, the boy to girl ratio decreased from 0.97:1 in 1998 to 0.59:1 in 2007. The median age of repair in Canada from 1998 to 2007 was 4.7 months for cleft lip and 11.6 months for cleft palate. Thirty percent of patients underwent cleft palate repair after age 1. The birth prevalence of cleft palate and cleft lip with or without cleft palate is stable in Canada. An increasing birth prevalence of cleft palate in girls is suggested. The timing of surgical intervention is consistent with current standards. The challenges associated with collecting these data in Canada are discussed.

  4. 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.

  5. 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.

  6. 双侧唇红矩形瓣前唇原长双侧唇裂修复术%Repair of the deformity of bilateral cleft lip with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion

    Institute of Scientific and Technical Information of China (English)

    贾志宇; 赵云转; 王维丽; 蒋崇槟; 屈鹏飞; 张英怀

    2009-01-01

    目的 介绍双侧唇红矩形瓣前唇原长双侧唇裂修复术的应用.方法 双侧唇裂患者29例,男性20例,女性9例.其中双侧完全裂15例,不完全裂11例,混合裂3例,均采用双侧唇红矩形瓣前唇原长法进行修复.首先采用传统的原长法原则修复唇白.修复唇红时,在两侧唇红设计形成包括黏膜和部分口轮匝肌的矩形瓣,并沿干湿唇交界线水平切开前唇,将两侧矩形瓣向下内旋转至前唇唇红对接缝合.缝合时口轮匝肌肌束的断端尽可能广阔而平整的接合,以恢复正常的环形结构.结果 所有患者的创口均Ⅰ期愈合,上唇高度宽度适中,唇珠明显,无口哨畸形.结论 该方法修复双侧唇裂,方法简单可靠,去除组织少,术后能获得较好的鼻唇外形,口唇功能较好,值得在临床推广.%Objective To introduce experiences with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion for repairing bilateral cleft lips. Methods 29 patients (20 males and 9 females) with bilateral cleft lips underwent operations of non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion. There were 15 bilateral complete cleft lips, 11 bilateral incomplete cleft lips and 3 bilateral mixed cleft lips. The deformity of white lips was reconstructed with traditional non-elongated cheiloplasty. When repairing the vermilion, the rectangular mucomuscular complex flaps which included mucous membrane of vermilion and part of orbicularis oris in double vermilion were designed, and vermilion of fore lip was incised along boundary of wet lip and dry lip. Then rectangular mucomuscular complex flaps of double vermilion were rotated downward and inward to be sewn with fore lip. At the step, the end of orbicularis otis should be sewn widely and fitly in order to form a normal annular structure. Results The wounds of all the patients were healed at one stage. The height and width of patients' upper

  7. Influence of timing of hard palate repair in a two-stage procedure on early language development in Danish children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2012-01-01

    Objective: to investigate the influence of timing of hard palate closure on early language development from 18 months to 3 years of age. Design: a prospective, randomized clinical trial. Participants: thirty-four children with UCLP with velum closure at 4 months of age, and hard palate closure...... vocalizations, consonants, and consonants permissible in word-initial position than the Early HPR group. In addition, both cleft palate groups had a smaller productive vocabulary than the Control group, but unlike the EarlyHPR group, the LateHPU group produced a smaller number of word tokens in social...... language development in cleft palate children. Key words: cleft palate, phonological development, lexical development, surgical timing....

  8. Osteoinductive calcium phosphate ceramics repair alveolar cleft defects%骨诱导性磷酸钙陶瓷材料修复牙槽突裂

    Institute of Scientific and Technical Information of China (English)

    陈浩东; 姚金凤; 梁志刚

    2016-01-01

    BACKGROUND:In our previous studies, we had prepared calcium phosphate ceramics with better ectopic osteogenesis. OBJECTIVE:To explore the effect of novel osteoinductive calcium phosphate ceramics in the repairing of alveolar cleft. METHODS:Bilaterl alveolar defects were created in nine immature beagles. Three months later, osteoinductive calcium phosphate ceramics with high modular surface (experimental group) and smooth surface (control group) were randomly implanted in each side of the defect. Meanwhile, the corresponding material was implanted into the thigh muscle. New bone formation in the implanted region, osteogenesis in the implanted region and muscle, and respair results were respectively observed by fluorescence microscope, light microscope and CT at 4, 8 and 12 weeks after implantation. RESULTS AND CONCLUSION:(1) Fluorescence microscope observation:A circular permutation of red, yel ow and green fluorescent strip could be observed in both two groups. (2) Light microscope observation:At 12 weeks after implantation, in the experimental group, the bone reconstruction was obvious, the implant material was decomposed gradual y, the gap was fil ed with a large number of mature bone that combined with the rest material closely, and numerous Haversian canals appeared;the control group was similar but slightly inferior to the experimental group in the quality of new bone. The experimental group material successful y induced heterotopic osteogenesis in muscle, while the control did not. (3) CT examination:The two group materials restored the appearance and continuity of the alveolar ridge, and made no effect on the eruption of permanent teeth in both sides of the defect. To conclude, our findings suggest that the novel osteoinductive calcium phosphate ceramic exhibits advantages in alveolar cleft repair with earlier osteogenesis activation, faster osteogenesis rate and more bone formation than those traditional materials.%背景:前期研究制备出异位成

  9. 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 ...

  10. 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

  11. 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.

  12. 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

  13. Evaluation of the clinical effect of presurgical nasoalveolar molding preoperative orthodontic in infants with unilateral complete cleft lip and palate%婴儿单侧完全性唇腭裂使用鼻-牙槽突矫治器术前正畸的效果评价

    Institute of Scientific and Technical Information of China (English)

    刘文莉; 庞雪晶; 张玉萍; 韩秀丽; 兰柳萍

    2016-01-01

    Objective To observe of presurgical nasoalveolar molding (PNAM) in infants with unilateral complete cleft lip and palate surgery treatment for infants with nasal labial ministry and the effect of the alveolar cleft of correction. Methods Choose 56 cases as experimental group with PNAM cleft lip surgery shape treatment, compared the experimental group infants use PNAM process shaping and compare the experimental group and control group before and after the treatment of infants with cleft palate preoperative labial ministry fracture, width of alveolar cleft, alar width, columella deviation, columella height. The data were analyzed with spss15.0 software. Results The experimental group after treatment with PNAM infants lip crack and width of alveolar cleft, alar width decrease obviously, columella highly increased signiifcantly, columella deviation decreases, and significant difference compared with before treatment and the control group, and significantly improve the bilateral symmetry of the nasal. Conclusion Through the PNAM treatment, reduce the lip crack and the width of the alveolar cleft, improve the nasal proifle, create good conditions for the operation, it is worth clinical promotion by treatment of cleft lip and palate sequence.%目的:观察婴儿单侧完全性唇腭裂术前行鼻-牙槽突塑形治疗对患儿鼻唇部和牙槽突部矫治的效果。方法:选用56例患儿做为实验组进行唇裂手术前鼻-牙槽突塑形治疗,比较实验组患儿使用鼻-牙槽突塑形治疗前后及实验组和对照组患儿唇裂术前的唇部裂隙,牙槽突裂隙,鼻翼宽度,鼻小柱倾斜度,鼻小柱高度。采用spss15.0软件包对数据进行统计学分析。结果:实验组患儿经鼻-牙槽突塑形治疗后唇部裂隙及牙槽突裂隙,鼻翼宽度明显减小,鼻小柱高度明显增加,鼻小柱倾斜度减小,与治疗前及对照组相比均具有显著性差异,且明显改善了双侧鼻部

  14. Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Bahrampour, Ehsan; Beladi, Amir Saied; Khojastepour, Leila

    2016-07-21

      The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion.   Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence.   There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups.   Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.

  15. Three-dimensional digital evaluation of dental arches in infants with cleft lip and/or palate.

    Science.gov (United States)

    Fernandes, Viviane Mendes; Jorge, Paula Karine; Carrara, Cleide Felício Carvalho; Gomide, Márcia Ribeiro; Machado, Maria Aparecida Andrade Moreira; Oliveira, Thais Marchini

    2015-01-01

    The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Effects of maxillary protraction in pre-pubertal patients with unilateral cleft lip and palate%前方牵引治疗单侧完全性唇腭裂患者术后前牙反(牙合)畸形的研究

    Institute of Scientific and Technical Information of China (English)

    贾海潮; 李巍然; 林久祥

    2009-01-01

    目的 探讨前方牵引治疗单侧完全性唇腭裂(UCLP)患者术后前牙反(牙合)畸形的效果.方法 进行前瞻性临床研究设计,UCLP术后骨性前牙反骀患者治疗组18例,年龄9.63±1.24岁,观察对照组14例,平均8.71±1.92岁,均处于生长发育高峰前期.使用前方牵引进行治疗,治疗或观察前后拍摄头颅侧位片并测量,进行成组设计和配对设计t检验.结果 UCLP治疗组前方牵引后,上颌骨前移;下颌后移合并后下旋转;上下颌间关系和面型改善明显,上颌与下颌改变的比值为1:1.7.对照组上下颌不调、前牙反覆盖、凹面型加重.结论 UCLP术后轻中度骨性前牙反(牙合)畸形,前方牵引能够促进上颌骨向前,改善上下颌骨关系和软组织面型,应该早期矫形治疗.%Objective To investigate the effects of maxillary protraction on anterior crossbite in repaired pre-pubertal patients with complete unilateral cleft lip and palate(UCLP).Methods Prospective controlled clinical trial was carried out.Eighteen UCLP patients with anterior crossbite,aged 9.63±1.24 years,were the experimental subjects.Fourteen UCLP patients with similar malocclusion,aged 8.71±1.92 years,were selected as controls.All patients were before puberty according to the evaluation of the hand wrist radiograms.A Hyrax appliance and reverse headgear were applied.Lateral cephalometric radiographs were taken before and after the treatment.Computerized cephalometric analysis was carried out.Results After treatment in experimental group.the maxilla moved forward more significantly.The mandible rotated downward and backward.The intermaxillary relationship and soft tissue profile improved significantly.The rate of maxillary and mandibular Contribution was 1:1.7. ConelusionsMaxillary protraction could improve the imermaxillary relationship and soft tissue profile in UCLP patients with mild or moderate skeletal deformity before puberty.

  1. 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

  2. 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.

  3. ImageJ软件在牙槽突裂骨移植术前骨缺损量评估中的应用%Application of ImageJ in preoperation bone defect measuring for alveolar cleft repair surgery

    Institute of Scientific and Technical Information of China (English)

    虎小毅; 屠军波; 蒋菲; 马瑞朝; 侯成群

    2013-01-01

    目的:探讨ImageJ软件在牙槽突裂术前骨缺损量评估中的应用价值.方法:选择单侧牙槽突裂患者31例为研究对象,在术前通过锥形束CT(CBCT)扫描获取患者上颌骨影像数据并导入ImageJ软件,在该软件中测量并获得牙槽突裂隙体积.在术中通过注射器测量植入牙槽突裂隙中的松质骨骨量,从而获取牙槽突裂的真实体积,并与术前测量结果对比分析.结果:术前ImageJ测量的体积为2.46±0.52ml,术中实际测量的体积为2.47±0.48ml,两者差异无统计学意义(P>0.05).结论:ImageJ是一种简单、易用且可靠的软件,可用于牙槽突裂隙术前测量评估.%Objective:To discuss the accuracy of the software ImageJ in preoperation measuring for alveolar cleft repair surgery .Methods :31 patients' image data were collected by CBCT scan and imported in the software ImageJ , the volume of the bone defect in alveolar cleft was calculated by ImageJ .The bone volumes transplanted during operation were measured by sterile syringes and were compared with that of preoperation measuring .Results :The average volume of bone defect measured in preoperation was 2 .46±0 .52ml and that measured in intraoperative was 2 .47±0 .48ml, there was no significant difference between preoperation measuring and intraoperative (P>0 .05 ) .Conclusion :ImageJ is a reliable and easy to use software in preoperation measuring for alveolar cleft repair surgery.

  4. 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 ...

  5. Nasolabial symmetry and esthetics in cleft lip and palate: analysis of 3D facial images.

    Science.gov (United States)

    Desmedt, Dries J; Maal, Thomas J; Kuijpers, Mette A; Bronkhorst, Ewald M; Kuijpers-Jagtman, Anne Marie; Fudalej, Piotr S

    2015-11-01

    To determine the relationship between nasolabial symmetry and esthetics in subjects with orofacial clefts. Eighty-four subjects (mean age 10 years, standard deviation 1.5) with various types of nonsyndromic clefts were included: 11 had unilateral cleft lip (UCL); 30 had unilateral cleft lip and alveolus (UCLA); and 43 had unilateral cleft lip, alveolus, and palate (UCLAP). A 3D stereophotogrammetric image of the face was taken for each subject. Symmetry and esthetics were evaluated on cropped 3D facial images. The degree of asymmetry of the nasolabial area was calculated based on all 3D data points using a surface registration algorithm. Esthetic ratings of various elements of nasal morphology were performed by eight lay raters on a 100 mm visual analog scale. Statistical analysis included ANOVA tests and regression models. Nasolabial asymmetry increased with growing severity of the cleft (p = 0.029). Overall, nasolabial appearance was affected by nasolabial asymmetry; subjects with more nasolabial asymmetry were judged as having a less esthetically pleasing nasolabial area (p treatment outcome in subjects with less severe cleft deformity. In subjects with more severe cleft types, other factors may play a decisive role. Assessment of nasolabial symmetry is a useful measure of treatment success in less severe cleft types.

  6. The histological analyse about repairing cleft palate through osteogenesis by periosteal distraction%腭裂缘骨膜牵张成骨不同阶段的组织学变化分析

    Institute of Scientific and Technical Information of China (English)

    宋庆高; 邓金勇; 陈尚; 黄桂林; 蒋练

    2011-01-01

    目的 对腭裂裂隙缘的骨膜进行牵张,研究新骨形成的过程及规律,初步探讨骨膜牵张成骨方法修复腭裂的机制.方法 选用健康杂种幼犬8只制作腭裂动物模型,采用安置骨膜牵张器的方法对裂隙缘的一侧骨膜进行牵张,牵张力为(2.45±0.20)N.在牵张器放置后20、30、40、60 d各处死动物2只,未放置一侧为对照侧.结果 裂隙缘骨膜受牵张后,新生成骨细胞数量随时间变化而增多,大量沿牵张方向排列的胶原纤维组织在增生的成骨细胞作用下,钙化沉积成新骨,并逐渐改建成熟.结论 新骨形成是沿牵张方向的膜内成骨方式完成的,在骨膜牵张器放置20d后牵张区已有新骨形成,随着牵张时间的延长,成骨量逐渐增加,40d时的成骨活动最活跃,至60d时新骨钙化程度较成熟,以骨改建和塑形为主.%Objective Based on a periosteal distraction to periosteum of cleft palate edge, to observe the structural features of newly formed bone in each phase, study its forming process and rule, and make a preliminary study on the mechanism of repairing cleft palate. Methods Firstly, develop model of cleft palate in 8 healthy hybrid juvenile dogs. Then place Nitinol periosteal distraction device under the periosteum of cleft palate edge and fix it and distract the periosteum with a force of (2.45±0.20) N. The opposite edge belongs to control group.Every 2 dogs were killed after 20, 30, 40, 60 days respectively. Results New bone eventually generated under the periosteum after the periosteal distraction at the edge of cleft. Histological observation indicates the increase of osteoblasts in the new bone and the changes of the directions of the collagenous fiber and bone trabecula. A large amount of collagenous fibers arrayed toward the direction of distraction, under the influence of proliferation of osteoblasts, was calcified and become new bone, which gradually became more mature. Conclusion Newly formed bone is

  7. Speech disorder correction after cleft palate repair with levator veli palatini retropositioning%腭帆提肌重建腭裂修补后的言语障碍矫治

    Institute of Scientific and Technical Information of China (English)

    闫大勇; 张瑞; 董汉华; 苏会芝

    2015-01-01

    BACKGROUND:Cleft palate repair with levator veli palatini retropositioning can achieve good effects on pharyngeal function and voice quality by dissecting the muscle and rebuilding the muscle function only at the incision, without opening the mucoperiosteal flap, OBJECTIVE: To investigate the clinical effects of cleft palate repair with levator veli palatini retropositioning versus traditional surgery treatment on speech disorder correction. METHODS:Totaly 176 children with cleft palate were randomly assigned into treatment group and control group, 88 cases in each group. Patients were subjected to traditional surgery treatment in the control group and levator veli palatini retropositioning in the treatment group. RESULTS AND CONCLUSION:The postoperative speech inteligibility in the treatment group and the control group were 81.8% and 54.5%, respectively, and there was a significant difference between the two groups (P < 0.05). After cleft palate repair, the folowing indicators were al improved in the two groups, including soft palate functional length at static state and when pronouncing, and soft palate elevation angle (P < 0.05), and moreover, these indicators were better in the treatment group than the control group (P < 0.05). Scores on high nasal tone and rhinorrhea tone were decreased significantly in the two groups after repair, and the scores were significantly lower in the treatment group than the control group (P < 0.05). These findings indicate that cleft palate repair with levator veli palatini retropositioning can effectively rebuild soft palate function and perfect velopharyngeal competence in patients, which is of great significance for speech disorder correction and voice quality recovery.%背景:腭帆提肌重建腭裂修补仅从裂隙缘切口处行肌肉的解剖和功能重建,不需要两侧黏骨膜瓣的翻开,能使修补后达到较好的腭咽功能与语音效果。目的:比较腭帆提肌重建腭裂修补后与传统手术

  8. Technique for Preserving Pterygoid Hamuli and Aponeurosis of Palate in Repairing Child's Cleft Palate%保留翼钩及腭腱膜修复小儿腭裂115例总结

    Institute of Scientific and Technical Information of China (English)

    高景恒; 徐振宽; 郑华翔; 王玉明

    1984-01-01

    From July;1969 to May;1982;115 cases of children's cleft palates were treated;58 boys and 57 girls;the 2 youngest being 1.5 years of age.The surgical technic used could be divided into 3 periods:namely;the first period(mainly hypotensive incisi on);the (Second period(synthetical technic)and the third period(technics of preserving pterygoid hamuli and aponeurosis of the palate).The recurrent disruption rate was 9.57%(11:115)among which 9 happened In the first period and 2 in the second.So far as the age for surgical intervention is concerned;it was believed that adequate closure of the cleft;satisfactory restoration of pronunciation;and not to increase the mortality or morbidity must be taken into consideration.Hence;earlier repair is recommendable only under 2 conditions;i.e.the child is well-nourished and the surgeon and anaesthetist are well-experienced.Otherwise;it is better to delay it until the patient is 5 or 6 years old.The principle for the selection of surgical approaches and the importance of preserving pterygoid hamuli and aponeurosis of palate are also discussed.%@@ 理想的腭裂修复不仅应封闭裂隙,而更重要的是创造良好的发音条件.重建正常的腭咽解剖结构是获得优良发音的必要条件.我院自1969年7月到1982年5月共收治小儿腭裂115例.

  9. 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 ...

  10. A cone beam computed tomographic evaluation of the size of the sella turcica in patients with cleft lip and palate.

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Khaleghi, Iman

    2017-07-04

    Changes in the size of the sella turcica are frequently related to pathologies and syndromes. The aim of this was to compare the sella turcica dimensions in patients with unilateral and bilateral cleft lip and palate and non-cleft subjects. Cone beam computed tomography (CBCT) images of three groups consisted of 20 patients with unilateral cleft lip and palate; 20 patients with bilateral cleft lip and palate and a control group consisting of 20 non-cleft subjects were the research population in this pilot study. The sella turcica linear dimensions in terms of length, depth and diameter were measured for all subjects. One-way ANOVA test was used to determine any significant differences among the three groups for the measured parameters. The length, depth and diameter of sella turcica were found to be significantly smaller in the unilateral and bilateral groups compared with the normal age and gender matched group. No significant differences were found in the measured variables between the unilateral and bilateral cleft patients. CBCT images showed a greater likelihood of abnormal sella turcica dimensions in patients with unilateral and bilateral cleft lip and palate. Therefore, the sella turcica dimensions may have an intrinsic relationship to the cleft condition.

  11. 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.

  12. EVALUATION OF MANDIBULAR HARD AND SOFT TISSUES IN CLEFT PATIENTS*

    Directory of Open Access Journals (Sweden)

    Işıl ARAS

    2017-04-01

    Full Text Available Purpose: The aim of this study was to compare the mandibular hard and soft tissue measurements of unilateral and bilateral cleft lip and palate patients with non-cleft individuals. Materials and Methods: The study sample comprised of lateral cephalograms of 45 subjects. Sample included 15 non-cleft (NC, 15 unilateral cleft lip and palate (UCLP and 15 bilateral cleft lip and palate (BCLP cases whose age were between 15 to 17. 1 angular 13 linear measurements were carried out using Arnett and Gunson soft tissue cephalometric analysis and 4 angular measurements were calculated with Steiner Analysis. Results: Mandibular incisor inclinations relative to the occlusal plane (Md1-Md OP were significantly greater and mandibular incisor projections (Md1-TVL were significantly retrusive in cleft subjects (p<0.05. Projection values pertaining to lower lip anterior (LLA-TVL, soft tissue B point (B’-TVL, and soft tissue pogonion (Pog’-TVL were significantly deficient as well in cleft patients (p<0.05. Sagittal position of the maxilla (SNA (p<0.001 and intermaxillary relation of the jaws (ANB were significantly deficient in UCLP subjects (p<0.05 and BCLP individuals (p<0.01. LLA-TVL and B’-TVL correlated with SNB in cleft patients (p<0.05. Conclusion: Decreased lower lip and chin projection values suggest that mandibular region of cleft patients should be taken into account in forming the treatment plan to improve the esthetic outcome of orthodontic and plastic surgery interventions.

  13. Cleft lip and palate review: Epidemiology, risk factors, quality of life, and importance of classifications

    Directory of Open Access Journals (Sweden)

    Laureen Supit

    2008-12-01

    Full Text Available Cleft lip with or without cleft palate is the most occurring craniofacial anomaly in human, resulting from a complex etiology involving multiple genetic and environmental factors. The defect carries lifelong morbidity and economic burden. Children with clefts will require continuous medical interventions for at least the first 18 years of life, affecting many aspects of their lives. The extent and complexity of clefts vary infinitely, later determining individual management and outcome. Identification and classification play significant roles in initial assessment of these unique cleft cases, which affect options for following correctional attempts. Some classifications even allow measurement of progress after anatomical repositioning, and success rate after surgical repairs. The challenge of developing one such widely inclusive classification is discussed. (Med J Indones 2008; 17: 226-39Keywords: Cleft lip, cleft palate, congenital anomaly, cleft  classfications

  14. Two-stage palatoplasty, is it still a valuable treatment protocol for patients with a cleft of lip, alveolus, and palate?

    Science.gov (United States)

    Gundlach, Karsten K H; Bardach, Janusz; Filippow, Daniel; Stahl-de Castrillon, Franka; Lenz, Jan-Hendrik

    2013-01-01

    Speech development is of utmost importance and requires early closure of a palatal cleft. On the other hand, it is well known that all types and timings of surgical repair of facial clefts are detrimental to maxillary growth. Nevertheless, these days one is more and more confronted with a world-wide tendency in favour of the one-in-all operation to close clefts of the lip, alveolus, and palate. Therefore, a three-centre study was performed for testing - once more - the value of two-stage palatoplasty as a means to reduce the detrimental effects of surgery on palatal growth and at the same time to also enable early speech development. Plaster casts from 85 patients have been re-evaluated. All of them had a complete unilateral cleft of lip, alveolus, and palate. They had been treated according to the old therapy protocols followed in either one of the three different cleft centres many years ago, namely in Hamburg, (Western) Germany, Iowa City, IO, USA, and Rostock, (in those days still Eastern) Germany. The impressions had been taken already in 1987 from patients being either 8 years (36 pts.) or 16 years of age (49 pts.). Three different treatment protocols had been followed for these patients in those centres in those days: The main difference was that in centres A and B the palates were closed in two stages whilst in centre C palatoplasty was performed in just one operation. The most interesting results regarding the palatal growth were that: 1. In centre C (one-stage palatoplasty) the patients had more constricted palates. 2. In centre A (two-stage palatoplasty) the patients had least often an anterior cross-bite. It appears that it was possible to show once more that closing the palate in one stage at age 1 year or less is interfering most with maxillary growth. This study leads us to conclude that two-stage palatoplasty is still a valuable treatment protocol for patients with a complete unilateral cleft of lip, alveolus, and palate, especially as apparently

  15. 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.

  16. 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.

  17. Lateral facial cleft associated with accessory mandible having teeth, absent parotid gland and peripheral facial weakness.

    Science.gov (United States)

    Ozçelik, D; Toplu, G; Türkseven, A; Senses, D A; Yiğit, B

    2014-07-01

    Transverse facial cleft is a very rare malformation. The Tessier no. 7 cleft is a lateral facial cleft which emanates from oral cavity and extends towards the tragus, involving both soft tissue and skeletal components. Here, we present a case having transverse facial cleft, accessory mandible having teeth, absent parotid gland and ipsilateral peripheral facial nerve weakness. After surgical repair of the cleft in 2-month of age, improvement of the facial nerve function was detected in 3-year of age. Resection of the accessory mandible was planned in 5-6 years of age.

  18. Early postnatal development of the mandible in children with isolated cleft palate and children with nonsyndromic Robin sequence

    DEFF Research Database (Denmark)

    Eriksen, J.; Hermann, N.V.; Darvann, Tron Andre

    2006-01-01

    Objective: Analysis of early postnatal mandibular size and growth velocity in children with untreated isolated cleft palate (ICP), nonsyndromic Robin sequence (RS), and a control group of children with unilateral incomplete cleft lip (UICL). Material: 114 children (66 isolated cleft palate, 7 Robin...... sequence, 41 unilateral incomplete cleft lip) drawn from a group representing all Danish cleft children born from 1976 through 1981. All children were examined at both 2 and 22 months of age. Methods: Cephalometric x-rays and maxillary plaster casts. Mandibular length and height were measured...... at 2 months of age. Conclusion: The children with isolated cleft palate and Robin sequence had small mandibles shortly after birth, but with a relatively normal growth potential. No true mandibular catch-up growth was found up to 22 months of age in either group. No significant correlation was found...

  19. 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;…

  20. 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.

  1. 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)

  2. 三种腭裂术式的术后腭咽功能评估%Postoperative evaluation of velopharyngeal function by three different cleft repairs

    Institute of Scientific and Technical Information of China (English)

    陈亦阳; 黎凡; 邬文莉; 刘佳玉; 王洪涛

    2013-01-01

    目的 通过对腭裂术后腭咽功能的评估,比较软腭直线缝合、Furlow术式和Sommerlad术式的优、缺点.方法 对248例年龄5个月至11岁的先天性腭裂患者分别采用软腭直线缝合、Furlow术式和Sommerlad术式,并观察、比较腭裂术后并发症、术区瘢痕、腭咽运动、语音等指标.结果 除术后并发症、咽反射水平三组无明显差异外,在术后瘢痕、头颅定位侧位片测量、鼻漏气、语音清晰度等指标的评估结果,Furlow术式和Sommerlad术式均优于软腭直线缝合法.结论 Furlow术式和Sommerlad术式在恢复腭咽闭合功能方面优于软腭直线缝合法.%Objective To compare the advantage and the shortage of straight line,Furlow and Sommerlad repair of soft palate,by postoperative evaluation of velopharyngeal function.Methods 248 patients,from 5 months to 11 years old,were treated in our department by straight line,Furlow and Sommerlad repair of soft palate respectively.Postoperative complications,scars,velopharyngeal movement and articulation of those patients were observed and evaluated.Results There was no significant difference among three groups on postoperative complications and pharyngeal reflection.But Furlow and Sommerlad repair are better than straight line repair of soft palate on evaluation of scars,X-ray velopharyngeal lateral radiographs,nasal leaking and speech intelligibility.Conclusion Furlow and Sommerlad repair are better than that of straight line repair of soft palate to recovery the function of velopharygeal closure.

  3. Protocols in Cleft Lip and Palate Treatment: Systematic Review

    Science.gov (United States)

    de Ladeira, Pedro Ribeiro Soares; Alonso, Nivaldo

    2012-01-01

    Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were made in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were considered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The experimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with bupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate, and alveoloplasty with bone morphogenetic protein-2 (BMP-2). Conclusions. Few randomized controlled trials were found approaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter collaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives an evidence-based clinical practice. PMID:23213503

  4. Protocols in Cleft Lip and Palate Treatment: Systematic Review

    Directory of Open Access Journals (Sweden)

    Pedro Ribeiro Soares de Ladeira

    2012-01-01

    Full Text Available Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs. Method. Searches were made in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were considered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The experimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with bupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate, and alveoloplasty with bone morphogenetic protein-2 (BMP-2. Conclusions. Few randomized controlled trials were found approaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter collaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives an evidence-based clinical practice.

  5. 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

  6. Early postnatal development of the mandible in children with isolated cleft palate and children with nonsyndromic Robin sequence

    DEFF Research Database (Denmark)

    Eriksen, J.; Hermann, N.V.; Darvann, Tron Andre

    2006-01-01

    sequence, 41 unilateral incomplete cleft lip) drawn from a group representing all Danish cleft children born from 1976 through 1981. All children were examined at both 2 and 22 months of age. Methods: Cephalometric x-rays and maxillary plaster casts. Mandibular length and height were measured...

  7. 骨诱导活性材料修复牙槽突裂骨缺损的可行与可靠性%Feasibility and reliability of osteoinduction active materials in repair of alveolar cleft defects

    Institute of Scientific and Technical Information of China (English)

    夏金圣

    2015-01-01

    BACKGROUND:In clinic, bone grafting can be adopted to treat alveolar bone defect, and the selected bone graft materials wil have a certain impact on the ultimate effect of bone grafting. OBJECTIVE:To explore the feasibility and reliability of osteoinduction active materials in the repair of alveolar cleft defects. METHODS:A total of 63 patients with alveolar cleft defect, including 33 male and 30 female patients, aged 8 to 15 years, were enroled and treated by bone grafting. Patients were divided into autologous bone group (n=32) and osteoinduction active material group (n=31) according to different bone graft materials. During 12 months of folow-up after the treatment, the bone grafting effect, bone density, canine condition and adverse reactions were observed. RESULTS AND CONCLUSION:There was no significant difference in the total effective rate between the autologous bone and osteoinduction active material groups (P > 0.05). Among the seven unerupted canines in the autologous bone group, two teeth erupted, four moved to the bone grafting area, and one appeared to have no obvious changes. Among the six unerupted canines in the osteoinduction active material group, two teeth erupted, two appeared to have no changes, and two moved to graft bone area. The bone density in these two groups was significantly increased after tooth restoration (P 0.05)。②未萌尖牙情况:自体骨组7颗未萌尖牙中,2颗萌出,4颗向植骨区移动,1颗未出现明显改变;骨诱导活性材料组6颗未萌尖牙中,2颗萌出,2颗未出现明显改变,2颗向植骨区移动。③牙槽骨密度:两组修复后的骨密度均较治疗前显著增加(P<0.05),修复后两组间比较差异无显著性意义。④不良反应:两组患者均未出现感染、排异及植骨材料脱落等不良事件。表明利用骨诱导活性材料修复牙槽突裂骨缺损可以获得与自体骨移植相似的效果,具有一定的临床应用可行性和可靠性。

  8. 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, ...

  9. 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.

  10. Fetal Cleft Lip/Palate Surgery: End of a Dream?

    Science.gov (United States)

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih; Inangil, Gökhan; Kara, Kemal

    2016-01-01

    Recognition that a fetus can scarlessly heal in intrauterine life led to various animal studies in the mid 1980s exploring the possibility of fetal cleft lip/palate surgery. The idea of scarless cleft repair seemed like a possible dream after the promising results from the early animal studies. In this review, we analyze the progress made in the 30 years since our first experience with animal models.

  11. 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.

  12. Identifying Genetic Sources of Phenotypic Heterogeneity in Orofacial Clefts by Targeted Sequencing.

    Science.gov (United States)

    Carlson, Jenna C; Taub, Margaret A; Feingold, Eleanor; Beaty, Terri H; Murray, Jeffrey C; Marazita, Mary L; Leslie, Elizabeth J

    2017-07-17

    Orofacial clefts (OFCs), including nonsyndromic cleft lip with or without cleft palate (NSCL/P), are common birth defects. NSCL/P is highly heterogeneous with multiple phenotypic presentations. Two common subtypes of NSCL/P are cleft lip (CL) and cleft lip with cleft palate (CLP) which have different population prevalence. Similarly, NSCL/P can be divided into bilateral and unilateral clefts, with unilateral being the most common. Individuals with unilateral NSCL/P are more likely to be affected on the left side of the upper lip, but right side affection also occurs. Moreover, NSCL/P is twice as common in males as in females. The goal of this study is to discover genetic variants that have different effects in case subgroups. We conducted both common variant and rare variant analyses in 1034 individuals of Asian ancestry with NSCL/P, examining four sources of heterogeneity within CL/P: cleft type, sex, laterality, and side. We identified several regions associated with subtype differentiation: cleft type differences in 8q24 (p = 1.00 × 10(-4) ), laterality differences in IRF6, a gene previously implicated with wound healing (p = 2.166 × 10(-4) ), sex differences and side of unilateral CL differences in FGFR2 (p = 3.00 × 10(-4) ; p = 6.00 × 10(-4) ), and sex differences in VAX1 (p < 1.00 × 10(-4) ) among others. Many of the regions associated with phenotypic modification were either adjacent to or overlapping functional elements based on ENCODE chromatin marks and published craniofacial enhancers. We have identified multiple common and rare variants as potential phenotypic modifiers of NSCL/P, and suggest plausible elements responsible for phenotypic heterogeneity, further elucidating the complex genetic architecture of OFCs. Birth Defects Research 109:1030-1038, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. Nuevo enfoque en el tratamiento quirúrgico de las fisuras labiales congénitas New approchment to the surgical treatment of congenital cleft lip deformities

    Directory of Open Access Journals (Sweden)

    P. Rossell-Perry

    2013-03-01

    very detail description of the morphology and a more individualized surgical treatment. Most of reference center around the world use one surgical technique or modifications of it, to address the different forms of cleft lip. During our first years of experience we repair all the cleft forms using only one technique (Millard for unilateral and Mulliken for bilateral with good and bad results. This scenario stimulates us to classify the cleft lips and propose a new strategy for their surgical treatment, making them more individualized. The purpose of this study is to compare the surgical results obtained using two different protocols. This is an analytic and comparative study of 2 protocols: protocol A, using one surgical technique to address all cleft types, and protocol and B, using different surgical techniques according to our proposed classification based on number of bad results obtained using each one. To establish the type of result obtained we did anthropometric measurements in both sides of the repaired lip before the cleft palate repair under general anesthesia. In both cases, we have seen statistically significant differences in the number of bad results between the two protocols, on behalf of protocol B (p: 0.0001 and p: 0.002. We observed less number of bad results using the individualized protocol (protocol B in the surgical treatment of unilateral and bilateral cleft lip showing the efficacy of the proposed classification and used techniques. These conclusions support our proposal in this article, with the new classification and surgical techniques.

  14. Orofacial clefts at Bugando Medical Centre: associated factors and postsurgical complications.

    Science.gov (United States)

    Buyu, Yunus; Manyama, Mange; Chandika, Alphonce; Gilyoma, Japhet

    2012-11-01

    To determine factors associated with orofacial clefts and postsurgical complications of cleft lip and palate repair surgeries in northwestern Tanzania. This was a cohort study involving patients with orofacial clefts. Associated factors (family history of orofacial clefts, maternal use of alcohol and cigarette smoking during pregnancy) were obtained through interviews with accompanying parents. Antenatal cards were used to obtain maternal age at birth and birth weight. Ninety-four patients with different orofacial clefts were seen. Among them, 46.8% (44/94), 13.8% (13/94), and 39.4% (37/94) had cleft lip, cleft palate, and cleft lip and palate, respectively. About 15% of orofacial cleft cases had a positive family history of orofacial clefts. Among these, 7.4% had an affected relative on the maternal side, 4.3% had an affected relative on the paternal side, and 3.2% had an affected sibling. This difference was statistically significant (chi-square  =  27.7, p Orofacial cleft was significantly associated with order of birth (chi-square  =  21.0, p orofacial clefts and order of birth were significantly associated with orofacial clefts in northwestern Tanzania. These factors have been associated with risk of orofacial clefts elsewhere and suggest a hereditary role in the etiology of orofacial cleft. Palatal fistula and philtrum dehiscence were postsurgical complications observed in orofacial clefts patients who had primary surgery past the recommended age. These complications could have resulted from delayed surgery and absence of presurgical procedures.

  15. 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

  16. Características vocais acústicas do som basal em homens com fissura pós-forame reparada Acoustic characteristics of vocal fry in men with repaired post-foramen cleft

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    Giseane Conterno

    2011-02-01

    Full Text Available TEMA: características vocais acústicas da emissão em registro basal de pacientes adultos masculinos, portadores de fissura palatina pós-forame reparada cirurgicamente. PROCEDIMENTOS: estudo de casos envolvendo quatro sujeitos do sexo masculino portadores de fissura palatina pós-forame reparada cirurgicamente. Foi realizada análise acústica da emissão sustentada da vogal [a] em registro modal e basal, através dos programas Multi Dimensional Voice Program (análise da fonte glótica e Real-Time Spectrogram (análise espectrográfica, ambos da Kay Elemetrics Corp. RESULTADOS: por meio da análise espectrográfica do basal, observou-se: diminuição de definição, intensidade e de largura de banda de alguns formantes, diminuição da intensidade de todo o espectro, e discreta diminuição do ruído nas altas frequências; o efeito damping apresentou discreto aumento. Pela análise da fonte glótica no basal através do MDVPA, observou-se: frequência fundamental dentro da faixa do registro modal de fala e aumentada quando comparada à emissão para comparação em registro modal; grande aumento das medidas que evidenciam variação de frequência e de amplitude; maioria das medidas de jitter e de shimmer significativamente aumentadas; medidas de ruído, de quebras de voz, de segmentos não sonorizados e de tremor aumentadas; e índice de fonação suave (SPI significativamente diminuído. CONCLUSÃO: os resultados evidenciam a alta instabilidade e ruído da emissão em registro basal, bem como sua fraca intensidade e diminuição do fluxo aéreo transglótico.PURPOSE: to describe the vocal acoustic characteristics of emission in vocal fry of male adult patients, with surgically repaired post-foramen cleft. METHODS: study of cases involving four male subjects with surgically repaired post-foramen cleft. Acoustic analysis concerning sustained emission of vowel [a] was accomplished in modal register and vocal fry, through the programs Multi

  17. 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.

  18. 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 ...

  19. 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.

  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. 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.

  2. Fissura palatina reparada: fechamento velofaríngeo antes e durante o som basal Cleft palate repair: velopharyngeal closure before and during the basal tone

    Directory of Open Access Journals (Sweden)

    Giseane Conterno

    2010-04-01

    Full Text Available Portadores de fissura palatina apresentam inadequado fechamento velofaríngeo (FVF, com consequente hipernasalidade vocal que pode ser diminuída com o som basal. OBJETIVO: Comparar o FVF durante a realização do som basal com a emissão em registro modal, em pacientes com fissura palatina pós-forame reparada. MATERIAIS E MÉTODOS: Estudo de Casos com quatro homens adultos, portadores de fissura palatina pós-forame reparada. Imagens do FVF por nasofaringoscopia, durante a emissão da vogal [a] em registro modal e basal. Julgamento das imagens realizado por quatro otorrinolaringologistas. RESULTADOS: Em três sujeitos, não houve mudança no tipo de FVF entre os registros analisados; as modificações que ocorreram na maioria dos sujeitos referem-se apenas ao grau de movimentação das estruturas envolvidas, pois, em registro basal, o movimento das paredes laterais da faringe se manteve, o movimento da parede posterior da faringe estabilizou, o movimento do véu palatino diminuiu discretamente, e a Prega de Passavant se evidenciou. CONCLUSÕES: O tipo de FVF se manteve em três dos quatro sujeitos analisados, quando comparado o registro modal com o basal, havendo modificações no grau da movimentação das estruturas envolvidas, evidenciando a Prega de Passavant.Patients with palatine fissure have inadequate velopharyngeal closure (VPC, with consequent vocal hypernasality which can be reduced by a basal tone. AIM: to compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. MATERIALS AND METHODS: case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. RESULTS: in three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects

  3. Perception of Place of Articulation by Children with Cleft Palate and Posterior Placement.

    Science.gov (United States)

    Whitehill, Tara L.; Francis, Alexander L.; Ching, Christine K-Y.

    2003-01-01

    A study examined if 10 children (ages 4-12) with repaired cleft palate who demonstrate posterior placement of alveolar targets differed from 10 children with cleft palate without such error patterns, and from 10 controls in the perception of alveolar targets. Children with posterior placement appeared unable to distinguish alveolar targets.…

  4. Outcome analysis of palatoplasty in various types of cleft palate

    Directory of Open Access Journals (Sweden)

    Venkatesh M Annigeri

    2012-01-01

    Full Text Available Aims: To analyse the factors affecting clinical and functional outcome of Veau-Wardill-Kilner palatoplasty in various types of cleft palate. Materials and Methods: Demographic data were retrieved from case records and a detailed speech, language and hearing and an orthodontic analysis were carried out prospectively. Results: Mean age at operation was 2.7 years; whereas mean age at the time of evaluation was 6 years. Most of the patients (43.3%, 13/30 had a bilateral cleft lip and palate. The postoperative fistula had developed in 31% (4/13 of the patients with bilateral clefts and in 17% (1/6 and 9% (1/11 of the patients with left unilateral and isolated cleft palate respectively (P0.05. Tympanic membrane (TM abnormalities were also more common in bilateral cleft patients (P<0.05. Mean maxillary arch length, arch circumference and maxillary inter-canine and inter-molar width were significantly reduced as compared to the control group (P<0.001. Conclusions: Socially acceptable quality of speech can be achieved in more than 85% of the patients. The postoperative fistula is associated with poor speech; bilateral cleft and older age being the risk factors for fistula formation. Many patients require audiological surveillance even when asymptomatic. Maxillary growth is impaired in all the patients despite early surgery.

  5. 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...

  6. 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.

  7. Facial tissue depths in children with cleft lip and palate.

    Science.gov (United States)

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-03-01

    Cleft lip and palate (CLP) is a craniofacial malformation affecting more than seven million people worldwide that results in defects of the hard palate, teeth, maxilla, nasal spine and floor, and maxillodental asymmetry. CLP facial soft-tissue depth (FSTD) values have never been published. The purpose of this research is to report CLP FSTD values and compare them to previously published FSTD values for normal children. Thirty-eight FSTDs were measured on cone beam computed tomography images of CLP children (n = 86; 7-17 years). MANOVA and ANOVA tests determined whether cleft type, age, sex, and bone graft surgical status affect tissue depths. Both cleft type (unilateral/bilateral) and age influence FSTDs. CLP FSTDs exhibit patterns of variation that differ from normal children, particularly around the oronasal regions of the face. These differences should be taken into account when facial reconstructions of children with CLP are created.

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

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    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.

  9. Treatment of 4-5 year old patients with cleft lip and cleft palate in Tawanchai center.

    Science.gov (United States)

    Pradubwong, Suteera; Volrathongchai, Kanittha; Chowchuen, Bowornsilp

    2013-09-01

    The occurrence of Cleft Lip/Palate condition in Thailand reaches a rate of 2.49% of child births, with estimates of 800 new cases per year in the Northeastern region. The healthcare process emphasizes interdisciplinary teamwork at each stage of the planning of treatment and services with the primary goal of achieving patient satisfaction and ability to live normally in society. The first 5 years are particularly important, with a focus on quality of care and ability to adapt to the environment before entering school. To study the treatment of patients with cleft lip and palate in Tawanchai center in the 4-5 year age range. A retrospective study of the clinical records was led, concerning the 123 cleft lip and cleft palate patients aged 4-5 years under treatment in Tawanchai center, Srinagarind Hospital. Data was collected during three months from October to December 2011, using the admission records of the interdisciplinary team. Percentages and mean values were calculated from these data. 120 of the 123 patients were operated, giving a ratio of 97.56%. 108 cases were under government universal health coverage regime, corresponding to 87.80% of cases. 74 cases (60.16%) presented both cleft lip and palate condition, and an average of 5-night stay in hospital per person. Medical services by the interdisciplinary team were provided as follows: (1) of 30 patients with cleft lip aged 3-4 months, 30 (100%) received pre and post-surgery care counseling, 29 (96.67%) received surgery; (2) of 19 patients with cleft palate aged 10-18 months, 17 (89.47%) received treatment information, pre and postsurgery counseling and were operated according to the protocols; (3) of 74 patients with cleft lip and palate, 53 (71.62%) received counseling for pre and post-surgery care for lip repair at the age of 3-4 months, 52 (70.27%) were operated following the protocols, while at the age of 10-18 months 63 patients (85.14%) received treatment information, pre and postsurgery care counseling

  10. [Maxillary advancement osteotomy with sequelae cleft lip and palate: Dilemma between occlusion and aesthetic profile].

    Science.gov (United States)

    Vigneron, A; Morand, B; Lafontaine, V; Lesne, V; Lesne, C; Bettega, G

    2015-11-01

    Maxillary hypoplasia is a common sequela of cleft lip and palate. Its surgical treatment consists in a maxillary advancement by distraction or by conventional orthognathic surgery but morphological results are unpredictable. Our goal in this study was to see if the esthetical results (on the lip and the nose) of maxillary advancement were correlated to the preservation of lateral incisor space of the cleft side. This retrospective study included 38 patients operated between 2002 and 2013. Unilateral clefts were studied independently from bilateral clefts. Profile aesthetics was evaluated independently and subjectively by two surgeons and scored on an 8-point scale. The result was classified as "good" if the score was superior or equal to 6. The score was correlated to the following parameters: amount of maxillary advancement, upper incisor axis, preservation of the missing lateral incisor space. In the "good result" group, the space of the lateral incisor was less often preserved. The nasolabial angle was more open and the upper central incisor axis more vertical. These results were more pronounced in bilateral clefts, but also found in unilateral clefts. Under reservation of the subjective evaluation and of the small number of patients, it seemed that lateral incisor space closure improved the profile of patients treated by maxillary advancement for cleft lip and palate sequelae. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. The Cleft Care UK study. Part 4: perceptual speech outcomes

    Science.gov (United States)

    Sell, D; Mildinhall, S; Albery, L; Wills, A K; Sandy, J R; Ness, A R

    2015-01-01

    Structured Abstract Objectives To describe the perceptual speech outcomes from the Cleft Care UK (CCUK) study and compare them to the 1998 Clinical Standards Advisory Group (CSAG) audit. Setting and sample population A cross-sectional study of 248 children born with complete unilateral cleft lip and palate, between 1 April 2005 and 31 March 2007 who underwent speech assessment. Materials and methods Centre-based specialist speech and language therapists (SLT) took speech audio–video recordings according to nationally agreed guidelines. Two independent listeners undertook the perceptual analysis using the CAPS-A Audit tool. Intra- and inter-rater reliability were tested. Results For each speech parameter of intelligibility/distinctiveness, hypernasality, palatal/palatalization, backed to velar/uvular, glottal, weak and nasalized consonants, and nasal realizations, there was strong evidence that speech outcomes were better in the CCUK children compared to CSAG children. The parameters which did not show improvement were nasal emission, nasal turbulence, hyponasality and lateral/lateralization. Conclusion These results suggest that centralization of cleft care into high volume centres has resulted in improvements in UK speech outcomes in five-year-olds with unilateral cleft lip and palate. This may be associated with the development of a specialized workforce. Nevertheless, there still remains a group of children with significant difficulties at school entry. PMID:26567854

  12. Unilateral diplophthalmos.

    Science.gov (United States)

    Stefani, F H; Hausmann, N; Lund, O E

    1991-11-15

    In a child born of a full-term pregnancy, unilateral diplophthalmos without proboscis was observed along with other craniocervical abnormalities (ipsilateral temporoparietal porencephaly, supernumerary teeth, and cervical cyst). A globe almost normal in shape and size was observed within the left orbit. The upper quadrant of this globe was attached to a smaller, pear-shaped, supernumerary eye containing a small lens, normal vitreous humor, ciliary body structures, avascular retina, choroid, and a rudimentary optic disk. When a two-peaked and enlarging intraocular mass was observed clinically, the eye was enucleated because of suspected neoplasm. The enlarging prominence had been caused by the growing second globe. Our findings indicated that a single primary optic vesicle was formed (globe I with an optic fasciculus), and some unknown damage was caused when this single primary optic vesicle induced the lens formation by contacting the ectoderm. Although the conception and early embryonal life of this child had taken place during a period of increased radiation exposure caused by the explosion of the nuclear plant at Chernobyl, U.S.S.R., in the spring of 1986, it seemed unlikely that the abnormality could have been caused by radioactive fallout in the mountains of Austria.

  13. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  14. 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.

  15. 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.

  16. 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

  17. Spectral Analysis of Word-Initial Alveolar and Velar Plosives Produced by Iranian Children with Cleft Lip and Palate

    Science.gov (United States)

    Eshghi, Marziye; Zajac, David J.; Bijankhan, Mahmood; Shirazi, Mohsen

    2013-01-01

    Spectral moment analysis (SMA) was used to describe voiceless alveolar and velar stop-plosive production in Persian-speaking children with repaired cleft lip and palate (CLP). Participants included 11 children with bilateral CLP who were undergoing maxillary expansion and 20 children without any type of orofacial clefts. Four of the children with…

  18. Spectral Analysis of Word-Initial Alveolar and Velar Plosives Produced by Iranian Children with Cleft Lip and Palate

    Science.gov (United States)

    Eshghi, Marziye; Zajac, David J.; Bijankhan, Mahmood; Shirazi, Mohsen

    2013-01-01

    Spectral moment analysis (SMA) was used to describe voiceless alveolar and velar stop-plosive production in Persian-speaking children with repaired cleft lip and palate (CLP). Participants included 11 children with bilateral CLP who were undergoing maxillary expansion and 20 children without any type of orofacial clefts. Four of the children with…

  19. Nasolabial appearance after two palatoplasty types in cleft lip and palate.

    Science.gov (United States)

    Brudnicki, A; Bronkhorst, E M; Nada, R; Dudkiewicz, Z; Kaminek, M; Katsaros, C; Fudalej, P S

    2014-05-01

    Facial appearance is important for normal psychosocial development in children with cleft lip and palate (CLP). There is conflicting evidence on how deficient maxillary growth may affect nasolabial esthetics. We retrospectively investigated nasolabial appearance in two groups, the Langenback (35 children; mean age 11.1 years; range: 7.9-13.6) and Vomerplasty (58 children; mean age 10.8 years; range: 7.8-14), who received unilateral CLP surgery by the same surgeon. The hard palate repair technique differed between the two groups. In the Langenback group, palatal bone on the non-cleft side only was left denuded, inducing scar formation and inhibiting maxillary growth. In the Vomerplasty group, a vomerplasty with tight closure of the soft tissues on the palate was applied. Thirteen lay judges rated nasolabial esthetics on photographs using a modified Asher-McDade's index. Nasolabial esthetics in both groups was comparable (p > 0.1 for each nasolabial component). Inferior view was judged as the least esthetic component and demonstrated mean scores 3.18 (SD = 0.63) and 3.13 (SD = 0.47) in the Langenback and Vomerplasty groups, respectively. Mean scores for other components were from 2.52 (SD = 0.63) to 2.81 (SD = 0.62). Regression analysis showed that vomerplasty is related with slight improvement in the nasal profile only (coefficient B = -0.287; p = 0.043; R(2 ) = 0.096). This study demonstrates that the use of vomerplasty instead of the Langenbeck technique is weakly associated with the nasolabial appearance among pre-adolescent patients with UCLP. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Two consecutive levels of unilateral cervical spondylolysis on opposite sides

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Kyeong Hwa; Kim, Seon Jeong; KIm Ok Hwa; Kim, Seung Ho; Lee, Kwang Hwi; Beak, Hye Jin; Lee, Ye Daun [Dept. of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan (Korea, Republic of); Cha, Yoon Ki [Dept. of Radiology, Dongguk University College of Medicine, Ilsan Hospital, Goyang (Korea, Republic of)

    2015-09-15

    Cervical spondylolysis, with or without spondylolisthesis, is a rare condition defined as a corticated cleft between the superior and inferior articular facets of the articular pillar. The defect occurs predominantly at C6, and is usually bilateral in up to two-thirds of cases. Multilevel involvement is uncommon, however, to date, no case of two consecutive levels of unilateral cervical spondylolysis on opposite sides has been reported. Here, we report a rare case of a patient affected by two consecutive levels of unilateral cervical spondylolysis at C5 and C6 on opposite sides in a 19-year-old male complaining of neck pain.

  1. 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.

  2. Branchial cleft cyst

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    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.

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

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    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.

  4. Pre-speech in children with cleft lip and palate or cleft palate only: phonetic analysis related to morphologic and functional factors.

    Science.gov (United States)

    Lohmander-Agerskov, A; Söderpalm, E; Friede, H; Persson, E C; Lilja, J

    1994-07-01

    Pre-speech in 35 children with clefts of the lip and palate or palate only were analyzed for place and manner of articulation. Transcriptions were made from tape recorded babbling sequences. Two children without clefts were used as reference. All of the children with clefts were treated according to a regimen of early surgical repair of the velum cleft and delayed closure of the cleft in the hard palate. The frequency of selected phonetic features was calculated. Correlations between phonetic/perceptual and functional and morphological factors were tested. Supraglottal articulation dominated among all the children indicating a sufficient velopharyngeal mechanism. The results also showed correlations between cleft type and place of articulation. Anteriorly placed sounds (i.e., bilabial, dental, and alveolar sounds) occurred frequently among the children with cleft palate only and in the noncleft children. In children with cleft lip and palate, posteriorly placed articulations predominated. It was postulated that early intervention may have a positive effect on articulatory development.

  5. Early postnatal development of the mandibular permanent first molar in infants with isolated cleft palate

    DEFF Research Database (Denmark)

    Hermann, Nuno V.; Zargham, Mostafa; Darvann, Tron Andre

    2012-01-01

    International Journal of Paediatric Dentistry 2012; 22: 280–285 Background. Based on measurements on dental casts, smaller permanent teeth in children with cleft palate have previously been reported in the literature; however, the early maturation of teeth and the size of the follicles and crowns...... have not been investigated. Hypothesis. The maturation of the mandibular permanent first molar (M1inf) is delayed, and the mesiodistal diameters of the follicle and crown of M1inf, respectively, are reduced in children with isolated cleft palate (ICP). Design. Retrospective, longitudinal. Cephalometric...... X‐rays were available for 2 and 22 months old children with clefts (64 children with ICP, and a control group of 38 children with unilateral incomplete cleft lip). The width of the follicle and the crown of M1inf, and the maturation of M1inf were assessed. Intra‐observer error was acceptable...

  6. 显微镜下腭帆张肌及腭帆提肌重建整复先天性腭裂临床研究%Using Operation Microscope for Cleft Palatet Repair by Reconstruction of the Tensor Veli Palatini Muscle and the Levator Veli Palatini Muscle

    Institute of Scientific and Technical Information of China (English)

    潘孟雄; 马祥伟; 邓力; 蒋英华; 覃小荣; 李波

    2013-01-01

    Objective:To explore a functional palatoplasty resulting in velopharyngeal competence.Methods:310 cases of cleft palate have been repaired with the operation microscope.Dislocation of the tensor veli palatini muscle and the levator veli palatini muscle have been dissected by revisiting anatomy of musculature of soft palate.50 patients were followed up.Results:Velopharyngeal closure is adequate in the 45 patients.Conclusion:Reconstruction of the tensor veli palatini muscle and the levator veli palatini muscle can restore normal anatomical structure and develop physiological function and obtain good pronunciation.It is a recommendable method for cleft palate repair.%目的:探讨一种具有良好腭咽闭合功能腭裂修复的方法.方法:对310例腭裂在显微镜下行手术修复,解剖错位的腭帆张肌及腭帆提肌,并对腭帆张肌及腭帆提肌重新定位恢复正常的生理位置,手术后对50例患者进行回访.结果:腭咽闭合好45例.结论:腭帆张肌,腭帆提肌重建术对于恢复正常腭帆提肌的解剖位置,充分发挥其生理功能,获得良好的发音,是一种值得推荐应用的功能性腭裂修复方法.

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

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    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.

  8. Repair of incomplete cleft palate and its clinical analysis by NPF and spectrum technology which were given modified Lan's operations%鼻咽内窥镜和频谱技术对改良兰氏法修复不完全性腭裂效果的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    闫冰冰; 闫漫; 赵增强; 苏波; 丁元刚; 刘国华; 汪涛

    2012-01-01

    目的:通过对2006年6月~2009年12月就诊于解放军第5 37医院口腔科的80例行改良兰氏法修复不完全性腭裂患者进行回访,评估该法临床治疗效果,为术式选择提供依据.方法:对80例改良兰氏法修复不完全性腭裂患者术后腭咽闭合状况进行评估,并行频谱分析,测出前三个共振峰F1、F2、F3的数据,与80例正常儿童对照.结果:在66例行鼻咽镜检查的患者中,有81.81%手术后的患儿达到腭咽闭合完全;在行频谱分析检查中,F1值两组患儿无统计学差异,F2、F3两组间有显著性差异.结论:改良兰氏法能有效改善患者腭咽闭合和语音功能,是一种较好的不完全性腭裂患者的修复术式.%Objective Through to the from June 2006 to December 2009 537 hospital dental clinic in the people's liberation army (PLA) 40 incomplete repair cleft patients visit which were given modified Lan's operations,evaluate the clinical treatment effect, which provides the basis for the selection of clinical work procedures. Methods In 80 cases improved method of incomplete bacterium repair cleft recovery after patient Velopharyngeal function, parallel spectrum analysis,measure the first three F1 and F2, resonant F3 data,and 80 patients with normal children controls. Results In 66 the routine nose pharynx of colonoscopy patients,81.81% of children after surgery to swallow gum closed completely; Spectrum analysis at the inspection,F1 value two groups was not statistically different children, F2, F3 between the two groups have significant differences. Conculsion Until now, Lan's operation Can effectively improve the patients swallow gum closed and speech function,which is still a good way to recover incomplete cleft palate.

  9. Prevalence of Oral Habits in Children with Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Paula Caroline Barsi

    2013-01-01

    Full Text Available This study investigated the prevalence of oral habits in children with clefts aged three to six years, compared to a control group of children without clefts in the same age range, and compared the oral habits between children with clefts with and without palatal fistulae. The sample was composed of 110 children aged 3 to 6 years with complete unilateral cleft lip and palate and 110 children without alterations. The prevalence of oral habits and the correlation between habits and presence of fistulae (for children with clefts were analyzed by questionnaires applied to the children caretakers. The cleft influenced the prevalence of oral habits, with lower prevalence of pacifier sucking for children with cleft lip and palate and higher prevalence for all other habits, with significant association (. There was no significant association between oral habits and presence of fistulae (. The lower prevalence of pacifier sucking and higher prevalence of other oral habits agreed with the postoperative counseling to remove the pacifier sucking habit when the child is submitted to palatoplasty, possibly representing a substitution of habits. There was no causal relationship between habits and presence of palatal fistulae.

  10. Prevalence of oral habits in children with cleft lip and palate.

    Science.gov (United States)

    Barsi, Paula Caroline; Ribeiro da Silva, Thaieny; Costa, Beatriz; da Silva Dalben, Gisele

    2013-01-01

    This study investigated the prevalence of oral habits in children with clefts aged three to six years, compared to a control group of children without clefts in the same age range, and compared the oral habits between children with clefts with and without palatal fistulae. The sample was composed of 110 children aged 3 to 6 years with complete unilateral cleft lip and palate and 110 children without alterations. The prevalence of oral habits and the correlation between habits and presence of fistulae (for children with clefts) were analyzed by questionnaires applied to the children caretakers. The cleft influenced the prevalence of oral habits, with lower prevalence of pacifier sucking for children with cleft lip and palate and higher prevalence for all other habits, with significant association (P oral habits and presence of fistulae (P > 0.05). The lower prevalence of pacifier sucking and higher prevalence of other oral habits agreed with the postoperative counseling to remove the pacifier sucking habit when the child is submitted to palatoplasty, possibly representing a substitution of habits. There was no causal relationship between habits and presence of palatal fistulae.

  11. Psychological issues in cleft lip and cleft palate

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    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.

  12. Presurgical nasoalveolar molding therapy in cleft lip and palate individuals: Case series and review

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    Narayan H Gandedkar

    2015-01-01

    Full Text Available The nasoalveolar molding (NAM therapy is advocated to reduce the severity of alveolar cleft and nasal deformity. NAM therapy has demonstrated to be an effective method for reducing cleft and improve nose anatomy. This paper presents a case report of three cleft lip and palate individuals treated with NAM therapy. Furthermore, the paper highlights the advantages of NAM therapy along with an enumeration of literature suggesting in favor of NAM therapy and otherwise. Regardless of controversies and divergent views involved with NAM therapy, the immediate success of NAM therapy facilitating primary lip repair surgery cannot be under-emphasized.

  13. Management of cleft lip and palate in adults

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    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 outcom