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Sample records for submucous cleft palates

  1. Transillumination of the occult submucous cleft palate.

    Science.gov (United States)

    Caterson, E J; Tsai, David M; Cauley, Ryan; Dowdall, Jayme R; Tracy, Lauren E

    2014-11-01

    Occult submucous cleft palate is a congenital deformity characterized by deficient union of the muscles that normally cross the velum and aid in elevation of the soft palate. Despite this insufficient muscle coverage, occult submucous cleft palate by definition lacks clear external anatomic landmarks. This absence of anatomic signs makes diagnosis of occult submucous cleft less obvious, more dependent on ancillary tests, and potentially missed entirely. Current diagnostic methodologies are limited and often are unrevealing in the presurgical patient; however, a missed diagnosis of occult submucous cleft palate can result in velopharyngeal insufficiency and major functional impairment in patients after surgery on the oropharynx. By accurately and easily diagnosing occult submucous cleft palate, it is possible to defer or modify pharyngeal surgical intervention that may further impair velopharyngeal function in susceptible patients. In this report, we introduce transillumination of the soft palate using a transnasal or transoral flexible endoscope as an inexpensive and simple technique for identification of submucous cleft palate. The use of transillumination of an occult submucous cleft palate is illustrated in a patient case and is compared to other current diagnostic methodologies.

  2. Congenital Palatal Fistula Associated with Submucous Cleft Palate

    OpenAIRE

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H. Wolfgang; Spiess, Alexander M.

    2016-01-01

    Background: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and managemen...

  3. Congenital Palatal Fistula Associated with Submucous Cleft Palate.

    Science.gov (United States)

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H Wolfgang; Spiess, Alexander M

    2016-02-01

    Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and management. Two cases of children with congenital palatal fistulae and a submucous cleft palate are presented who were treated in different settings by different surgeons. Cases are discussed along with a thorough review of the available literature. Patient 1 presented at 4 years of age with "a hole in the palate" since birth and abnormal speech. His palatal fistula and submucous cleft were repaired with a modified von Langenbeck technique in Ethiopia. At a 2-year follow-up, the palate remained closed, but hypernasal speech persisted. Patient 2 was a 1-year-old presenting with failure to thrive and nasal regurgitation, who underwent a Furlow palatoplasty in the United States with good immediate results. She was unfortunately lost to follow-up. A congenital fenestration of the palate is rare. Reports reveal suboptimal speech at follow-up, despite various types of repair, especially when combined with a submucous cleft. Available literature suggests that repair should not focus on fistula closure only but instead on providing adequate palate length to provide good velopharyngeal function, as in any cleft palate repair.

  4. Repair of submucous cleft palate with Furlow palatoplasty.

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    Abdel-Aziz, Mosaad; El-Hoshy, Hassan; Naguib, Nader; Talaat, Nassim

    2012-07-01

    Submucous cleft palate is a congenital anomaly caused by abnormal insertion of the levator veli palatini muscles to the posterior border of the hard palate, normally these muscles unite together to form the levator sling. Velopharyngeal insufficiency (VPI) may occur in about 10% of cases, our previous treatment protocol was pharyngeal flap that may result in obstructive breathing. Furlow technique seems to be a more physiologic solution as it reconstructs the levator sling. The aim of this study was to determine the efficacy of Furlow palatoplasty in treatment of submucous cleft palate cases presented with VPI. This prospective study was conducted on 15 children with symptomatic submucous cleft palate. All cases were treated by Furlow double opposing Z-plasty technique for repositioning of levator muscles, preoperative and postoperative speech evaluation was done using auditory perceptual assessment and nasometry, while velopharyngeal closure was assessed with flexible nasopharyngoscopy. Significant improvement of speech and overall nasalance score were achieved. Flexible nasopharyngoscopy showed complete velopharyngeal closure of 13 cases (86.7%), while one case needed secondary pharyngoplasty for correction of residual VPI and the parents of the other case refused secondary surgery as the speech improvement of their child was satisfactory. Furlow palatoplasty technique is an effective method in treatment of VPI in cases of submucous cleft palate as it has high success rate with no morbidity. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery

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    Ie Hyon Park

    2016-11-01

    Full Text Available It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.

  6. Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery.

    Science.gov (United States)

    Park, Ie Hyon; Chung, Jee Hyeok; Choi, Tae Hyun; Han, Jihyeon; Kim, Suk Wha

    2016-11-01

    It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.

  7. Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery

    OpenAIRE

    Ie Hyon Park; Jee Hyeok Chung; Tae Hyun Choi; Jihyeon Han; Suk Wha Kim

    2016-01-01

    It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete ...

  8. Age of diagnosis and evaluation of consequences of submucous cleft palate

    NARCIS (Netherlands)

    ten Dam, E.; van der Heijden, P.; Korsten-Meijer, A. G. W.; Goorhuis-Brouwer, S. M.; van der Laan, B. F. A. M.

    Objectives: To evaluate the frequency of submucous cleft palate (SMCP) in a group of children with clefts. The reason for suspecting submucous cleft, age of diagnosis, effect of age on speech development, problems in speech, hearing and swallowing were compared with previous literature. Methods:

  9. [Morphological classification and velopharyngeal function analysis of submucous cleft palate patients].

    Science.gov (United States)

    Heng, Yin; Chunli, Guo; Bing, Shi; Yang, Li; Jingtao, Li

    2016-10-01

    To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details. Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment. Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan. Given that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized manage-ment of submucous cleft palate.

  10. Craniofacial and pharyngeal cephalometric morphology in seven-year-old boys with unoperated submucous cleft palate and without a cleft.

    Science.gov (United States)

    Heliövaara, Arja; Rautio, Jorma

    2009-05-01

    To evaluate cephalometrically the craniofacial and pharyngeal morphology in 7-year-old boys with unoperated submucous cleft palate and to compare the findings with the morphology of 7-year-old boys without clefts. Thirty-two boys with unoperated submucous cleft palate and 49 boys without a cleft were compared retrospectively from lateral cephalograms taken at the mean age of 7 years (range, 5.5 to 8.6 years). A retrospective case-control study. Linear and angular measurements were obtained from lateral cephalograms. A Student's t test was used in the statistical analysis. The maxilla of the boys with submucous cleft palate was shorter and slightly more retrusive in relation to the cranial base than that of boys without clefts. Also, the mandible of the boys with submucous cleft palate was smaller, with a steeper mandibular plane. The relationship between the jaws was similar in both groups; although, those without clefts showed higher values for soft tissue maxillary prominence. In the pharyngeal area, the boys with submucous cleft palate had larger nasopharyngeal depths, smaller hypopharyngeal depths, and shorter soft palates than the boys without a cleft. This small study suggests that the boys with unoperated submucous cleft palate have minor distinctive morphological features in the maxillary, mandibular, and pharyngeal areas.

  11. Postoperative Speech Outcomes and Complications in Submucous Cleft Palate Patients

    Directory of Open Access Journals (Sweden)

    Tae Seo Park

    2016-05-01

    Full Text Available BackgroundThe postoperative speech outcomes of submucous cleft palate (SMCP surgery are known to be poorer than those of other types of cleft palate. We attempted to objectively characterize the postoperative complications and speech outcomes of the surgical treatment of SMCP through a comparison with the outcomes of incomplete cleft palate (ICP.MethodsThis study included 53 SMCP patients and 285 ICP patients who underwent surgical repair from 1998 to 2015. The average age of the patients at the time of surgery was 3.9±1.9 years for the SMCP patients and 1.3±0.9 years for the ICP patients. A retrospective analysis was performed of the complications, the frequency of subsequent surgical correction for velopharyngeal dysfunction (VPD, and speech outcomes.ResultsIn both the SMCP and ICP patients, no cases of respiratory difficulty, bleeding, or wound disruption were noted. Delayed wound healing and fistula occurred in 18.9% and 5.7% of the SMCP patients and in 14% and 3.2% of the ICP patients, respectively. However, no statistically significant difference in either delayed wound healing or fistula occurrence was observed between the two groups. The rate of surgical correction for VPD in the SMCP group was higher than in the ICP group. In the subset of 26 SMCP patients and 62 ICP patients who underwent speech evaluation, the median speech score value was 58.8 in the SMCP group and 66 in the ICP group, which was a statistically significant difference.ConclusionsSMCP and ICP were found to have similar complication rates, but SMCP had significantly worse speech outcomes.

  12. Submucous Clefts

    Science.gov (United States)

    ... are necessary to fully assess the palate. These tests include x-ray examination and nasopharyngoscopy (looking at the palate through a very small tube that is placed in the nose). These evaluations are most commonly done by members of a cleft palate team. If you suspect your child has ...

  13. Magnetic resonance imaging as a predictor of submucous cleft palate severity and guide for surgical intervention.

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    Argenta, Anne; Petropoulou, Kalliopi; Cray, Jim; Ford, Matthew; Jiang, Shao; Losee, Joseph; Grunwaldt, Lorelei

    2013-05-01

    Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outcomes. Previous studies show that MRI reliably identifies structural abnormalities in velopharyngeal musculature. This information has potential to assist with diagnosis and treatment decisions. The objectives of this study were to (1) develop a clinician-friendly MRI grading scale of SMCP anatomy, (2) identify correlations between radiographic cleft severity and clinical severity using Pittsburgh Weighted Speech Scores (PWSS), and (3) determine if MRI is a predictor of surgical efficacy in improving PWSS. Thirty patients presenting to our Cleft Palate-Craniofacial Clinic for evaluation of velopharyngeal insufficiency (VPI) and suspected SMCP were reviewed. VPI severity was clinically graded using PWSS. All patients underwent MRI to grade palatal abnormalities, using a novel MRI grading scale. PWSS and cleft severity on MRI were compared. A subgroup of patients (n = 19) underwent palatoplasty. Preoperative and postoperative PWSS were compared. Degree of PWSS improvement was then correlated with the preoperative MRI grade. Twenty-nine out of 30 MRIs demonstrated abnormal palate anatomy. Of the 30 patients evaluated, 5 clinically improved with speech therapy alone. In this subgroup, MRI severity did not correlate with PWSS (P = 0.06-0.6). Nineteen patients underwent palatoplasty. Of these, 14 demonstrated improved postoperative PWSS. There were no significant correlations between severity of cleft on imaging and preoperative PWSS or score improvement (P = 0.056-0.65). While MRI accurately identifies structural abnormalities of the soft palate, these abnormalities do not reliably correspond to clinical severity. Clinical examination including speech scores and dynamic speech testing, rather than static MRI, should guide treatment decisions and surgical indications.

  14. Is Cleft Severity Correlated With Intrinsic Growth Pattern? Observation From Unoperated Adult Patients With Submucous Cleft Palate.

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    Cao, Congcong; Xu, Xue; Shi, Bing; Zheng, Qian; Li, Jingtao

    2017-09-01

    This study aimed to evaluate the craniofacial morphology of unoperated adult submucous cleft palate (SMCP) patients and to explore the possible correlation between the intrinsic growth insufficiency of the maxillofacial complex and the severity of the cleft. A total of 20 unoperated SMCP patients, 20 unoperated overt cleft palate (OCP) patients, and 32 normal controls, ages between 18 and 30, were included for cephalometric analysis. One-way ANOVA and rank-sum tests were used for comparison, and the threshold of significance was at 95% (P  SMCP = OCP). Maxillary protrusion (∠ S-N-ANS, ∠ S-N-ANS) was similar between the SMCP group and the control, but significantly reduced in the OCP group (normal = SMCP > OCP). Significant differences in ∠ A-N-B were found between each of the 3 groups (normal > SMCP > OCP). Compared with normal, unoperated adult SMCP patients were of smaller mandible and shorter maxillae, but almost normal maxillary protrusion. Overt clefts demonstrated significantly more evident maxillary retrusion and crossbite than SMCP, indicating a correlation between the cleft severity and the intrinsic growth pattern of the maxillofacial complex.

  15. Incidence of bifid uvula and its relationship to submucous cleft palate and a family history of oral cleft in the Brazilian population.

    Science.gov (United States)

    Sales, Sizina Aguiar G; Santos, Maria Luiza; Machado, Renato Assis; Dias, Verônica Oliveira; Nascimento, Jairo Evangelista; Swerts, Mario Sérgio Oliveira; Júnior, Hercílio Martelli; Martelli, Daniella Reis Barbosa

    2017-08-24

    Bifid uvula is a frequently observed anomaly in the general population and can be regarded as a marker for submucous cleft palate. In this study aimed to determine the frequency of bifid uvula and submucous cleft palate and their relationship with oral clefts in a Brazilian population. We conducted a transversal, descriptive and quantitative study of 1206 children between August 2014 and December 2015. A clinical examination of the children was conducted by means of inspection of the oral cavity with the aid of a tongue depressor and directed light. After the clinical examination in children, parents answered a questionnaire with questions about basic demographic information and their family history of oral clefts in their first-degree relatives. After application of the questionnaires, the information collected was archived in a database and analyzed by the statistical program SPSS(®) version 19.0, by applying Chi-Square tests. Values with pcleft palate was not found in any child. When the family histories of children were examined for the presence of nonsyndromic cleft lip and/or cleft palate, no first degree relatives presented with the congenital anomaly. This study revealed that the incidence of bifid uvula and submucous cleft palate in this population was quite similar to previously reported incidence rates. Our study suggests an intensification of new reviews, with broader and diverse populations, seeking to associate the occurrence of bifid uvula, submucous cleft palate and oral clefts. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate.

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    Filip, Charles; Matzen, Michael; Aagenæs, Ingegerd; Aukner, Ragnhild; Kjøll, Lillian; Høgevold, Hans Erik; Tønseth, Kim

    2013-03-01

    Autologous fat transplantation to the velopharynx has been described in a few smaller studies including heterogeneous groups of patients for the treatment of velopharyngeal insufficiency (VPI). The aim of this study was to evaluate speech and to measure velopharyngeal closure with magnetic resonance imaging (MRI) in patients who underwent autologous fat transplantation for the treatment of persistent VPI of mild degree secondary to overt or submucous cleft palate. A prospective study of 16 patients with persistent VPI of mild degree secondary to overt or submucous cleft palate who underwent autologous fat transplantation to the velopharynx. The patients were injected with a median of 5.6 (3.8-7.6) ml autologous fat to the velopharynx. Pre- and 1-year postoperative audio recordings were blinded for scoring independently by three senior speech therapists. Hypernasality, hyponasality, nasal turbulence and audible nasal emission were scored on a five-point scale. Pre- and 1-year postoperative MRIs were obtained during vocal rest and during phonation in 12 patients. Data measured were the velopharyngeal distance in the sagittal plane and the velopharyngeal gap area in the axial plane. Hypernasality improved significantly (p=0.030), but not audible nasal emission (p=0.072) or nasal turbulence (p=0.12). The velopharyngeal distance during phonation decreased significantly (p=0.013), but not the velopharyngeal gap area (p=0.16). There was no significant correlation between speech and MRI results. Autologous fat transplantation to the velopharynx improved hypernasality significantly, but not audible nasal emission or nasal turbulence in patients with persistent VPI of mild degree secondary to overt or submucous cleft palate. Given the low number of patients and the lack of a control group, the value of fat transplantation for the treatment of mild VPI is not proven for sure. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by

  17. Velopharyngeal insufficiency, submucous cleft palate and a phonological disorder as the associated clinical features which led to the diagnosis of Jacobsen syndrome. Case report and review of the literature.

    Science.gov (United States)

    Ysunza, Antonio; Shaheen, Kenneth; Aughton, David J; Micale, Mark A; Merson, Richard; Rutkowski, Kris

    2013-09-01

    Jacobsen syndrome is an uncommon but well-known contiguous gene syndrome caused by partial deletion involving the long arm of chromosome 11. Most common features include: psychomotor impairment, facial dysmorphism, and thrombocytopenia. Cleft palate has been rarely reported. A case of Jacobsen syndrome confirmed by cytogenomic analysis is presented with review of the literature. Main clinical features were phonological disorder, submucous cleft palate (SMCP) and velopharyngeal insufficiency (VPI). VPI was corrected surgically according to findings of videonasopharyngoscopy and videofluoroscopy. It is concluded that clinicians should consider that VPI associated with SMCP may be the main manifestations of a chromosomal syndrome. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Cleft Lip and Cleft Palate

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    ... babies with cleft lip and cleft palate, the fusion never takes place or occurs only part way, ... Mayo Clinic Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for- ...

  19. The effect of age at surgery and compensatory articulation on speech outcome in submucous cleft palate patients treated with double-opposing Z-plasty: A 10-year experience.

    Science.gov (United States)

    Baek, Rong-Min; Kim, Baek-Kyu; Jeong, Jae Hoon; Ahn, Taeseon; Park, Mikyong; Han, Jihyeon

    2017-05-01

    Submucous cleft palate is a congenital deformity that may present as velopharyngeal insufficiency. The degree of anatomical abnormality varies widely among patients and does not predict severity of symptom. We present our 10-year experience treating submucous cleft palate patients with double opposing z-plasty and explore the effect of age at surgery and compensatory articulation on speech. Preoperative assessment included intraoral examination, nasoendoscopy, and perceptual speech evaluation. Age, gap size, and severity of hypernasality were assessed to determine the timing and type of surgery. A retrospective study of 74 submucous cleft palate patients undergoing double-opposing z-plasty from 2005 to 2016 by a single surgeon (Baek RM) was conducted. Double opposing z-plasty was modified to fully release all abnormal insertions of the levator veli palatini muscle. Postoperative velopharyngeal function was measured and statistical analyses were performed. The ages of patients at surgery ranged from 11 months to 19 years. Postoperatively 87 percent of the patients achieved velopharyngeal competency and 13 percent had remaining mild hypernasality. Age was a significant factor in predicting speech outcome, and patients receiving surgery prior to the age of 5.5 years had a higher normalization rate. Compensatory articulation did not have an impact on postoperative hypernasality. There were no cases of postoperative hyponasality or airway problems. Satisfactory speech outcome was achieved with the authors' protocol and modification of the double-opposing z-plasty. A comprehensive assessment of patient age, intraoral findings, severity of hypernasality, and gap size, is necessary for proper treatment of submucous cleft palate patients. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Cleft lip and palate

    Science.gov (United States)

    ... nose, and palate confirms a cleft lip or cleft palate. Medical tests may be done to rule out other possible ... in. Hearing problems are common in children with cleft lip or palate. Your child should have a hearing test at an early age, and it should be ...

  1. Cleft lip, cleft palate, and velopharyngeal insufficiency.

    Science.gov (United States)

    Fisher, David M; Sommerlad, Brian C

    2011-10-01

    This article provides an introduction to the anatomical and clinical features of the primary deformities associated with unilateral cleft lip-cleft palate, bilateral cleft lip-cleft palate, and cleft palate. The diagnosis and management of secondary velopharyngeal insufficiency are discussed. The accompanying videos demonstrate the features of the cleft lip nasal deformities and reliable surgical techniques for unilateral cleft lip repair, bilateral cleft lip repair, and radical intravelar veloplasty.

  2. Cleft Lip and Palate

    Science.gov (United States)

    ... special baby bottles that can help. Ear and hearing problems Kids with cleft palate can have hearing loss . ... will get regular hearing tests to check for hearing problems caused by fluid building up in the ears. ...

  3. Late detection of cleft palate

    NARCIS (Netherlands)

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

    2016-01-01

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

  4. Cleft Lip and Palate Repair.

    Science.gov (United States)

    Gatti, Gian Luca; Freda, Nicola; Giacomina, Alessandro; Montemagni, Marina; Sisti, Andrea

    2017-11-01

    Cleft lip and palate is the most frequent congenital craniofacial deformity. In this article, the authors describe their experience with cleft lip and palate repair. Data regarding patients presenting with primary diagnosis of cleft lip and/or palate, between 2009 and 2015, were reviewed. Details including demographics, type of cleft, presence of known risk factors, surgical details, and follow-up visits were collected. Documented complications were reported. Caregivers' satisfaction was assessed with a survey. The survey used to assess satisfaction with cleft-related features was based on the cleft evaluation profile (CEP). In addition, 4 assessors used visual analog scale (VAS) to assess the aesthetic satisfaction. Seven hundred fifty-two patients with primary diagnosis of cleft lip and/or palate underwent surgical correction at "S. Chiara" Hospital, 432 (57.45%) male and 320 (42.55%) female. The most common cleft types in our study were incomplete cleft palate (152 patients) and left unilateral complete cleft lip and palate (152 patients). Associated syndromes were found in 46 patients (6.12%). Cleft lip was repaired using a modified Tennison-Randall technique when the defect was unilateral, whereas a modified Mulliken technique was used for bilateral cleft lip. Cleft palate was repaired using the Bardach technique or Von Langenbeck technique at 5 to 6 months of age. Cleft lip and palate was repaired in several surgical steps. In total, complications were reported in 81 of 752 patients (14.16%). Average fathers' satisfaction score assessed using CEP was 4.5 (lip), 4.8 (nose), 4.7 (teeth), 4.8 (bite), 4.2 (breathing), 4.6 (profile). Average mothers' satisfaction score assessed using CEP was 4.3 (lip), 4.6 (nose), 4.4 (teeth), 4.5 (bite), 4.1 (breathing), 4.4 (profile). Average level of aesthetic satisfaction, assessed using VAS, was 8.7 (fathers), 8.1 (mothers), 7.9 (lay person), and 8.0 (senior cleft surgeon). The multidisciplinary management of children with

  5. CLEFT PALATE. FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    Science.gov (United States)

    RUTHERFORD, DAVID; WESTLAKE, HAROLD

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

  6. Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... lip or palate is often referred to a multidisciplinary team of experts for treatment. The team may include: ... receive follow-up care from members of the multidisciplinary team on issues of speech, hearing, growth, dental, and ...

  7. Cleft lip and palate repair

    Science.gov (United States)

    ... or cleft palate. Your child should have a hearing test early on, and it should be repeated over time. Your child may still have problems with speech after the surgery. This is caused by muscle problems in the palate. Speech therapy will help your child.

  8. Patterns of Cleft Lip and Cleft Palate in Northern Pakistan

    Directory of Open Access Journals (Sweden)

    Mansoor Khan

    2012-04-01

    Results: A total of 159 patients of cleft lip and cleft palate deformities were included in the study, having a mean age of 3.5+6.59 years and containing 59.1% males and 40.9% females with a ratio of 1.4:1. A cleft lip with palate, cleft palate and cleft lip were found in 51.6%, 31.4% and 17% of cases, respectively. Left-sided clefts were most common in the cleft lip with palate and the isolated cleft lip deformity. A cleft lip with palate was a male dominant variety (62.8% of cases, while in the cleft palate variety, the dominant gender was female. In 61.6% of cases, the parent had a consanguineous relationship. In 21.4% of cases, family history was positive for the cleft lip/palate. Other congenital anomalies were associated in 10.7% of cases. Conclusion: Cleft deformities of the lip and palate affect the male population more than females with cleft lips, in association with a cleft palate being the most common anomaly. Females are mainly affected by an isolated cleft palate. The high prevalence of these deformities in consanguineous marriages emphasizes educating people. The lower number of patients from distant distracts of Northern Pakistan calls for the attention of the health department. [Arch Clin Exp Surg 2012; 1(2.000: 63-70

  9. Cleft palate repair and variations

    Directory of Open Access Journals (Sweden)

    Agrawal Karoon

    2009-10-01

    Full Text Available Cleft palate affects almost every function of the face except vision. Today a child born with cleft palate with or without cleft lip should not be considered as unfortunate, because surgical repair of cleft palate has reached a highly satisfactory level. However for an average cleft surgeon palatoplasty remains an enigma. The surgery differs from centre to centre and surgeon to surgeon. However there is general agreement that palatoplasty (soft palate at least should be performed between 6-12 months of age. Basically there are three groups of palatoplasty techniques. One is for hard palate repair, second for soft palate repair and the third based on the surgical schedule. Hard palate repair techniques are Veau-Wardill-Kilner V-Y, von Langenbeck, two-flap, Aleveolar extension palatoplasty, vomer flap, raw area free palatoplasty etc. The soft palate techniques are intravelar veloplasty, double opposing Z-plasty, radical muscle dissection, primary pharyngeal flap etc. And the protocol based techniques are Schweckendiek′s, Malek′s, whole in one, modified schedule with palatoplasty before lip repair etc. One should also know the effect of each technique on maxillofacial growth and speech. The ideal technique of palatoplasty is the one which gives perfect speech without affecting the maxillofacial growth and hearing. The techniques are still evolving because we are yet to design an ideal one. It is always good to know all the techniques and variations so that one can choose whichever gives the best result in one′s hands. A large number of techniques are available in literature, and also every surgeon incorporates his own modification to make it a variation. However there are some basic techniques, which are described in details which are used in various centres. Some of the important variations are also described.

  10. Cleft palate cells can regenerate a palatal mucosa in vitro.

    NARCIS (Netherlands)

    Liu, J.; Lamme, E.N.; Steegers-Theunissen, R.P.M.; Krapels, I.P.C.; Bian, Z.; Marres, H.A.M.; Spauwen, P.H.M.; Kuijpers-Jagtman, A.M.; Hoff, J.W. Von den

    2008-01-01

    Cleft palate repair leaves full-thickness mucosal defects on the palate. Healing might be improved by implantation of a mucosal substitute. However, the genetic and phenotypic deviations of cleft palate cells may hamper tissue engineering. The aim of this study was to construct mucosal substitutes

  11. Improving Informed Consent for Cleft Palate Repair

    Science.gov (United States)

    2017-03-07

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

  12. Speech production of preschoolers with cleft palate

    National Research Council Canada - National Science Library

    Hardin-Jones, Mary A; Jones, David L

    2005-01-01

    The present investigation was conducted to examine the prevalence of preschoolers with cleft palate who require speech therapy, demonstrate significant nasalization of speech, and produce compensatory articulations...

  13. Olfactory deficits in boys with cleft palate.

    Science.gov (United States)

    Richman, R A; Sheehe, P R; McCanty, T; Vespasiano, M; Post, E M; Guzi, S; Wright, H

    1988-12-01

    An odor identification task was used to determine whether individuals with cleft palate (with or without cleft lip) also have an increased prevalence of olfactory deficits. Olfactory responses of 35 affected subjects (7 to 22 years of age) were compared with those of 68 subjects of comparable age without cleft palates. Subjects were requested to identify the smell of ten common household odors. They selected their responses from an alphabetized list of the test odorants. After a practice trial, the set of odorants was presented five times in randomized sequences. The percentage of correct responses increased with age for prepubertal and pubertal subjects without cleft palates. Although the olfactory scores of girls without cleft palates continued to increase after puberty, this trend was absent in boys. On the average, the girls with cleft palates, compared with only three of 34 boys without cleft palates, had olfactory scores less than 60% correct. There was no evidence of heterogeneity in the magnitude or direction of the relationship between any of the subtypes of cleft palate and olfactory dysfunction. In this study, cleft palate is more strongly associated with olfactory deficits in boys than in girls, suggesting the possibility that the deficit may be a sex-influenced trait.

  14. [Comparative morphometrical study on development of palatal shelves in cleft and non-cleft palate mice].

    Science.gov (United States)

    Cai, Zhi-gang; von Domarus, Helmut; Engel, Eveley

    2003-05-01

    To quantitatively compare the relationship between the congenital cleft palate and development of the palatal shelf. Fifty two pairs palatal shelves were macroscopic measured, and 60 series coronal sections were microscopically measured, which were precisely orientated in the coronal plane and serially sectioned at 7 micro m thickness. With the aid of computer imaging analysis system the widths and areas of the palatal shelves in vertical and coronal direction, the maximal areas of the palatal bone and palatal process and alveolar process were measured and compared quantitatively between the cleft group and non-cleft group. The widths and areas of palatal shelves in cleft foetuses showed significant reduction macroscopically and microscopically as well as the maximal areas of the palatal bone, in addition, both of two processes of the maxilla showed significant developmental deficiency. The palatal shelves show significant developmental hypoplasia in three dimension directions, which have significant correlation between palatal cleft and trisomic condition.

  15. Intrinsic effects of congenital cleft palate on craniofacial morphology and growth characteristics in puberty.

    Science.gov (United States)

    Iwasaki, Hiroshi; Kudo, Motonori; Yamamoto, Yuko

    2010-09-01

    Of the 12 children in prepuberty (then aged 9 years) with unoperated submucous cleft palate where we previously found a characteristic morphology of the maxilla, we examined changes in the maxillary morphology in their puberty (until age 14 years), aiming to determine the intrinsic effects of congenital cleft palate on their craniofacial morphology and growth characteristics, which also involve the formation of cranioface, by retrospectively comparing their findings and those of noncleft children with normal occlusion. Twelve Japanese children (7 girls and 5 boys) with unoperated submucous cleft palate at age 14 years were examined cephalometrically. None of them had undergone dentofacial orthopedic treatment of the maxilla. Their craniofacial morphologic characteristics were compared with those of 60 Japanese noncleft children aged 14 years (30 girls and 30 boys) with normal occlusion. The results were nearly identical to the previous findings when they were 9 years old: the maxillary length was short, the anterior part of the maxilla being retruded and the posterior part of the maxilla being in anterior position in the cleft children at age 14 years, compared with the noncleft children. In the craniofacial growth changes between the ages 9 and 14 years, an increase in the posterior upper facial height was markedly small, and the inclination of the palatal plane was promoted in the cleft children, compared with the noncleft children. We confirmed that the intrinsic effects of congenital cleft were influential on the morphology of cranioface and its growth changes, which also involve craniofacial formation.

  16. Pathology of the palatal aponeurosis in cleft palate.

    Science.gov (United States)

    Koch, K H; Grzonka, M A; Koch, J

    1998-11-01

    The palatal aponeurosis is a controversial structure, both in terms of its anatomy and its function. This article points out a pathologic finding in the cleft palate condition that has not been previously described. By means of surgical dissections, this study demonstrates in detail that the palatal aponeurosis exists even in cleft palates, but it is disrupted, malpositioned, and folded in two layers. This dissection method has been performed on more than 150 patients with cleft of the hard and soft palate, with or without cleft of the lip and alveolus. At the time of operation, the children were between 6 and 8 months of age. It is possible to dissect the two layers of the palatal aponeurosis, to unfold the aponeurosis, and to form a tough tendinous plane. For a functional physiologic reconstruction of the cleft palate, it is necessary not only to reconstruct the levator veli palatini and palatopharyngeus muscle slings, but also to approximate and suture the fibers of the palatal aponeurosis to the corresponding fibers of the opposite side after unfolding them in a medio-dorso-cranial direction. In this manner, a continuous palatal aponeurosis can be created, which subsequently can serve as a transmitter of the muscle forces.

  17. Magnetic resonance imaging of cleft palate

    Energy Technology Data Exchange (ETDEWEB)

    Naito, Yasushi; Tasaka, Yasuyuki; Honjo, Iwao; Nishimura, Kazumasa; Nakano, Yoshihisa

    1987-03-01

    Magnetic resonance imaging (MRI) of the nasopharynx and the eustachian tube was performed in five patients with cleft palate and compared with the results of those without this anomaly. Various degrees of deformity of the eustachian tube cartilage were found in cleft palate patients. The levator veli palatini muscles were situated more laterally in cleft palate patients than in normal subjects. Also, changes in the position of these muscles after palatoplasty were clearly depicted by MRI. Besides several autopsy reports, this is the first demonstration of the characteristic anomaly around the eustachian tube by a non-invasive method.

  18. Cleft Lip and Palate Repair: Our Experience.

    Science.gov (United States)

    Gatti, Gian Luca; Freda, Nicola; Giacomina, Alessandro; Montemagni, Marina; Sisti, Andrea

    2017-09-12

    Cleft lip and palate is the most frequent congenital craniofacial deformity. In this article, the authors describe their experience with cleft lip and palate repair. Data regarding patients presenting with primary diagnosis of cleft lip and/or palate, between 2009 and 2015, were reviewed. Details including demographics, type of cleft, presence of known risk factors, surgical details, and follow-up visits were collected. Documented complications were reported. Caregivers' satisfaction was assessed with a survey. The survey used to assess satisfaction with cleft-related features was based on the cleft evaluation profile (CEP). In addition, 4 assessors used visual analog scale (VAS) to assess the aesthetic satisfaction. Seven hundred fifty-two patients with primary diagnosis of cleft lip and/or palate underwent surgical correction at "S. Chiara" Hospital, 432 (57.45%) male and 320 (42.55%) female. The most common cleft types in our study were incomplete cleft palate (152 patients) and left unilateral complete cleft lip and palate (152 patients). Associated syndromes were found in 46 patients (6.12%). Cleft lip was repaired using a modified Tennison-Randall technique when the defect was unilateral, whereas a modified Mulliken technique was used for bilateral cleft lip. Cleft palate was repaired using the Bardach technique or Von Langenbeck technique at 5 to 6 months of age. Cleft lip and palate was repaired in several surgical steps. In total, complications were reported in 81 of 752 patients (14.16%). Average fathers' satisfaction score assessed using CEP was 4.5 (lip), 4.8 (nose), 4.7 (teeth), 4.8 (bite), 4.2 (breathing), 4.6 (profile). Average mothers' satisfaction score assessed using CEP was 4.3 (lip), 4.6 (nose), 4.4 (teeth), 4.5 (bite), 4.1 (breathing), 4.4 (profile). Average level of aesthetic satisfaction, assessed using VAS, was 8.7 (fathers), 8.1 (mothers), 7.9 (lay person), and 8.0 (senior cleft surgeon). The multidisciplinary management of children with

  19. 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

  20. Lip Prints and Inheritance of Cleft Lip and Cleft Palate

    Science.gov (United States)

    CJ, Manasa Ravath; HC, Girish; Hegde, Ramesh B; JK, Savita

    2014-01-01

    Background: Labial mucosa has elevations and depressions forming a pattern called ‘Lip Prints’. Parents of patients with cleft lip &/or palate are known to have a particular lip print pattern. Objectives: Analysis of lip prints and relationship between Cheiloscopy and inheritance of cleft lip &/or cleft palate. Methodology: The study included 100 subjects [study groupparents with children having cleft lip &/or cleft palate, 50 fathers and 50 mothers) and 50 subjects (control group-parents having children without cleft lip &/or cleft palate, 25 fathers and 25 mothers. The lip prints of the subjects were obtained using the cellophane method and analysed using Suzuki & Tsuchihashi classification of lip prints. The data was subjected to Chi- Square test, Fisher Exact test and Student t-test [two tailed, independent]. Results: A new whorl pattern was present in the study group. The groove count was higher in the fathers’ than in the mothers’ prints in the upper lip and vice versa in the lower lip. Conclusion: The new pattern was present in the study group in a significant number of cases. The groove count was significantly high in the study group. These two parameters can be of significant value to similar future studies. PMID:25177633

  1. Facts about Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... children with orofacial clefts may have issues with self-esteem if they are concerned with visible differences between ... commit" type="submit" value="Submit" /> Information For… Media Policy Makers Language: English (US) Español (Spanish) File ...

  2. Evaluation of Teeth Development in Unilateral Cleft Lip and Palate ...

    African Journals Online (AJOL)

    2018-02-23

    CBCT). The tomography images obtained as high resolution medical images on the computer control system (MIMICS 15.0, ..... outcome of surgical and orthodontic correction of bilateral clefts of lip, palate, and alveolus. Cleft Palate ...

  3. Cleft palate repair and velopharyngeal dysfunction.

    Science.gov (United States)

    Hopper, Richard A; Tse, Raymond; Smartt, James; Swanson, Jordan; Kinter, Sara

    2014-06-01

    After studying this article, the participant should be able to: (1) Describe the technical details common to all cleft palate repairs that optimize outcomes and minimize complications. (2) Explain the subjective and objective evaluation of speech in children with cleft palate. (3) Practice with an increased awareness of the management of complications associated with cleft palate repair. (4) Design a treatment plan for velopharyngeal dysfunction. Goals of a successful cleft palate repair include separation of the oral and nasal components without fistula, achieving sufficient velar length, and creating functional transverse orientation of the levator muscle sling. A number of techniques have been described to achieve these goals, but they all have the following technical details in common: elevation of oral mucosal flaps based on the greater palatine arteries, tension free nasal lining mobilization, and functional intervelar muscle dissection. After palate repair, speech evaluation needs to be performed by an objective interdisciplinary team following a standardized protocol. Identification of velopharyngeal insufficiency secondary to an incompetent nasopharyngeal port will necessitate secondary speech surgery. These secondary techniques include pharyngeal flaps, soft palate lengthening, or pharyngeal sphincters, which should be tailored to optimize speech, while minimizing the risk of obstructive sleep apnea.

  4. Management of Cleft Lip and Palate in Nigeria: A Survey

    African Journals Online (AJOL)

    2018-01-24

    6 days ago ... Background: Clefts of the lip and/or palate are the most common congenital craniofacial defects and second only to ... Keywords: Cleft lip, management, palate, Nigeria, survey. Management of Cleft Lip and Palate in .... With regard to the timing for surgical intervention, although majority of surgeons carry out ...

  5. 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...

  6. Cleft palate only: current concepts.

    Science.gov (United States)

    Tettamanti, L; Avantaggiato, A; Nardone, M; Silvestre-Rangil, J; Tagliabue, A

    2017-01-01

    Cleft palate only (CPO) is one of the most common congenital malformations worldwide. The etiopathogenesis of CPO is not completely understood. Environmental factors, such as smoking, alcohol consumption, intake of drugs during pregnancy, advanced paternal age, have been demonstrated to be a risk of CPO, but conflicting results have also been published. Insufficient intake of folic acid during the pregnancy has been suggested to increase the risk for CPO. The demonstrated risk for siblings and the higher risk for monozygotic twins suggest a genetic etiopathogenesis for CPO. In some cases of CPO a prevalent mode of inheritance has been reported, but oligogenic models with reduced penetrance, and the risk related to environmental factors have also been proved. One of the first manifestations associated with CPO is difficulty with feeding. Aerophagia is a problem in these infants with CPO and requires more frequent burping and slower feeding. The inability to generate intraoral breath pressure due to nasal air emission in CPO children frequently manifests as articulation difficulties, particularly consonant weakness, and unintelligible speech. Hearing disorders are prevalent among individuals with CPO, as a result of chronic otitis media with effusion due to eustachian tube dysfunction. A multidisciplinary team is essential to manage the many aspects of CPO. In treating CPO, the reconstructive surgeon works in cooperation with otolaryngologists, dentists and orthodontists, speech pathologists, audiologists, geneticists, psychiatrists, maxillofacial surgeons, social workers, and prosthodontists. CPO can be considered a genetically complex disease, but new knowledge and new therapeutic approaches have greatly improved the quality of life of these children. Prenatal diagnosis is an important step in the treatment of this disease.

  7. Genetics of Cleft Lip and Cleft Palate

    OpenAIRE

    Leslie, Elizabeth J.; Marazita, Mary L.

    2013-01-01

    Orofacial clefts are common birth defects and can occur as isolated, nonsyndromic events or as part of Mendelian syndromes. There is substantial phenotypic diversity in individuals with these birth defects and their family members: from subclinical phenotypes to associated syndromic features that is mirrored by the many genes that contribute to the etiology of these disorders. Identification of these genes and loci has been the result of decades of research using multiple genetic approaches. ...

  8. 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...

  9. Cleft lip and palate: diagnosis and management.

    Science.gov (United States)

    Taib, Bilal G; Taib, Adnan G; Swift, Andrew C; van Eeden, Simon

    2015-10-01

    Cleft lip and palate is the most common congenital facial anomaly in children, which can affect appearance, speech, hearing, growth, psychosocial wellbeing and social integration. This article provides an overview of the condition for the benefit of all health-care professionals.

  10. Asymmetrical soft palate cleft repair: preliminary results.

    Science.gov (United States)

    Bütow, K-W; Engelbrecht, H; Naidoo, S

    2014-06-01

    The reconstructions of the asymmetrical soft palate cleft is a surgical challenge when it comes to achieving symmetry and optimal soft palate muscular function. Three different versions of the intravelar veloplasty have been used: the intravelar veloplasty (1969) (type I), the modification according to anatomical defects (1991) (type II), and the modification using part of Sommerlad's technique and part of Ivanov's technique (2008) (type III). The perioperative outcomes of the type II and type III intravelar veloplasty were assessed and compared in asymmetrical cleft cases. Two hundred and seventy-seven soft palate clefts were reconstructed: 153 type II and 124 type III. Of these, 49 were asymmetrical (17.7%); 23 underwent the type II procedure and 26 the type III procedure. Of the type II procedure cases, 30.4% remained asymmetrical postoperatively compared to 3.8% of the type III cases. The uvula appeared subjectively atrophic in 47.8% of the type II cases and in 7.7% of type III cases. Oro-nasal fistula occurred in 13.0% of the type II cases and 3.8% of the type III cases. Speech results will only be assessed after 4 years of age. The type III modified intravelar veloplasty has had a major beneficial impact on patients who had an asymmetrical soft palate cleft. Copyright © 2014. Published by Elsevier Ltd.

  11. Periodontal Status Among Patients With Cleft Lip (CL), Cleft Palate (CP) and Cleft Lip, Alveolus and Palate (CLAP) In Chennai, India. A Comparative Study.

    Science.gov (United States)

    Nagappan, N; John, Joseph

    2015-03-01

    Long term health of the stomatognathic system as well as esthetic aspects is the therapeutic goals in patients with oro facial clefts. The aim of this study was to assess and compare the periodontal status of patients with cleft lip (CL), cleft palate (CP) and cleft lip, alveolus and palate (CLAP) reporting to a hospital in Chennai, India. The study group consisted of 80 cleft patients. Subjects were divided into three groups. Group 1: patients with cleft lip (CL), Group 2: subjects with cleft palate (CP) and Group 3: subjects with cleft lip alveolus and palate (CLAP). Community Periodontal Index for Treatment needs CPITN Index was recorded. Among the 80 study subjects, 51 (63.8%) were males and 29 (36.2%) were females. Among the 26 study subjects with cleft lip, 10 (38.5%) had healthy periodontium, 4 (15.4%) had bleeding on probing and 12 (46.1%) had calculus. Mean number of sextants coded for healthy and bleeding was maximum among the subjects with cleft palate. Mean number of sextants coded for calculus was maximum among the subjects with cleft lip alveolus and palate. Prevalence of periodontal disease is high among patients with cleft lip, alveolus and palate (35%) than in Cleft lip (32.5%) and Cleft Palate (32.5%). Gingivitis and Calculus is predominantly high in patients with Cleft Palate and Cleft Lip respectively.

  12. Articulation proficiency and error pattern of cleft palate children with delayed hard palate closure.

    Science.gov (United States)

    Wu, J; Chen, Y R; Noordhoff, M S

    1988-07-01

    Prior to 1982, children with cleft palate received delayed hard palate closure at Chang Gung Memorial Hospital. In this treatment, soft palate is usually repaired with Widmaier palatoplasty at about 18 months with surgery; hard palate is not closed until the age of 6 or 7. Our previous study indicated that the articulation skill of the cleft palate children before delayed hard palate closure is generally far inferior to the non-cleft children of the same age. Further investigation was carried out to look into the articulation proficiency and error patterns of the cleft palate children undergoing delayed hard palate closure. Data of 47 children (32 boys, 15 girls) were analyzed. Articulation proficiency was compared in four phoneme categories: nasals, plosives, fricatives and affricates. The results indicated that affricates are most difficult for Chinese cleft palate children to pronounce. At age 5, just before the hard palate closure, none of the phonemes is produced correctly except nasals.

  13. Cleft deformities (lip and palate)

    African Journals Online (AJOL)

    dell

    The gestational period in which these drugs where taken was not stated so we could not ascertain their influence on the embryogenesis of the neonates born with clefts. 5/17 mothers reported to have suffered from syphilis in the past; although it is considered to be one of the teratogenic infections, the association was not ...

  14. Cleft lip and palate surgery in children: Anaesthetic considerations ...

    African Journals Online (AJOL)

    Background: The Care of cleft patients is very challenging. Team cleft care is usually lacking in many developing countries due to shortage of qualified manpower. This study is aimed at highlighting anaesthetic challenges in the management of cleft in children. Patients and Methods: This was a study of cleft lip and palate ...

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

    Directory of Open Access Journals (Sweden)

    Boloor Vinita

    2010-01-01

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

  16. [Prenatal diagnosis of cleft lip with or without cleft palate: retrospective study and review].

    Science.gov (United States)

    Guyot, A; Soupre, V; Vazquez, M-P; Picard, A; Rosenblatt, J; Garel, C; Gonzales, M; Marlin, S; Benifla, J-L; Jouannic, J-M

    2013-04-01

    To evaluate the management of prenatally diagnosed cleft lip with or without cleft palate and the immediate postnatal outcome. Retrospective study of all cases of cleft lip with or without cleft palate referred to our fetal medicine unit, between January 2005 and January 2011. The anatomical type of cleft, associated malformations, and the postnatal outcome were reviewed. Forty-three cases of fetal cleft lip with or without cleft palate were reviewed. The mean gestational age at diagnosis was 24 weeks ± 4. The postnatal distribution of clefts was: 30 cleft lip and palate (70%) and 13 cleft lip (30%). The prenatal diagnosis of the cleft type was exact in 27 cases (62.8%). Nine cases had associated anomalies (21%), detected prenatally in three cases (37.5%). There was no karyotypical abnormality. Six pregnancies were terminated (14%). The immediate postnatal outcome was comparable with unselected newborns. The prenatal diagnosis of cleft lip with or without cleft palate is correct, with two thirds of exact diagnoses. Large clefts palate are the best detected. Associated malformations cannot always be diagnosed by prenatal ultrasound, but have to be searched for because they modify the fetal outcome. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  17. Cleft palate, retrognathia and congenital heart disease in velo-cardio-facial syndrome: a phenotype correlation study.

    Science.gov (United States)

    Friedman, Marcia A; Miletta, Nathanial; Roe, Cheryl; Wang, Dongliang; Morrow, Bernice E; Kates, Wendy R; Higgins, Anne Marie; Shprintzen, Robert J

    2011-09-01

    Velo-cardio-facial syndrome (VCFS) is caused by a microdeletion of approximately 40 genes from one copy of chromosome 22. Expression of the syndrome is a variable combination of over 190 phenotypic characteristics. As of yet, little is known about how these phenotypes correlate with one another or whether there are predictable patterns of expression. Two of the most common phenotypic categories, congenital heart disease and cleft palate, have been proposed to have a common genetic relationship to the deleted T-box 1 gene (TBX1). The purpose of this study is to determine if congenital heart disease and cleft palate are correlated in a large cohort of human subjects with VCFS. This study is a retrospective chart review including 316 Caucasian non-Hispanic subjects with FISH or CGH microarray confirmed chromosome 22q11.2 deletions. All subjects were evaluated by the interdisciplinary team at the Velo-Cardio-Facial Syndrome International Center at Upstate Medical University, Syracuse, NY. Each combination of congenital heart disease, cleft palates, and retrognathia was analyzed by Chi square or Fisher exact test. For all categories of congenital heart disease and cleft palate or retrognathia no significant associations were found, with the exception of submucous cleft palate and retrognathia (nominal p=0.0325) and occult submucous cleft palate and retrognathia (nominal p=0.000013). Congenital heart disease and cleft palate do not appear to be correlated in human subjects with VCFS despite earlier suggestions from animal models. Possible explanations include modification of the effect of TBX1 by genes outside of the 22q11.2 region that may further influence the formation of the palate or heart, or the presence of epigenetic factors that may effect genes within the deleted region, modifying genes elsewhere, or polymorphisms on the normal copy of chromosome 22. Lastly, it is possible that TBX1 plays a role in palate formation in some species, but not in humans. In VCFS

  18. Does Cleft Palate Width Correlate With Veau Classification and Outcome?

    Science.gov (United States)

    Wu, Robin; Cheraghlou, Shayan; Parsaei, Yassmin; Travieso, Roberto; Steinbacher, Derek M

    2017-07-01

    Wider cleft palates are thought to be associated with increased complications and poorer outcomes following cleft palate repair. Objective cleft palate photographic measurement and assessment of complications have not been previously performed. The purpose of this study is to quantitatively characterize a series of cleft palate dimensions and to investigate possible correlations with Veau classification and intra-, peri-, and postoperative outcomes. The analytic sample included primary cleft palate repairs performed by the senior author over a 2-year period. Standard photographs of clefts taken at the time of repair were analyzed using Image-J software. Demographic, intraoperative, perioperative, and postoperative information were collected. Width measurements were correlated with Veau classification, intraoperative variables, perioperative variables, and adverse outcomes. Statistical tests performed included simple regression analyses and multiple regression analysis. Out of 70 patients, 50 had adequate photographic documentation for inclusion in the study; 44% of patients were classified as Veau I with an average cleft width of 5.4 mm, 28% Veau II with an average of 8.9 mm, 16% Veau III with an average of 11.3 mm, and 12% Veau IV with an average of 10.0 mm. No patients exhibited postoperative bleeding, dehiscence, airway problems, infection, fistula formation, or return to the operating room. The authors found that increasing cleft width significantly predicts increasing Veau classification (P clefts) significantly predicts fluid emission (P cleft width did not predict fluid emission. Increased cleft width did not significantly predict length of stay. Our data demonstrate that wider preoperative cleft palates correlate with Veau classification, increased operating time, and slightly worsened postoperative sequela. There were no perioperative instances of bleeding, dehiscence, respiratory complications, infection, fistula formation, and return to

  19. EPIDEMIOLOGICAL SURVEY OF TOOTH DECAY IN YOUNG CHILDREN WITH CLEFT LIP AND PALATE

    OpenAIRE

    Liliana-Gabriela HALIŢCHI; Agripina ZAHARIA; Oana-Maria DARABĂ; Daniela Ivona TOMIŢĂ; Codruţa ILIESCU; Cătălina GÎRBEA; Veronica PINTILICIUC ŞERBAN

    2017-01-01

    Aim. Evaluation of the extension of caries risk and incidence of decays of temporary teeth in children with cleft lip and palate. Materials and methods. The study was conducted on a sample of 64 children with various types of cleft lip and palate (31 children with unilateral cleft lip and palate, 18 children with bilateral cleft lip and palate, 5 children with cleft lip and 10 children with cleft palate), aged between 3 and 6 years, investigated in the Orthodontics Cli...

  20. Single-Word Intelligibility in Speakers with Repaired Cleft Palate

    Science.gov (United States)

    Whitehill, Tara L.; Chau, Cynthia H.-F.

    2004-01-01

    Many speakers with repaired cleft palate have reduced intelligibility, but there are limitations with current procedures for assessing intelligibility. The aim of this study was to construct a single-word intelligibility test for speakers with cleft palate. The test used a multiple-choice identification format, and was based on phonetic contrasts…

  1. Evaluation of Teeth Development in Unilateral Cleft Lip and Palate ...

    African Journals Online (AJOL)

    2018-02-23

    5 days ago ... Evaluation of Teeth. Development in Unilateral Cleft Lip and Palate Patients in Mixed. Dentition by Using Medical Image Control Systems. Niger J Clin Pract. 2018 ... cleft lip and palate, on obtaining a solid model of the tooth structure by using ..... study performed by Maciel et al.,[38] enamel changes in.

  2. Perioperative adverse airway events in cleft lip and palate repair ...

    African Journals Online (AJOL)

    Background: Airway-related problems account for the majority of anaesthetic morbidity in paediatric anaesthesia, but more so for cleft lip and palate repair. The aim of this study was to assess the frequency, pattern, management and outcome of adverse airway events during the perioperative period in cleft lip and palate ...

  3. Nonsurgical Management of Adult Cleft Palate Patient

    Directory of Open Access Journals (Sweden)

    Poornima Ksheerasagara

    2012-01-01

    Full Text Available Successful cleft lip and palate rehabilitation requires an interdisciplinary approach. When the patient is reluctant to interdisciplinary approach then the problem becomes even more challenging. This case report describes management of 18-year-old postpubertal male cleft patient who was referred by a plastic surgeon for the orthodontic correction of irregular upper teeth. Patient had maxillary deficiency. Initially maxillary advancement was planned to address the problem. In the mid course of treatment, patient was reluctant to orthognathic surgery. Therefore, an alternate nonsurgical orthodontic camouflage treatment plan was designed with extractions of lower first premolars and proclination of upper anteriors. Though the presented case showed improved esthetics with nonsurgical orthodontic camouflage treatment, which is not possible in all cases. Interdisciplinary approach is must to get optimal facial and dental esthetics.

  4. Genetic studies of cleft lip and palate in dogs.

    Science.gov (United States)

    Cooper, H K; Mattern, G W

    1971-06-01

    In a colony of Shih-Tzu dogs, familial cleft palate frequently associated with hind leg deformity was demonstrated. Colonies of dogs centered around purebred wirehaired terrier females or a mongrel collie male, both with isolated cleft palate did not result in cleft offspring with one exception. Reproductive fitness of a low order was encountered as expected. Difficulty was experienced in raising affected animals. Multiple associated congenital anomalies were found. These include convulsive disorders, clubfoot and dysgenesis of musculature of the thigh.

  5. Craniofacial morphology in unoperated infants with isolated cleft palate. A cephalometric analysis in three projections

    DEFF Research Database (Denmark)

    Hermann, N.V.; Kreiborg, S.; Jensen, B.L.

    58th Annual Meeting of the American Cleft Palate-Craniofacial Association, Minneapolis, Craniofacial morphology, unoperated infants, isolated cleft palate, cephalometric analysis, three projections......58th Annual Meeting of the American Cleft Palate-Craniofacial Association, Minneapolis, Craniofacial morphology, unoperated infants, isolated cleft palate, cephalometric analysis, three projections...

  6. Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome

    OpenAIRE

    Reema Sharma Dhar; Amitava Bora

    2014-01-01

    Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and ro...

  7. Cross-linguistic perspectives on speech assessment in cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Henningsson, Gunilla

    2012-01-01

    This chapter deals with cross linguistic perspectives that need to be taken into account when comparing speech assessment and speech outcome obtained from cleft palate speakers of different languages. Firstly, an overview of consonants and vowels vulnerable to the cleft condition is presented. Then......, consequences for assessment of cleft palate speech by native versus non-native speakers of a language are discussed, as well as the use of phonemic versus phonetic transcription in cross linguistic studies. Specific recommendations for the construction of speech samples in cross linguistic studies are given....... Finally, the influence of different languages on some aspects of language acquisition in young children with cleft palate is presented and discussed. Until recently, not much has been written about cross linguistic perspectives when dealing with cleft palate speech. Most literature about assessment...

  8. Dental fear in children with a cleft lip and/or cleft Palate

    NARCIS (Netherlands)

    Vogels, W.E.J.C.; Aartman, I.H.A.; Veerkamp, J.S.J.

    2011-01-01

    Objective: To assess the level of dental fear in children with a cleft lip and/or palate, to compare this level with that of a normative group testing the hypothesis that children with a cleft lip and/or palate have a higher level of dental anxiety than children from the general population, and to

  9. Use of Biphasic Continuous Positive Airway Pressure in Premature Infant with Cleft Lip–Cleft Palate

    Directory of Open Access Journals (Sweden)

    Lovya George

    2015-10-01

    Full Text Available Preterm infants (PIs often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure ventilation. PI with a cleft lip and palate often fail noninvasive respiratory support and require continued intubation and mechanical ventilation. We are presenting the first case report of a PI with cleft lip and palate who was managed by biphasic nasal continuous positive airway pressure.

  10. Velopharyngeal valving during speech, in patients with velocardiofacial syndrome and patients with non-syndromic palatal clefts after surgical and speech pathology management.

    Science.gov (United States)

    Ysunza, Antonio; Carmen Pamplona, Maria; Santiago Morales, M A

    2011-10-01

    Velocardiofacial syndrome (VCFS) is the most common genetic syndrome associated with cleft palate. There are reports describing several anomalies associated with the palatal cleft in patients with VCFS, which can affect the characteristics of the velopharyngeal insufficiency (VPI) in these cases. The purpose of this study is to assess velopharyngeal sphincter function during speech, using videonasopharyngoscopy (VNP) and videofluoroscopy (VF), in patients with VCFS, as compared with patients with non-syndromic palatal clefts (NSCP). Twenty patients with VCFS corroborated by a FISH test were studied. All patients showed a palatal cleft. All patients had received previous management including speech therapy and palatal repair. These patients underwent a thorough clinical speech evaluation, including VNP and VF. Twenty patients with NSCP matched by sex, type of cleft and within the age range of the patients with VCFS were studied as controls. From the patients with VCFS, seventeen patients showed a submucous cleft palate. Three patients showed sub-total cleft of the secondary palate. Fourteen patients (70%) showed a coronal velopharyngeal closure pattern. Six patients (30%) showed a circular pattern. In contrast, 10 patients (50%) from the NSCP group showed a circular pattern, two of them showed a Passavant's ridge. Seven patients (35%) showed a coronal pattern and 3 patients (15%) showed a saggital pattern. Mean velum (V) and lateral pharyngeal wall (LPW) motion were significantly decreased in patients with VCFS (V=46% vs 71%; LPW=14% vs 30%; Pspeech was significantly increased in patients with VCFS (34.57% vs 67.37%; Pspeech is significantly different in patients with VCFS as compared with patients with NSCP. Several anomalies associated with the palatal cleft in patients with VCFS can explain these differences. Thus, the surgical approach for repairing a palatal cleft should consider these differences. Moreover, surgical planning should be performed according to

  11. Cytokeratin expression in palatal and marginal mucosa of cleft palate patients.

    NARCIS (Netherlands)

    Guo, J.; Maltha, J.C.; He, S.G.; Krapels, I.P.C.; Spauwen, P.H.M.; Steegers-Theunissen, R.P.M.; Hoff, J.W. Von den

    2006-01-01

    OBJECTIVE: The margin of a palatal cleft is a unique anatomical site since the palatal mucosa is continuous with the nasal or nasopharyngeal mucosa. The aim of this study was to compare the expression patterns of cytokeratins and basal membrane components of the mucosa in the area of the cleft.

  12. The development of speech production in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Chapman, Kathy

    2012-01-01

    The purpose of this chapter is to provide an overview of speech development of children with cleft palate +/- cleft lip. The chapter will begin with a discussion of the impact of clefting on speech. Next, we will provide a brief description of those factors impacting speech development...... for this population of children. Finally, research examining various aspects of speech development of infants and young children with cleft palate (birth to age five) will be reviewed. This final section will be organized by typical stages of speech sound development (e.g., prespeech, the early word stage...

  13. An Innovative Approach to Evaluate the Morphological Patterns of Soft Palate in Oral Submucous Fibrosis Patients: A Digital Cephalometric Study

    OpenAIRE

    Chintamaneni Raja Lakshmi; Dharmavaram Ayesha Thabusum; Sujana Mulk Bhavana

    2016-01-01

    Oral submucous fibrosis (OSMF) is a chronic insidious disease affecting mucosa and submucosa of oral cavity and soft palate. The present study aimed to evaluate the morphology of soft palate in normal individuals and OSMF patients using lateral cephalometry and to compare and correlate these variants of soft palate with different stages of OSMF. 100 subjects were included in the study, who were divided into two groups. Group I included 50 subjects with clinical diagnosis of OSMF and Group II ...

  14. Craniofacial Morphology and Growth Comparisons in Children With Robin Sequence, Isolated Cleft Palate, and Unilateral Complete Cleft Lip and Palate

    DEFF Research Database (Denmark)

    Hermann, N. V.; Kreiborg, S.; Darvann, Tron Andre

    2003-01-01

    Objective: Comparison of early craniofacial morphology and growth in children with nonsyndromic Robin Sequence (RS), isolated cleft palate (ICP), and unilateral complete cleft lip and palate (UCCLP). Subjects: One hundred eight children with cleft: 7 with RS, 53 with ICP, and 48 with UCCLP were...... included in the study. The children were drawn from the group of all Danish children with cleft born 1976 through 1981. Method: Three-projection infant cephalometry. Results: The craniofacial morphology in the RS, ICP, and UCCLP groups had some common characteristics: a wide maxilla with decreased length...

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

    Science.gov (United States)

    Jamilian, Abdolreza; Lucchese, Alessandra; Darnahal, Alireza; Kamali, Zinat; Perillo, Letizia

    2016-01-01

    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. 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. 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 cleft area.

  16. NiTi Expansion in Operated Unilateral Cleft Palate Patients

    Directory of Open Access Journals (Sweden)

    K Y Poornima

    2011-01-01

    Conclusion : NiTi expansion in operated cleft patients, showed mainly orthodontic expansion. The significant change in the maxillary inter- molar region is due to the direct placement of NiTi palatal expander to 16, 26.

  17. Helping parents cope with a cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Jenny Steyn

    1980-09-01

    Full Text Available For the layman, the area of cleft palate is one shrouded in mystery and half-knowledge. An unrepaired cleft lip and palate is an unpleasant, if not alarming sight, and parents are not always totally convinced by the reassuring words of doctors and nurses that “ plastic surgeons do a marvellous job on cleft palate babies.” They need proof that their baby will indeed look and be like any other baby within a few months. Equally important, they need reassurance that whatever feelings they may experience when their babies are born are natural and appropriate ones. As the baby grows and develops parents may need practical assistance, emotional support and information regarding their baby’s condition. It is essentially for these reasons that a fellowship group has been established under the auspices of SAIDA (Southern Africa Inherited Disorders Association to help parents and families of cleft lip and palate children.

  18. Computational Embryology and Predictive Toxicology of Cleft Palate

    Science.gov (United States)

    Capacity to model and simulate key events in developmental toxicity using computational systems biology and biological knowledge steps closer to hazard identification across the vast landscape of untested environmental chemicals. In this context, we chose cleft palate as a model ...

  19. Prevention of communication problems associated with cleft palate.

    Science.gov (United States)

    Pannbacker, M

    1988-09-01

    The purpose of this paper is to review principles of preventative intervention and their application to communication problems associated with cleft palate. Ten specific suggestions and activities are described.

  20. Psychological interventions for the adolescent with cleft lip and palate

    National Research Council Canada - National Science Library

    Kapp-Simon, K A

    1995-01-01

    .... Accomplishment of each of these tasks is potentially more difficult for the adolescent who is also coping with the ongoing treatment demands of cleft lip and palate or other craniofacial disorders (CFA...

  1. Psychological Interventions for the Adolescent with Cleft Lip and Palate

    National Research Council Canada - National Science Library

    Kapp-Simon, Kathleen A

    1995-01-01

    .... Accomplishment of each of these tasks is potentially more difficult for the adolescent who is also coping with the ongoing treatment demands of cleft lip and palate or other craniofacial disorders (CFA...

  2. 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

  3. Communicative abilities in toddlers and in early school age children with cleft palate

    NARCIS (Netherlands)

    Ruiter, Jolien S.; Korsten-Meijer, Astrid G. W.; Goorhuis-Brouwer, Siena M.

    Objectives: Evaluation of improvement in communicative abilities in children with nonsyndromic cleft palate. Methods: Longitudinal retrospective case history Study. Out of 117 children with cleft lip and/or cleft palate born in 1998, 1999 and 2000 and enrolled in the cleft palate team of the

  4. The recognition and management of isolated cleft palate.

    Science.gov (United States)

    Williams, Jennifer

    2012-10-01

    Cleft palate in the absence of a cleft lip (i.e. isolated cleft palate) causes upset for parents whenever it is diagnosed; however, delayed diagnosis at over 24 hours of age can cause increased distress due to feeding difficulties and fear of what else could have been missed. One third of cleft palates are not recognised within 24 hours of delivery. Considerable effort is being made to ensure early diagnosis following delivery, by raising awareness of midwives, neonatologists and paediatricians of the need to visualise the whole palate including the uvula, and through changes to the Newborn Screening Programme. Community practitioners including health visitors and school nurses are ideally placed to recognise key feeding and speech features associated with cleft palate, and then to refer to one of the nine regional cleft teams (England and Wales). There is a managed clinical network in Scotland, and there are also centres in Northern Ireland and Eire. Multidisciplinary cleft care commences in conjunction with local health services following referral to the regional specialist team.

  5. Speech and language development in toddlers with and without cleft palate

    NARCIS (Netherlands)

    Priester, G. H.; Goorhuis-Brouwer, S. M.

    Objective: The effect of early palate closure on speech and language development in children with cleft palate. Design: Comparative study. Setting: University Medical Center Groningen, Cleft Palate Team (The Netherlands). Materials and methods: Forty-three toddlers with cleft palate and thirty-two

  6. 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

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

    NARCIS (Netherlands)

    Verwoerd, C. D.; Mladina, R.; Nolst Trenité, G. J.; Pigott, R. W.

    1995-01-01

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

  8. Management of cleft lip and palate in Nigeria: A survey ...

    African Journals Online (AJOL)

    The highest number of surgeons was from southwest geopolitical region while the northeast had the least. Fifty‑eight (84.1%) were specialists with the fellowships. Forty‑seven had been cleft surgeons for <10 years. Majority undertook lip repair between 3 and 4 months while 50% did cleft palate at or more than 9 months.

  9. Associated anomalies in cleft lip and palate: analysis of 811 ...

    African Journals Online (AJOL)

    2017-08-03

    Aug 3, 2017 ... incidence of associated anomalies among patients with combined cleft lip and palate [3]. We recommend that doctors in Sub-Saharan Africa. (and worldwide) dealing with cleft patients (often dental, facio-maxillary and plastic surgeons) request. Type of. Anomalies. CLA BCLP UCLP ICP Total (%).

  10. 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.

  11. 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...

  12. Bilateral optic disc pit with maculopathy in a patient with cleft lip and cleft palate

    Directory of Open Access Journals (Sweden)

    Anisha Seth

    2015-01-01

    Full Text Available Optic disc pit (ODP is small, gray-white, oval depression found at the optic nerve head. It is a congenital defect that occurs due to imperfect closure of superior edge of the embryonic fissure. Cleft lip and palate are also congenital midline abnormalities occurring due to defect in the fusion of frontonasal prominence, maxillary prominence and mandibular prominence. There is only one case report describing the occurrence of ODP in a young patient with cleft lip and palate who also had basal encephalocele. We describe a 52-year-old patient with congenital cleft lip and palate with bilateral ODP with maculopathy but without any other midline abnormality.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    Nonsyndromic orofacial clefts are a common complex birth defect caused by genetic and environmental factors and/or their interactions. A previous genome-wide linkage scan discovered a novel locus for cleft lip with or without cleft palate (CL/P) at 9q22-q33. To identify the etiologic gene, we....... Significant SNP and haplotype association signals (p=1.45E-08) narrowed the interval to a 200Kb region containing: FOXE1, C9ORF156 and HEMGN. Association results were replicated in CL/P families of European descent and when all populations were combined the two most associated SNPs, rs3758249 (p= 5.01E-13......) and rs4460498 (p=6.51E-12) were located inside a 70Kb high LD block containing FOXE1. Association signals for Caucasians and Asians clustered 5' and 3' of FOXE1, respectively. Isolated cleft palate (CP) was also associated indicating that FOXE1 plays a role in two phenotypes thought to be genetically...

  14. Simplified feeding appliance for an infant with cleft palate

    Directory of Open Access Journals (Sweden)

    Shaila Masih

    2014-01-01

    Full Text Available A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient′s weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.

  15. Prevalence of cleft lip and cleft palate in rural north-central guatemala.

    Science.gov (United States)

    Matute, Jorge; Lydick, Elaine A; Torres, Olga R; Owen, Karen K; Jacobsen, Kathryn H

    2015-05-01

    To estimate the number of new cases of cleft lip and cleft palate in the department (state) of Alta Verapaz, Guatemala, in 2012. Cross-sectional survey of midwives from communities identified through a two-stage cluster-sampling process. Midwives were asked how many babies they had delivered in the past year and how many of those newborns had various types of birth defects, as illustrated in pictures. Indigenous Mayan communities in rural north-central Guatemala. Midwives (n = 129) who had delivered babies in the previous year. Reports of babies born with cleft lip and cleft palate. A 1-year prevalence rate of 18.9 per 10,000 for cleft lip and 4.7 per 10,000 for cleft palate was estimated for Alta Verapaz. None of the cases of cleft lip also had cleft palate. The indigenous communities in north-central Guatemala might have a relatively high cleft lip prevalence rate compared with the global average.

  16. The Effect of DynaCleft® on Cleft Width in Unilateral Cleft Lip and Palate Patients.

    Science.gov (United States)

    Vinson, LaQuia

    2017-01-01

    The specific aim of this retrospective cross-sectional study was to assess the efficacy of DynaCleft® as a method of presurgical orthopedics with infants with a unilateral cleft lip and cleft palate who used an oral obturator. Data was collected from 25 infants all of comparable age diagnosed with a unilateral complete cleft lip and palate. Eight patients used DynaCleft ® and an obturator (Group Alpha) and seventeen patients only had an obturator (Group Beta). Maxillary impression casts were obtained from each patient at the initial clinic visit and at the time of cleft lip repair. Differences in alveolar cleft width were compared between the two groups. Casts were measured twice by one observer using a digital caliper. Group Alpha began treatment on an average age of 24.25 days and Group Beta an average of 15.35 days of age. The average cleft width of Group Alpha was 8.13 mm and after treatment it was 4.59 mm. The average cleft width of Group Beta was 8.09 mm and 6.92 mm after treatment. Results of paired t-tests and two-sample t-test showed that cleft width changes between the two groups were significant (P = .03). DynaCleft ® significantly decreased the size of the alveolar cleft width compared to infants who did not use it. Providers should consider using DynaCleft® for patients who may not have access to infant maxillary orthopedics.

  17. 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.

  18. 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.

  19. Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome

    Directory of Open Access Journals (Sweden)

    Reema Sharma Dhar

    2014-01-01

    Full Text Available Ectrodactyly-ectodermal dysplasia-cleft (EEC syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and role of a dentist in the multidisciplinary treatment approach have been elaborated in this case report.

  20. Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome.

    Science.gov (United States)

    Dhar, Reema Sharma; Bora, Amitava

    2014-01-01

    Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and role of a dentist in the multidisciplinary treatment approach have been elaborated in this case report.

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

    DEFF Research Database (Denmark)

    Andersen, Kristian

    2012-01-01

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

  2. 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 < .02). At time of palatoplasty, 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.

  3. Prevalence, diagnosis and outcome of cleft lip with or without cleft palate in The Netherlands

    NARCIS (Netherlands)

    Fleurke-Rozema, J. H.; Van De Kamp, K.; Bakker, M. K.; Pajkrt, E.; Bilardo, C. M.; Snijders, R. J. M.

    2016-01-01

    Objective To examine the accuracy and timing of diagnosis of fetal cleft lip with or without cleft palate (CL +/- P) in the years following the introduction of a national screening program, and to assess the completeness and accuracy of information in The Netherlands Perinatal Registry. Methods A

  4. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer

    OpenAIRE

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-01-01

    Background Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Methods Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this exp...

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Manoel, Rosana Ribeiro

    2010-09-01

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

  7. A comparative cephalometric study for adult operated cleft palate and unoperated cleft palate patients.

    Science.gov (United States)

    Ye, Bin; Wu, Yeke; Zhou, Yuqiao; Jing, Huan; Hu, Jing; Zhang, Guozhi

    2015-09-01

    To determine the effects of a cleft deformity unilateral cleft lip and palate (UCLP) and the subsequent surgical interventions on maxillary growth. This retrospective study evaluated the lateral cephalograms of 3 groups of individuals: 40 adult patients with ULCP who underwent surgery for both lip and palate; 40 adult patients with ULCP who underwent surgery for lip only; and 40 age- and gender-matched noncleft controls. Differences in jaw morphology among them were analyzed statistically. Adult UCLP patients in both groups showed maxillary hypoplasia in anteroposterior and vertical directions compared with noncleft control adults. Significant differences (p ≤ 0.01) in the ANB (subspinale-nasion-supramentale angle), NA-FH (the angle formed between Frankfort horizontal plane and the plane from nasion to subspinale), MP-FH (the angle formed between mandibular plane and Frankfort horizontal plane), and GoMe/SN (the ratio between length of mandibular body and length of anterior cranial base) were found between the two UCLP patient groups. Although maxillary growth in the two UCLP groups was less than that in the noncleft control group, the anteroposterior growth in the UCLP patients with palatoplasty was even less than that in the UCLP patients with unoperated palate. There may be an intrinsic deficiency of maxillary anteroposterior and vertical development in UCLP patients compared with the noncleft controls. Palatoplasty can further limit the anteroposterior growth of maxilla but has no detrimental effect on maxillary vertical development. The mandible is rotated clockwise after palatoplasty in UCLP patients. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate.

    Science.gov (United States)

    Sheahan, Patrick; Miller, Ian; Sheahan, Jerome N; Earley, Michael J; Blayney, Alexander W

    2003-07-01

    Otitis media with effusion is known to be very common among children with cleft palate, however, less is known regarding the natural history and outcome in this group. The purpose of the present study was to examine the incidence, natural history, treatment, and outcome of middle ear disease in children with clefts. A questionnaire was sent to the parents of all children registered on the cleft lip and palate database at our institution. The medical records of all respondents were also reviewed. Statistical analysis of the results was performed using Fisher's exact test in contingency tables and binary logistic regression analyses, where appropriate. 397 fully completed questionnaires were returned. Ear disease was much more common in children with cleft palate, or cleft lip and palate, than in children with cleft lip. Among children with cleft palate, ear problems (infections and/or hearing loss) were most prevalent in the 4-6-year-old age group. However, ear problems persisted at a substantial level for many years after this; only after the age of 12 years did problems appear to settle. The incidence of below normal current hearing and of surgery for chronic otitis media was significantly related to history of ear infections (P=0.000 and 0.000, respectively), and to increased number of ventilation tube insertions (P=0.000 and 0.000, respectively). Middle ear disease is common in children with cleft palate, and, unlike the case for children without clefts, has a prolonged recovery, and a substantial incidence of late sequelae. The higher incidence of below normal hearing and surgery for chronic otitis media in children undergoing a greater number of ventilation tube insertions, although most likely reflecting an increased underlying severity of otitis media in these children, also underlines the lack of long-term benefits of ventilation tubes in this group.

  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. 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...

  11. [Audiological and Otological Status of 45 Infants with Cleft Palate].

    Science.gov (United States)

    Shi, Dian-yin; Zhou, Lian; Shang, Ying-ying

    2016-04-01

    To study the audiological and otological status of cleft palate infants with the application of distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), tympanometry with 1000 Hz and 226 Hz probe tones. Totally 45 cleft palate infants aged 8-24 months were included in the study. Most of them were examined for DPOAE, ABR and two frequency tympanometry. Most infants failed the three tests,among whom 6.7% ears passed DPOAE and 33.3% of ears had normal ABR hearing threshold. In addition, 8.9% of ears turned out normal in the 1000 Hz probe-tone tympanometry, and 13.3% were type A in the 226 Hz probe-tone tympanometry. Finally, 1000 Hz tympanometry had more agreement with DPOAE and latency of ABR wave I than 226 Hz tympanometry. Most cleft palate infants have audiological and otological problems, which should be evaluated in a more comprehensive manner.

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

    Directory of Open Access Journals (Sweden)

    Bajevska Jagoda

    2017-01-01

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

  13. FOXE1 association with both isolated cleft lip with or without cleft palate, and isolated cleft palate

    Science.gov (United States)

    Moreno, Lina M.; Mansilla, Maria Adela; Bullard, Steve A.; Cooper, Margaret E.; Busch, Tamara D.; Machida, Junichiro; Johnson, Marla K.; Brauer, David; Krahn, Katherine; Daack-Hirsch, Sandy; L'Heureux, Jamie; Valencia-Ramirez, Consuelo; Rivera, Dora; López, Ana Maria; Moreno, Manuel A.; Hing, Anne; Lammer, Edward J.; Jones, Marilyn; Christensen, Kaare; Lie, Rolv T.; Jugessur, Astanand; Wilcox, Allen J.; Chines, Peter; Pugh, Elizabeth; Doheny, Kim; Arcos-Burgos, Mauricio; Marazita, Mary L.; Murray, Jeffrey C.; Lidral, Andrew C.

    2009-01-01

    Nonsyndromic orofacial clefts are a common complex birth defect caused by genetic and environmental factors and/or their interactions. A previous genome-wide linkage scan discovered a novel locus for cleft lip with or without cleft palate (CL/P) at 9q22–q33. To identify the etiologic gene, we undertook an iterative and complementary fine mapping strategy using family-based CL/P samples from Colombia, USA and the Philippines. Candidate genes within 9q22–q33 were sequenced, revealing 32 new variants. Concurrently, 397 SNPs spanning the 9q22–q33 2-LOD-unit interval were tested for association. Significant SNP and haplotype association signals (P = 1.45E − 08) narrowed the interval to a 200 kb region containing: FOXE1, C9ORF156 and HEMGN. Association results were replicated in CL/P families of European descent and when all populations were combined the two most associated SNPs, rs3758249 (P = 5.01E − 13) and rs4460498 (P = 6.51E − 12), were located inside a 70 kb high linkage disequilibrium block containing FOXE1. Association signals for Caucasians and Asians clustered 5′ and 3′ of FOXE1, respectively. Isolated cleft palate (CP) was also associated, indicating that FOXE1 plays a role in two phenotypes thought to be genetically distinct. Foxe1 expression was found in the epithelium undergoing fusion between the medial nasal and maxillary processes. Mutation screens of FOXE1 identified two family-specific missense mutations at highly conserved amino acids. These data indicate that FOXE1 is a major gene for CL/P and provides new insights for improved counseling and genetic interaction studies. PMID:19779022

  14. 3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate

    Czech Academy of Sciences Publication Activity Database

    Rusková, H.; Bejdová, Š.; Peterka, Miroslav; Krajíček, V.; Velemínská, J.

    2014-01-01

    Roč. 42, č. 5 (2014), e140-e147 ISSN 1010-5182 Grant - others:GA UK(CZ) 309611 Institutional support: RVO:68378041 Keywords : unilateral cleft of lip and palate * palate shape * surface scanning Subject RIV: FF - HEENT, Dentistry Impact factor: 2.933, year: 2014

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

    NARCIS (Netherlands)

    D. Budolfsen; G. Galiwango; Anke Luyten; A. Hodges; E. D'haeseleer; K. van Lierde; H. Vermeersch

    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

  16. Cleft Palate Children: Performance In Auditory Processing Tests

    OpenAIRE

    Boscariol M.; Andre K.D.; Feniman M.R.

    2009-01-01

    Many children with auditory processing disorders have a high prevalence of otitis media, a middle ear alterations greatly prevalent in children with palatine and lip clefts. Aim: to check the performance of children with palate cleft alone (PC) in auditory processing tests. Prospective study. Materials and Methods: twenty children (7 to 11 years) with CP were submitted to sound location tests (SL), memory for verbal sounds (MSSV) and non verbal sounds in sequence (MSSNV), Revised auditory fus...

  17. BITE FORCE EVALUATION IN SUBJECTS WITH CLEFT LIP AND PALATE

    OpenAIRE

    Carla Renata Sipert; Ana Claudia Martins Sampaio; Inge Elly Kiemle Trindade; Alceu Sérgio Trindade Junior

    2009-01-01

    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 (in...

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

    OpenAIRE

    Sipert, Carla Renata; Sampaio,Ana Claudia Martins; Trindade, Inge Elly Kiemle; TRINDADE JUNIOR, Alceu Sérgio

    2009-01-01

    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 (in...

  19. Analysis of complications in primary cleft lips and palates surgery.

    Science.gov (United States)

    Zhang, Zhaoqiang; Fang, Silian; Zhang, Qingbin; Chen, Lei; Liu, Yarui; Li, Kefeng; Zhao, Yan

    2014-05-01

    A series of retrospectively recorded patients with cleft lip and palate was uniquely investigated to demonstrate and analyze the complications after cleft repairing operations in a selected Chinese population. From January 2005 to January 2012, a selected group of 2100 patients with cleft lip and/or palate who have complete records were chosen from a large sample in the units. Complete data were retrieved, including sex, age, clinical classification, surgical modality, complications, and follow-up results. The complications were classified into 2 categories: early and long-term complications. After surgery, most patients with cleft lip remained in the hospital for 7 days and cleft palate repairs for 10 days. A standard regimen of antibiotics was administered for 3 to 5 days clinically. Of the 2100 patients, there were 1360 males and 760 females who had congenital cleft deformity with complete clinical records in the department of oral and maxillofacial surgery. The age distribution was as follows: 1600 patients in the group of 3 months to 2 years, 320 patients in the group of 2 to 10 years, 130 patients in the group of 11 to 19 years, and 50 patients in the group of older than 20 years. As to the treatment modality, cleft lips were repaired by rotation advancement method with various minor modifications or Tennison modality. The cleft palates were closed using the von Langenbeck, Veau/Wardill/Kilner, or Furlow technique. The overall complication rate was 16.8% of the patients. Of the early complications, there were 6 cases of asphyxia, 17 cases of pyrexia, 5 cases of edema of the respiratory tract, 8 cases of upper respiratory tract infection, 6 cases of bronchiolitis, 7 cases of pneumonia, 9 cases of diarrhea and vomiting, 6 cases of hemorrhage, 5 patients of odontoptosis, 11 cases of erosion of the corner of mouth, 5 cases of drowsiness, 11 cases of incision dehiscence, 9 cases of wound infection, 6 cases of palatal dehiscence/fistula, 3 cases of nostril floor

  20. COMPARATIVE STUDY OF DERMATOGLYPHIC FINGERTIP PATTERNS AND ‘ atd ’ ANGLE IN PATIENTS OF CLEFT LIP WITH OR WITHOUT CLEFT PALATE AND ISOLATED CLEFT PALATE WITH NORMAL POPULATION

    OpenAIRE

    Siraz M.; Meraj M

    2015-01-01

    Dermatoglyphics is the scientific study of epidermal ridges and their configurations on the volar aspect of palmar and plantar region. The main etiological factor of cleft lip and cleft palate is genetic in nature. The influences of genetic and environmental factors on early development are often reflected by the altered dermatoglyphics. AIMS...

  1. Contractile Properties of Single Permeabilized Muscle Fibers from Congenital Cleft Palates and Normal Palates of Spanish Goats

    Science.gov (United States)

    Hanes, Michael C.; Weinzweig, Jeffrey; Kuzon, William M.; Panter, Kip E.; Buchman, Steven R.; Faulkner, John A.; Yu, Deborah; Cederna, Paul S.; Larkin, Lisa M.

    2009-01-01

    Background Analysis of the composition of muscle fibers constituent to a cleft palate could provide significant insight into the cause of velopharyngeal inadequacy. The authors hypothesized that levator veli palatini muscle dysfunction inherent to cleft palates could affect the timing and outcome of cleft palate repair. Methods Single, permeabilized muscle fibers from levator veli palatini muscles of three normal (n = 19 fibers) and three chemically induced congenital cleft palates (n = 21 fibers) of 14-month-old goats were isolated, and contractile properties were evaluated. The maximum isometric force and rate constants of tension redevelopment (ktr) were measured, and the specific force and normalized power were calculated for each fiber. Results The ktr measures indicate that cleft fibers are predominantly fast-fatigable; normal fibers are slow fatigue-resistant: after a 10-minute isometric contraction, fibers from cleft palates had a loss of force 16 percent greater than that from normal palates (p = 0.0001). The cross-sectional areas of the fibers from cleft palates (2750 ± 209 μm2) were greater (p = 0.05) than those from normal palates (2226 ± 143 μm2). Specific forces did not differ between the two groups. Maximum normalized power of fibers from cleft palates (11.05 ± 1.82 W/l) was greater (p = 0.0001) than fibers from normal palates (1.60 ± 0.12 W/l). Conclusions There are clear physiologic differences in single muscle fibers from cleft palates and normal palates: cleft palate fibers are physiologically fast, have greater fatigability, and have greater power production. Detection of functional and/or fiber type differences in muscles of cleft palates may provide preoperative identification of a patient's susceptibility to velopharyngeal inadequacy and permit early surgical intervention to correct this clinical condition. PMID:17440342

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

    DEFF Research Database (Denmark)

    Jakobsen, L.P.; Borup, R.; Vestergaard, J.

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  4. Postpalatoplasty Eustachian tube function in young children with cleft palate.

    Science.gov (United States)

    Alper, Cuneyt M; Losee, Joseph E; Mandel, Ellen M; Seroky, James T; Swarts, J Douglas; Doyle, William J

    2012-07-01

    To characterize Eustachian tube function using the forced response test in young children with cleft palate with or without cleft lip after palatoplasty with tympanostomy tubes inserted prepalatoplasty and compare these results with those of a 1986 study that evaluated a similar population using identical methods. Outpatient research clinic. A total of 34 children with cleft palate were tested at an average age of 18.6 ± 4.0 months. MAIN OUTCOME MEASUREs: Passive and active measures for the forced response test. Of the sample, 13 ears could not be tested, and tests on 24 ears were incomplete. The forced response test showed that the passive Eustachian tube function parameters were similar to those of normal adults and children. The percentage of ears that showed tubal dilation with swallowing was 60%. The active resistance and dilatory efficiency were similar to those of a normal adult population. A 1986 study of Eustachian tube function in postpalatoplasty subjects with cleft palate (37 ears) aged 15 to 26 months documented Eustachian tube dilation with swallowing in 84% of the ears. In the present study, which focused on a similar population, the frequency of tubal dilation was 60%. Nonetheless, both frequencies are significantly greater than the dilation frequency of 27% reported for 56 ears of subjects with cleft palate tested between 3 months and 18 years with tympanostomy tubes inserted for persistent otitis media with effusion. This suggests that dilation during the forced response test may be a prognostic marker for those children with cleft palate who will resolve their ear disease at an early age.

  5. Temporal characteristics of nasalization in speakers with and without cleft palate.

    Science.gov (United States)

    Ha, Seunghee; Kuehn, David P

    2011-03-01

    The purposes of the study were to compare the temporal characteristics of nasalization between speakers with cleft palate with or without cleft lip and normal adult speakers and to investigate the relationship between acoustic temporal measures and perceived nasality. Fifteen speakers with cleft palate with or without cleft lip and 15 speakers without cleft palate aged 13 to 45 years participated in this study. Two listeners judged the degree of nasality in speakers with cleft palate with or without cleft lip. Two distinct acoustic energies derived from the mouth and nose were recorded simultaneously while speakers were producing the speech tasks /pimip/, /pamap/, and /pumup/. Absolute and proportional measures related to nasalization duration were obtained. Speakers with cleft palate with or without cleft lip exhibited more extensive acoustic nasalization in the time domain than did speakers without cleft palate with or without cleft lip. Speakers without cleft palate with or without cleft lip showed larger nasalization-duration ratios in the high vowel contexts than in the low vowel context. Speakers with cleft palate with or without cleft lip did not exhibit distinct differences in nasalization-duration ratios among the vowel contexts. The acoustic measurements reflecting temporal patterns of oral-nasal acoustic impedance were related to the perception of hypernasality. These results suggest that the speakers with cleft palate with or without cleft lip showed longer duration of acoustic nasalization than speakers without cleft palate with or without cleft lip. Temporal characteristics of acoustic nasalization grew longer as the degree of perceived hypernasality increased. The positive correlation between temporal measures of acoustic nasalization and degree of perceived nasality suggests that temporal measures of nasalization would provide supplementary diagnostic information in relation to the degree of hypernasality.

  6. Prevalence, pattern and perceptions of cleft lip and cleft palate among children born in two hospitals in Kisoro District, Uganda

    OpenAIRE

    Kesande, Teopista; Muwazi, Louis Mugambe; Bataringaya, Aisha; Rwenyonyi, Charles Mugisha

    2014-01-01

    Background Cleft lip with or without cleft palate is one of the most common congenital anomalies that affect the oro-facial region. The aim of the study was to determine the period prevalence, pattern and perceptions of cleft lip and cleft palate in children born between 2005 and 2010 in two hospitals in Kisoro District, Uganda. Methods The study involved a retrospective review of medical records of mothers who delivered live babies between January 2005 and December 2010 in Kisoro Hospital an...

  7. Maxillary growth in a congenital cleft palate canine model for surgical research.

    Science.gov (United States)

    Paradas-Lara, Irene; Casado-Gómez, Inmaculada; Martín, Conchita; Martínez-Sanz, Elena; López-Gordillo, Yamila; González, Pablo; Rodríguez-Bobada, Cruz; Chamorro, Manuel; Arias, Pablo; Maldonado, Estela; Ortega, Ricardo; Berenguer, Beatriz; Martínez-Álvarez, Concepción

    2014-01-01

    We have recently presented the Old Spanish Pointer dog, with a 15-20% spontaneous congenital cleft palate rate, as a unique experimental model of this disease. This study aimed to describe the cleft palate of these dogs for surgical research purposes and to determine whether congenital cleft palate influences maxillofacial growth. Seven newborn Old Spanish Pointer dogs of both sexes, comprising a cleft palate group (n = 4) and a normal palate group (n = 3), were fed using the same technique. Macroscopic photographs and plaster casts from the palate, lateral radiographs and computer tomograms of the skull were taken sequentially over 41 weeks, starting at week 5. The cleft morphology, the size and the tissue characteristics in these dogs resembled the human cleft better than current available animal models. During growth, the cleft width varies. Most of the transverse and longitudinal measures of the palate were statistically lower in the cleft palate group. The cleft palate group showed hypoplasia of the naso-maxillary complex. This model of congenital cleft palate seems suitable for surgical research purposes. A reduced maxillofacial pre- and post-natal development is associated to the congenital cleft palate in the Old Spanish Pointer dog. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Morphometric analysis of brain shape in children with nonsyndromic cleft lip and/or palate.

    Science.gov (United States)

    Chollet, Madeleine B; DeLeon, Valerie B; Conrad, Amy L; Nopoulos, Peg

    2014-12-01

    The purpose of this study was to test for differences in brain shape among children with cleft palate only (n = 22), children with cleft lip and palate (n = 35), and controls (n = 39) using Euclidean distance matrix analysis. Sixteen percent of interlandmark distances differed between children with cleft palate only and controls, 10% differed between children with cleft lip and palate and controls, and 10% differed between children with cleft palate only and children with cleft lip and palate. Major differences in brain shape associated with cleft lip and/or palate included posterior expansion of the occipital lobe, reorientation of the cerebellum, heightened callosal midbody, and posterior displacement of the caudate nucleus and thalamus. Differences in brain shape unique to cleft palate only and to cleft lip and palate were also identified. These results expand upon previous volumetric studies on brain morphology in individuals with cleft lip and/or palate and provide additional evidence that the primary defect in cleft lip and/or palate results in both facial and brain dysmorphology. © The Author(s) 2013.

  9. Awareness, knowledge and attitude on cleft lip and palate among ...

    African Journals Online (AJOL)

    2012-11-09

    Nov 9, 2012 ... Background: Adequate knowledge and awareness of cleft lip and palate (CLP) deformity may help to counter the negative beliefs and attitudes toward the condition. The objective of this study was to assess the level of awareness, knowledge and attitude of women attending antenatal clinics about CLP.

  10. Awareness, knowledge and attitude on cleft lip and palate among ...

    African Journals Online (AJOL)

    Awareness, knowledge and attitude on cleft lip and palate among antenatal clinic attendees of tertiary hospitals in Nigeria. ... administered questionnaire was conducted among 200 women attending antenatal clinics in three Federal Government Teaching Hospitals in the Northern and Southwestern regions of Nigeria.

  11. Production of Two Nasal Sounds by Speakers With Cleft Palate.

    Science.gov (United States)

    Bressmann, Tim; Radovanovic, Bojana; Harper, Susan; Klaiman, Paula; Fisher, David; Kulkarni, Gajanan V

    2016-12-29

    Manyspeakers with cleft palate develop atypical consonant productions, especially for pressure consonants such as plosives, fricatives, and affricates. The present study investigated the nature of nasal sound errors. The participants were eight female and three male speakers with cleft palate between the ages of 6 to 20. Speakers were audio-recorded, and midsagittal tongue movement was captured with ultrasound. The speakers repeated vowel-consonant-vowel with the vowels /α/, /i/, and /u/ and the alveolar and velar nasal consonants /n/ and //. The productions were reviewed by three listeners. The participants showed a variety of different placement errors and insertions of plosives, as well as liquid productions. There was considerable error variability between and within speakers, often related to the different vowel contexts. Three speakers co-produced click sounds. The study demonstrated the wide variety of sound errors that some speakers with cleft palate may demonstrate for nasal sounds. Nasal sounds, ideally in different vowel contexts, should be included in articulation screenings for speakers with cleft palate, perhaps more than is currently the case.

  12. Prevention of Communication Problems Associated with Cleft Palate.

    Science.gov (United States)

    Pannbacker, Mary

    1988-01-01

    The paper reviews principles of preventative intervention and their application to communication problems associated with cleft palate. Ten specific suggestions (such as continuing professional education, identification of adenoidal atrophy, and prompt referral for secondary management) and activities are described. (Author/DB)

  13. Distraction osteogenesis for cleft palate closure: A finite element analysis

    Directory of Open Access Journals (Sweden)

    Majid Ghasemianpour

    2014-01-01

    Full Text Available Background: Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process. Materials and Methods: DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1 and posteriorly (models A2 and B2. Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D finite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA. Results: In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1. Conclusion: The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively.

  14. 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. © 2014 American Academy of Forensic Sciences.

  15. 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.

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

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    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.

  17. Management of cleft lip and palate in adults

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2009-10-01

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

  18. Palatoglossal fusion with cleft palate and hypoplasia of cerebellar vermis

    Directory of Open Access Journals (Sweden)

    Shailesh Solanki

    2016-01-01

    Full Text Available A new-born male presented within 12 h of birth with respiratory distress. On examination and workup, he had palatoglossal fusion, cleft palate and hypoplasia of the cerebellar vermis. A 2.5 Fr endotracheal tube was inserted into the pharynx through nostril as a nasopharyngeal stent, following which his respiratory distress improved. Once child was optimised, then feeding was started by nasogastric tube and feeds were tolerated well. Elective tracheostomy and gastrostomy were done, followed by release of adhesions between the tongue and palate at a later stage. Review of literature suggests that palatoglossal fusion is uncommon and presents as an emergency. Mostly, these oral synechiae are associated with digital and/or cardiac anomaly. Other disorders associated with intra-oral synechiae include congenital alveolar synechiae, van der Woude syndrome, popliteal pterygium syndrome and oromandibular limb hypogenesis syndrome. The authors report a hitherto undescribed association of palatoglossal fusion with cleft palate and hypoplasia of the cerebellar vermis.

  19. Occipital meningoencephalocele with Cleft Lip, Cleft Palate and Limb Abnormalities- A Case Report

    Science.gov (United States)

    T, Sadeesh; Swer, Mary Hydrina; Rao, Sudha

    2014-01-01

    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. PMID:25653933

  20. Assessment of Speech in Primary Cleft Palate by Two‑layer Closure ...

    African Journals Online (AJOL)

    INTRODUCTION. The history of treatment of cleft palate deformities can be traced back many centuries. The variety of techniques used in palatoplasty have ... Peruvian civilizations has described persons with untreated cleft deformities who lived until they were adults.[1] For many centuries, cleft palates were often confused ...

  1. 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

  2. Hearing and otitis media with effusion in young adults with cleft lip and palate.

    Science.gov (United States)

    Flynn, Traci; Möller, Claes; Lohmander, Anette; Magnusson, Lennart

    2012-09-01

    Speech recognition in noise is affected when otitis media with effusion (OME) is present in young adults with unilateral cleft lip and palate. The objective of this study was to describe the hearing and performance on auditory tasks of young adults with unilateral cleft lip and palate as compared to young adults without cleft lip and palate. Twenty-six young adults with unilateral cleft lip and palate and 23 young adults without cleft lip and palate participated in the study. Pure tone audiometry, tympanometry, speech recognition in noise at the word and sentence level, and masking level difference were examined. Results revealed elevated hearing thresholds in the young adults with cleft lip and palate as compared with young adults without cleft lip and palate. No differences concerning speech recognition in noise and binaural processing were observed between the young adults with cleft lip and palate and those without. However, there was poorer speech recognition performance in those adults with unilateral cleft lip and palate and OME on the day of testing as compared with young adults with unilateral cleft lip and palate without OME on the day of testing.

  3. 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.

  4. CIRPLAST: Cleft Lip and Palate Missions in Peru.

    Science.gov (United States)

    Navarro, Carlos E

    2015-06-01

    The author presents a 20-year experience leading cleft lip and palate surgical volunteer missions in Peru for CIRPLAST, a nonprofit volunteer plastic surgery goodwill program that has provided free surgery for patients with cleft lip and palate deformities in remote areas of Peru. Surgical procedures were performed by the author, together with a group of experienced plastic surgeons, under the auspices of the Peruvian Plastic Surgery Society, and local health authorities. CIRPLAST missions are scheduled annually in different locations around Peru. Selected patients for surgery after adequate screening are photographed, and their cleft deformity is recorded. Scheduled patients or their parents, when they are minors, sign an informed consent form. Patients operated on in any given day are examined and photographed 1 day after surgery, before discharge. Between 30 and 35 patients are operated on at each mission site. About 2 weeks after the mission, patients are checked and photographed, and the outcome of surgery is recorded. Complications that may occur are recorded and treated by the CIRPLAST team as soon as possible. Almost all operations are performed under general endotracheal anesthesia coupled by local anesthesia containing a vasoconstrictor, to reduce bleeding and facilitate tissue dissection. All wounds of the lip and palate are closed with absorbable sutures, to avoid the need for suture removal. After cleft lip surgery, patients go to the recovery room for monitoring by nurses until they recover completely. A total of 6108 cleft lip and palate repairs, primary and secondary, were performed by CIRPLAST in 141 missions, between May 12, 1994, and October 15, 2014. The medical records of the 5162 patients (84.5%) who returned for follow-up (ranging from 12 days to 9 years) were reviewed retrospectively. Between 45% and 70% of the patients operated on a mission have returned for early follow-up and some the following year. There were 3176 males (51.9%) and 2932

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

    Directory of Open Access Journals (Sweden)

    João Paulo Schwartz

    2014-01-01

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

  6. Morphological evaluation of clefts of the lip, palate, or both in dogs.

    Science.gov (United States)

    Peralta, Santiago; Fiani, Nadine; Kan-Rohrer, Kimi H; Verstraete, Frank J M

    2017-08-01

    OBJECTIVE To systematically characterize the morphology of cleft lip, cleft palate, and cleft lip and palate in dogs. ANIMALS 32 client-owned dogs with clefts of the lip (n = 5), palate (23), or both (4) that had undergone a CT or cone-beam CT scan of the head prior to any surgical procedures involving the oral cavity or face. PROCEDURES Dog signalment and skull type were recorded. The anatomic form of each defect was characterized by use of a widely used human oral-cleft classification system on the basis of CT findings and clinical images. Other defect morphological features, including shape, relative size, facial symmetry, and vomer involvement, were also recorded. RESULTS 9 anatomic forms of cleft were identified. Two anatomic forms were identified in the 23 dogs with cleft palate, in which differences in defect shape and size as well as vomer abnormalities were also evident. Seven anatomic forms were observed in 9 dogs with cleft lip or cleft lip and palate, and most of these dogs had incisive bone abnormalities and facial asymmetry. CONCLUSIONS AND CLINICAL RELEVANCE The morphological features of congenitally acquired cleft lip, cleft palate, and cleft lip and palate were complex and varied among dogs. The features identified here may be useful for surgical planning, developing of clinical coding schemes, or informing genetic, embryological, or clinical research into birth defects in dogs and other species.

  7. What's New in Cleft Palate and Velopharyngeal Dysfunction Management?

    Science.gov (United States)

    Naran, Sanjay; Ford, Matthew; Losee, Joseph E

    2017-06-01

    After studying this article, the participant should be able to: 1. Have a clear understanding of the evolution of concepts of velopharyngeal dysfunction, especially as it relates to patients with a cleft palate. 2. Explain the subjective and objective evaluation of speech in children with velopharyngeal dysfunction. 3. On the basis of these diagnostic findings, be able to classify types of velopharyngeal dysfunction. 4. Develop a safe, evidence-based, patient-customized treatment plan for velopharyngeal dysfunction founded on objective considerations. Velopharyngeal dysfunction is improper function of the dynamic structures that work to control the velopharyngeal sphincter. Approximately 30 percent of patients having undergone cleft palate repair require secondary surgery for velopharyngeal dysfunction. A multidisciplinary team using multimodal instruments to evaluate velopharyngeal function and speech should manage these patients. Instruments may include perceptual speech analysis, video nasopharyngeal endoscopy, multiview speech videofluoroscopy, nasometry, pressure-flow, and magnetic resonance imaging. Velopharyngeal dysfunction may be amenable to surgical or nonsurgical treatment methods or a combination of each. Nonsurgical management may include speech therapy or prosthetic devices. Surgical interventions could include palatal re-repair with repositioning of levator veli palatini muscles, posterior pharyngeal flap, sphincter pharyngoplasty, or soft palate or posterior wall augmentation. Treatment interventions should be based on objective assessment and rating of the movement of lateral and posterior pharyngeal walls and the palate to optimize speech outcomes. Treatment should be tailored to specific anatomical and physiologic findings and the overall needs of the patient.

  8. Association studies of low-frequency coding variants in nonsyndromic cleft lip with or without cleft palate

    DEFF Research Database (Denmark)

    Leslie, Elizabeth J; Carlson, Jenna C; Shaffer, John R

    2017-01-01

    Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a group of common human birth defects with complex etiology. Although genome-wide association studies have successfully identified a number of risk loci, these loci only account for about 20% of the heritability of orofacial clefts...

  9. The Effect of Cleft Size in Infants With Unilateral Cleft Lip and Palate on Mixed Dentition Dental Arch Relationship.

    Science.gov (United States)

    Russell, Lisa M; Long, Ross E; Romberg, Elaine

    2015-09-01

    To determine the relationship between infant cleft size and dental arch relationship in the mixed dentition in patients with complete unilateral cleft lip and palate. Retrospective analysis of mixed longitudinal records. A total of 29 consecutively enrolled patients with unilateral cleft lip and palate participated in a longitudinal study that included dental casts prior to lip surgery (T1: age 1 month), prior to palate surgery (T2: age 10 months), and in mixed dentition (T3: age 9 years). All infants were managed with lip repair (2.5 months), hard palate repair (12 months), and soft palate repair (16 months) but without any presurgical orthopedic treatment and no orthodontic intervention prior to mixed dentition records. The outcome measures included determination of an infant cleft severity ratio, defined as the ratio of palatal cleft area to palatal surface area, at both T1 and T2, and the 9-year-old (T3) dental arch relationship as determined using the GOSLON Yardstick. The correlation between the infant cleft severity ratio at T1 and T2 and the later GOSLON Yardstick score at T3 was determined using Pearson r. The intrarater reliability of the infant cleft severity ratio was assessed with Pearson r and the interrater reliability of the GOSLON Yardstick ratings, by weighted kappa. Reliability for the infant cleft severity ratio method was r = .92 to .95, and for GOSLON ratings κ = .81 to .91. There was no significant correlation between 1-month infant cleft severity ratio and GOSLON (r = .3) and 10-month infant cleft severity ratio and GOSLON (r = .1). Cleft size versus the amount of palatal tissue available for repair and concern over more scarring with a greater infant cleft severity ratio were not factors in affecting the eventual dental arch relationship.

  10. Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

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    Renato da Silva Freitas

    2012-01-01

    Full Text Available Goals/Background. To evaluate children’s growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF, in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50 and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.

  11. Facial growth in children with complete cleft of the primary palate and intact secondary palate.

    Science.gov (United States)

    Saperstein, Elliot L; Kennedy, Daniel L; Mulliken, John B; Padwa, Bonnie L

    2012-01-01

    Children with unoperated cleft lip/palate have nearly normal facial growth, whereas patients who have had labiopalatal repair often exhibit midfacial retrusion. The aim of this study was to compare cephalometric data in patients with repaired unilateral or bilateral complete cleft lip/alveolus (UCCLA or BCCLA) with patients with repaired unilateral or bilateral complete cleft lip/palate (UCCLP or BCCLP). This study might provide insight into the etiology of impaired facial growth in patients with repaired cleft lip/palate. This was a retrospective, cross-sectional analysis of nonsyndromic patients with UCCLA, BCCLA, UCCLP, and BCCLP. Angular and linear measurements of the midfacial region were made on traced lateral cephalograms. Paired t tests were used to compare each group with normative controls from the Michigan Growth Study. Multivariate analysis of variance was used to determine possible differences among the groups. There were 77 patients (38 male and 39 female) with a mean age of 11.2 years (range, 6 to 16 years; UCCLA, n = 25; BCCLA, n = 7; UCCLP, n = 18; and BCCLP, n = 27). There was no significant difference in midfacial position between the UCCLA and BCCLA groups and noncleft age-matched controls. In contrast, the maxilla in patients with UCCLP and BCCLP was significantly smaller and more retruded (P palate is responsible for midfacial hypoplasia in these patients. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Early correction of septum JJ deformity in unilateral cleft lip-cleft palate.

    Science.gov (United States)

    Morselli, Paolo G; Pinto, Valentina; Negosanti, Luca; Firinu, Antonella; Fabbri, Erich

    2012-09-01

    The treatment of patients affected by unilateral cleft lip-cleft palate is based on a multistage procedure of surgical and nonsurgical treatments in accordance with the different types of deformity. Over time, the surgical approach for the correction of a nasal deformity in a cleft lip-cleft palate has changed notably and the protocol of treatment has evolved continuously. Not touching the cleft lip nose in the primary repair was dogmatic in the past, even though this meant severe functional, aesthetic, and psychological problems for the child. McComb reported a new technique for placement of the alar cartilage during lip repair. The positive results of this new approach proved that the early correction of the alar cartilage anomaly is essential for harmonious facial growth with stable results and without discomfort for the child. The authors applied the same principles used for the treatment of the alar cartilage for correction of the septum deformity, introducing a primary rhinoseptoplasty during the cheiloplasty. The authors compared two groups: group A, which underwent septoplasty during cleft lip repair; and group B, which did not. After the anthropometric evaluation of the two groups, the authors observed better symmetry regarding nasal shape, correct growth of the nose, and a strong reduction of the nasal deformity in the patients who underwent primary JJ septum deformity correction. The authors can assume that, similar to the alar cartilage, the septum can be repositioned during the primary surgery, without causing growth anomaly, improving the morphologic/functional results.

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

    OpenAIRE

    Jobe Andrea L; D′Mello Joan; Kumar Sanjay

    2007-01-01

    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...

  14. Hearing process in children with cleft lip and palate with or without history of otitis

    OpenAIRE

    Moraes, Tamyne Ferreira Duarte de; Salvador, Karina Krähembühl; Cruz, Mariana Sodário [UNESP; Campos, Carolina Ferreira; Feniman, Mariza Ribeiro

    2011-01-01

    Introduction: Considering that hearing loss and otologic complications can interfere in the maturation process of central nervous system, this study aimed to check the performance of children with cleft lip and palate with or without the history of otitis media in the evaluation of the hearing process. Method: Prospective study. Were evaluated 20 children with operated cleft lip and palate, aged between 7 to 10 years old, divided into group I - 10 children with cleft lip and palate with histo...

  15. Speech and expressive language in Swedish-speaking children with unilateral cleft lip and palate

    OpenAIRE

    Klintö, Kristina

    2014-01-01

    Introduction and aims: A cleft palate may hamper development of speech and expressive language. Expressive language, including phonology, has been sparsely explored in children with cleft lip and palate, and extended knowledge is essential in order to improve intervention for this patient group. The aims of the project were to assess the effectiveness of different speech materials used when evaluating cleft palate speech, to assess the development of speech and expressive langu...

  16. Ectrodactyly, ectodermal dysplasia, cleft lip, and palate (EEC syndrome

    Directory of Open Access Journals (Sweden)

    Mohita Marwaha

    2012-01-01

    Full Text Available The ectodermal dysplasias (EDs are a large and complex group of diseases. More than 170 different clinical conditions have been recognized and defined as ectodermal dysplasias. Commonly involved ectodermal-derived structures are hair, teeth, nails, and sweat glands. In some conditions, it may be associated with mental retardation. We report a case of 10-year-old male child with ectrodactyly, syndactyly, ED, cleft lip/palate, hearing loss, and mental retardation.

  17. 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.

  18. BITE FORCE EVALUATION IN SUBJECTS WITH CLEFT LIP AND PALATE

    Science.gov (United States)

    Sipert, Carla Renata; Sampaio, Ana Claudia Martins; Trindade, Inge Elly Kiemle; Trindade, Alceu Sérgio

    2009-01-01

    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. PMID:19274400

  19. 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.

  20. Application of palatal RB obturator in babies with isolated palatal cleft

    Directory of Open Access Journals (Sweden)

    Radojičić Julija

    2009-01-01

    Full Text Available Background. Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding. Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. Case report. We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate. Hereby, the procedure of obturator making with an explanation of its function is presented. Conclusion. The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.

  1. Antenatal detection of cleft lip with or without cleft palate: incidence of associated chromosomal and structural anomalies.

    Science.gov (United States)

    Gillham, J C; Anand, S; Bullen, P J

    2009-10-01

    To ascertain how many fetuses with prenatally diagnosed cleft lip with or without cleft palate have associated congenital structural and/or chromosomal abnormalities and whether there is an association with the anatomical type of cleft lip or palate. This was a retrospective review of infants referred to the North-West England Regional Cleft Lip and Palate (CLAP) team between January 2000 and January 2006. Referrals made to the Regional Fetal Management Unit (FMU) in the same time period were investigated to identify the corresponding antenatal ultrasound findings and data on termination of pregnancy and intrauterine fetal death. Over the 6-year period investigated, 570 infants were referred to the FMU and/or CLAP team. Among these, there were 24 terminations of pregnancy, two intrauterine fetal deaths and one early neonatal death identified. Data on 69 of the 543 patients that survived were incomplete. Of 188 cases with unilateral and 34 cases with bilateral cleft lip +/- palate there were no karyotypical abnormalities without other structural abnormalities. The incidence of associated structural abnormalities varied with the anatomical type of cleft: that of unilateral cleft lip +/- palate was 9.8% (19/194), that of bilateral cleft lip and palate was 25% (11/44) and that of midline cleft lip and palate was 100% (11/11). None of 252 cases with isolated cleft palate was identified antenatally; of these, 5.6% (n = 14) had either karyotypical or associated structural abnormalities and 21.0% (n = 53) had a genetic syndrome as an underlying diagnosis. It is essential to tailor the antenatal counseling of patients to the specific scan diagnosis, considering both the anatomical type of cleft and the presence or absence of associated abnormalities. It is inappropriate to offer invasive testing to all patients. The use of three-dimensional ultrasound as an adjunct should be considered in these patients to improve the accuracy of prenatal diagnosis.

  2. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer.

    Science.gov (United States)

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-12-01

    Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.

  3. Centre-based statistics of cleft lip with/without alveolus and palate as well as cleft palate only patients in Aden, Yemen.

    Science.gov (United States)

    Esmail, Ahlam Hibatulla Ali; Abdo, Muhgat Ahmed Ali; Krentz, Helga; Lenz, Jan-Hendrik; Gundlach, Karsten K H

    2014-06-01

    The purpose of the study was to report the types and patterns of cleft lip with/without cleft alveolus and palate as well as cleft palate only as seen in Aden, Yemen. Retrospective, centre-based study conducted at the Cleft Lip and Palate Centre, Aden University, Yemen. Statistical evaluation of the data from all cleft patients who were registered at or referred to this centre during the years 2005-2011. A total of 1110 cleft patients were seen during the period studied (2005-2011). Amongst these there were 183 (16.48%) with a cleft lip and 144 (12.98) with a cleft of lip and alveolus, 228 (20.54%) had a cleft palate, and 555 (50%) had a combination of cleft lip, alveolus, and palate. The clefts were found more often in males than in females (56.5% boys versus 43.5% girls). This difference was statistically significant (p ≤ 0.001). Statistically significant sex differences were also noted when evaluating the various cleft types. Isolated cleft palates were found most often in females. Among the cleft palate cases there were 102 (9.2%) with a cleft soft palate only. The ages of the patients were between one day and 40 years. Two hundred and one children (18%) had a positive family history of clefts. Among the risk factors considered in this study, consanguineous marriages among cousins were found most frequently (in 48% of the cases). In contrast to this, only 10% of the mothers had reported to have been taking medication directly prior to or during the first trimester of their pregnancy. On average the mothers were neither very young nor very old. The prevalence rate of orofacial cleft types among this Yemeni sample was similar to prevalence rates previously reported in white Caucasians. The present study did neither find many cases with medication before, nor during, pregnancy; there were few young or very old mothers; and the incidence of positive family histories was similar to those found in other studies on clefts. However, consanguineous marriages were

  4. Chondrodystrophic mice with coincidental agnathia: evidence for the tongue obstruction hypothesis in cleft palate.

    Science.gov (United States)

    Clarke, L; Hepworth, W B; Carey, J C; Seegmiller, R E

    1988-12-01

    Mice homozygous for either of two mutations, chondrodysplasia (cho) or cartilage matrix deficiency (cmd), have short-limbed chondrodystrophy. This phenotype includes retrognathia, relative macroglossia, and cleft palate. It has been postulated that the cleft palate in these mice is the result of tongue obstruction during palatogenesis. Agnathia associated with microglossia is an independent spontaneously occurring defect in the strains bearing these mutations. The coincidental occurrence of agnathia-microglossia with chondrodystrophy lends itself to the study of the mechanism of cleft palate formation. We examined approximate midsagittal histological sections of normal and chondrodystrophic newborn mice, both with and without agnathia. Mandibular measurements and examinations of palate closure and tongue structure were made from photographic prints. Typical chondrodystrophic mutants with cleft palates had a mean mandibular length that was 66% of normal and a tongue that appeared large relative to the shortened mandible. Chondrodystrophic mutants with agnathia and microglossia had a mean mandibular length that was further reduced to 30% of normal, yet had a closed palate. We also observed two nonagnathic chondrodystrophic mutants that had slightly decreased mandibular lengths, microglossia, and closed palates. These observations suggest that tongue obstruction during palatogenesis is the pathogenetic mechanism of cleft palate in chondrodystrophic mice. A similar tongue obstruction hypothesis has been proposed as the mechanism of cleft palate formation in the human Pierre Robin sequence, which consists of retrognathia, glossoptosis, and cleft palate. This mechanistic hypothesis has been challenged, but our findings support the tongue obstruction hypothesis in the Robin cleft.

  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. Electropalatography for articulation disorders associated with cleft palate.

    Science.gov (United States)

    Lee, Alice S-Y; Law, James; Gibbon, Fiona E

    2009-07-08

    Cleft palate is the most common congenital deformity of the face. It could affect speech acquisition, resulting in articulation errors that could persist into adulthood. Electropalatography (EPG) has been used in speech therapy with individuals who have articulation problems that are unresponsive to "standard treatment" procedures. To determine the effectiveness of speech intervention using electropalatography (EPG) for treating articulation errors in individuals with repaired cleft palate. The following databases were searched: CENTRAL 2008 (Issue1), MEDLINE 1966 to March 2008, EMBASE 1974 to March 2008, CINAHL 1982 to March 2008, PsycINFO 1967 to March 2008 and eight other databases. We handsearched Clinical Linguistics and Phonetics (1987 to 2008, Issue 2), Cleft Palate Journal/ Cleft Palate-Craniofacial Journal (1980 to 2008, Issue 1), and the International Journal of Language and Communication Disorders (1980 to 2008, Issue 1). We searched the EPG bibliography (Gibbon 2007). We reviewed reference lists of relevant articles and approached researchers to identify other possible published and unpublished studies. Randomised controlled studies comparing EPG intervention to no treatment, delayed treatment, "standard treatment", or alternative treatment techniques for managing articulation problems associated with cleft palate in children or adults. One author searched the titles and abstracts and assessed trial quality. A second author checked judgements; disagreement was resolved through discussion. Three authors were available to examine any potential trials for possible inclusion in the review. One trial using parallel design met the inclusion criteria of this review; no meta-analysis was performed. The study reported that fewer therapy sessions were needed to achieve the treatment goals for the EPG therapy and frication display method (N = 2), followed by EPG therapy (N = 2) and "standard treatment" (N = 2). The included trial was a small-scaled study and there

  7. An Innovative Approach to Evaluate the Morphological Patterns of Soft Palate in Oral Submucous Fibrosis Patients: A Digital Cephalometric Study

    Science.gov (United States)

    Ayesha Thabusum, Dharmavaram; Bhavana, Sujana Mulk

    2016-01-01

    Oral submucous fibrosis (OSMF) is a chronic insidious disease affecting mucosa and submucosa of oral cavity and soft palate. The present study aimed to evaluate the morphology of soft palate in normal individuals and OSMF patients using lateral cephalometry and to compare and correlate these variants of soft palate with different stages of OSMF. 100 subjects were included in the study, who were divided into two groups. Group I included 50 subjects with clinical diagnosis of OSMF and Group II included 50 normal subjects (control group). Using digital lateral cephalometry, velar length and width were measured and soft palatal patterns were categorized based on You et al.'s classification. Leaf and rat-tail patterns of soft palate were predominant in control group, whereas butt and crook shaped variants were more in study group. Anteroposterior (A-P) length of soft palate was significantly greater in stage I OSMF, while superoinferior (S-I) width was greater in stage III OSMF. Interestingly, a negative correlation was observed in staging of OSMF and A-P dimensions. As the staging of OSMF advances, the A-P length of soft palate decreases, but S-I width increases. PMID:27034975

  8. An Innovative Approach to Evaluate the Morphological Patterns of Soft Palate in Oral Submucous Fibrosis Patients: A Digital Cephalometric Study

    Directory of Open Access Journals (Sweden)

    Chintamaneni Raja Lakshmi

    2016-01-01

    Full Text Available Oral submucous fibrosis (OSMF is a chronic insidious disease affecting mucosa and submucosa of oral cavity and soft palate. The present study aimed to evaluate the morphology of soft palate in normal individuals and OSMF patients using lateral cephalometry and to compare and correlate these variants of soft palate with different stages of OSMF. 100 subjects were included in the study, who were divided into two groups. Group I included 50 subjects with clinical diagnosis of OSMF and Group II included 50 normal subjects (control group. Using digital lateral cephalometry, velar length and width were measured and soft palatal patterns were categorized based on You et al.’s classification. Leaf and rat-tail patterns of soft palate were predominant in control group, whereas butt and crook shaped variants were more in study group. Anteroposterior (A-P length of soft palate was significantly greater in stage I OSMF, while superoinferior (S-I width was greater in stage III OSMF. Interestingly, a negative correlation was observed in staging of OSMF and A-P dimensions. As the staging of OSMF advances, the A-P length of soft palate decreases, but S-I width increases.

  9. Presurgical cleft lip and palate orthopedics: an overview

    Science.gov (United States)

    Alzain, Ibtesam; Batwa, Waeil; Cash, Alex; Murshid, Zuhair A

    2017-01-01

    Patients with cleft lip and/or palate go through a lifelong journey of multidisciplinary care, starting from before birth and extending until adulthood. Presurgical orthopedic (PSO) treatment is one of the earliest stages of this care plan. In this paper we provide a review of the PSO treatment. This review should help general and specialist dentists to better understand the cleft patient care path and to be able to answer patient queries more efficiently. The objectives of this paper were to review the basic principles of PSO treatment, the various types of techniques used in this therapy, and the protocol followed, and to critically evaluate the advantages and disadvantages of some of these techniques. In conclusion, we believe that PSO treatment, specifically nasoalveolar molding, does help to approximate the segments of the cleft maxilla and does reduce the intersegment space in readiness for the surgical closure of cleft sites. However, what we remain unable to prove equivocally at this point is whether the reduction in the dimensions of the cleft presurgically and the manipulation of the nasal complex benefit our patients in the long term. PMID:28615974

  10. Association between maternal smoking, gender, and cleft lip and palate.

    Science.gov (United States)

    Martelli, Daniella Reis Barbosa; Coletta, Ricardo D; Oliveira, Eduardo A; Swerts, Mário Sérgio Oliveira; Rodrigues, Laíse A Mendes; Oliveira, Maria Christina; Martelli Júnior, Hercílio

    2015-01-01

    Cleft lip and/or palate (CL/P) represent the most common congenital anomalies of the face. To assess the relationship between maternal smoking, gender and CL/P. This is an epidemiological cross-sectional study. We interviewed 1519 mothers divided into two groups: mothers of children with CL/P (n=843) and mothers of children without CL/P (n=676). All mothers were classified as smoker or non-smoker subjects during the first trimester of pregnancy. To determine an association among maternal smoking, gender, and CL/P, odds ratios were calculated and the adjustment was made by a logistic regression model. An association between maternal smoking and the presence of cleft was observed. There was also a strong association between male gender and the presence of cleft (OR=3.51; 95% CI 2.83-4.37). By binary logistic regression analysis, it was demonstrated that both variables were independently associated with clefts. In a multivariate analysis, male gender and maternal smoking had a 2.5- and a 1.5-time greater chance of having a cleft, respectively. Our findings are consistent with a positive association between maternal smoking during pregnancy and CL/P in male gender. The results support the importance of smoking prevention and introduction of cessation programs among women with childbearing potential. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. Taurodontism in twins with cleft lip and/or palate.

    Science.gov (United States)

    Laatikainen, T; Ranta, R

    1996-04-01

    The aims of this study were to determine the frequency of taurodontism of the first and second permanent molars in twins discordant or concordant for clefts, the frequency for each type of cleft in twins, and the concordance-discordance ratio in mono- and dizygotic twins. Thirty-nine pairs of twins (13 monozygotic, 26 dizygotic) between the ages of 7 and 23 yrs were investigated. Taurodontism and hypodontia were determined from orthopantomograms of the dentition. Of the 39 pairs of twins investigated, 16 (41%) had taurodontism, equally in mono- and dizygotic pairs. The highest frequency of the trait was noted in subjects with isolated cleft palate and the lowest in cleft lip subjects. Four of 13 monozygotic pairs with taurodontism were concordant for the trait, as were 9 of 12 dizygotic pairs. Taurodontism was symmetric in 91% of the affected molar pairs. Concomitant taurodontism and hypodontia was observed in 8 of 16 taurodontic twin pairs. We conclude that the etiology of clefting in our group of twins seems to have an effect on the frequency of taurodontism. A high concordance for taurodontism and a high symmetry of the trait may indicate a strong genetic etiology of taurodontism.

  12. The FGF and FGFR Gene Family and Risk of Cleft Lip With or Without Cleft Palate.

    Science.gov (United States)

    Wang, Hong; Zhang, Tianxiao; Wu, Tao; Hetmanski, Jacqueline B; Ruczinski, Ingo; Schwender, Holger; Liang, Kung Yee; Murray, Tanda; Fallin, M Daniele; Redett, Richard J; Raymond, Gerald V; Jin, Sheng-Chih; Chou, Yah-Huei Wu; Chen, Philip Kuo-Ting; Yeow, Vincent; Chong, Samuel S; Cheah, Felicia S H; Jee, Sun Ha; Jabs, Ethylin W; Scott, Alan F; Beaty, Terri H

    2013-01-01

    Background : Isolated, nonsyndromic cleft lip with or without cleft palate is a common human congenital malformation with a complex and heterogeneous etiology. Genes coding for fibroblast growth factors and their receptors (FGF/FGFR genes) are excellent candidate genes. Methods : We tested single-nucleotide polymorphic markers in 10 FGF/FGFR genes (including FGFBP1, FGF2, FGF10, FGF18, FGFR1, FGFR2, FGF19, FGF4, FGF3, and FGF9) for genotypic effects, interactions with one another, and with common maternal environmental exposures in 221 Asian and 76 Maryland case-parent trios ascertained through a child with isolated, nonsyndromic cleft lip with or without cleft palate. Results : Both FGFR1 and FGF19 yielded evidence of linkage and association in the transmission disequilibrium test, confirming previous evidence. Haplotypes of three single-nucleotide polymorphisms in FGFR1 were nominally significant among Asian trios. Estimated odds ratios for individual single-nucleotide polymorphic markers and haplotypes of multiple markers in FGF19 ranged from 1.31 to 1.87. We also found suggestive evidence of maternal genotypic effects for markers in FGF2 and FGF10 among Asian trios. Tests for gene-environment (G × E) interaction between markers in FGFR2 and maternal smoking or multivitamin supplementation yielded significant evidence of G × E interaction separately. Tests of gene-gene (G × G) interaction using Cordell's method yielded significant evidence between single-nucleotide polymorphisms in FGF9 and FGF18, which was confirmed in an independent sample of trios from an international consortium. Conclusion : Our results suggest several genes in the FGF/FGFR family may influence risk for isolated, nonsyndromic cleft lip with or without cleft palate through distinct biological mechanisms.

  13. Self-reports of psychosocial functioning among children and young adults with cleft lip and palate.

    Science.gov (United States)

    Hunt, Orlagh; Burden, Donald; Hepper, Peter; Stevenson, Mike; Johnston, Chris

    2006-09-01

    A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate. The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age. Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview. Participants with cleft lip and/or palate reported greater behavioral problems (p .05) or self-esteem (p > .05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p < .001). Teasing was greater among participants who had cleft lip and/ or palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.

  14. Epidemiology, Etiology and Treatment of Isolated Cleft Palate

    Directory of Open Access Journals (Sweden)

    Madeleine L Burg

    2016-03-01

    Full Text Available Isolated cleft palate (CPO is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of children born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving both genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke exposure has been found to have a strong association with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and potential gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1 monitoring of the occurrence of CPO (capacity building; (2 detailed phenotyping of the severity (biology; (3 understanding of the genetic and environmental risk factors (primary prevention; (4 access to early detection and multidisciplinary treatment (clinical services; and (5 understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention.

  15. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate

    Science.gov (United States)

    Burg, Madeleine L.; Chai, Yang; Yao, Caroline A.; Magee, William; Figueiredo, Jane C.

    2016-01-01

    Isolated cleft palate (CPO) is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of cases born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects) and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke has been found to be strongly associated with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1) monitoring of the occurrence of CPO (capacity building); (2) detailed phenotyping of the severity (biology); (3) understanding of the genetic and environmental risk factors (primary prevention); (4) access to early detection and multidisciplinary treatment (clinical services); and (5) understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention). PMID:26973535

  16. MRI for definitive in utero diagnosis of cleft palate: a useful adjunct to antenatal care?

    Science.gov (United States)

    Descamps, Marjanne J L; Golding, Stephen J; Sibley, Jane; McIntyre, Anthony; Alvey, Christopher; Goodacre, Timothy

    2010-11-01

    To assess the use of fetal magnetic resonance imaging (MRI) in obtaining a definitive prenatal diagnosis of cleft palate. All expectant mothers with a sonographically diagnosed fetal cleft lip or a previously affected child with cleft palate were offered antenatal MRI at around 34 weeks' gestation. Images were interpreted by a consultant radiologist who was blinded to the ultrasound diagnosis. Two MRI readings were performed: one at the time of examination and one at the end of the study to elicit the radiologist's learning curve. MRI findings were correlated with the birth diagnosis. Tertiary referral center for facial clefts--the Spires Cleft Centre, Oxford Children's Hospital, Oxford, United Kingdom. Study participants included 49 pregnant women between 24 and 37 weeks' gestation, four with a family history of cleft posterior palate and 45 with a facial cleft on a 20-week ultrasound. The positive predictive value of fetal MRI for involvement of the palate was 96%, and the negative predictive value was 80%. The accuracy in predicting palatal clefting of four different MRI signs is discussed. The radiologist's interpretation skills significantly improved between the two MRI readings. Fetal MRI enables us to predict accurately the extent of a cleft palate after an ultrasound diagnosis of cleft lip. With more accurate diagnosis of the severity of the cleft, we can counsel patients more precisely and plan postnatal management correctly.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  18. 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)...

  19. Timing of palate repair affecting growth in complete unilateral cleft lip and palate.

    Science.gov (United States)

    Xu, Xue; Zheng, Qian; Lu, Dawei; Huang, Ning; Li, Jingtao; Li, Sheng; Wang, Yan; Shi, Bing

    2012-12-01

    To evaluate the facial morphology characteristics of patients with complete unilateral cleft lip and palate (UCCLPs) who had undergone cleft palate repair at different times. This study included 46 nonsyndromic UCCLPs and 38 age and sex matched non-cleft patients. 35 cephalometric measurements were used to evaluate the facial morphology. Student's t-test, one-way ANOVA and rank sum tests were used for comparison. Significant difference was defined at 95% level. The data showed that UCCLPs who had palatoplasty between 7 and 12 years had greater PMP-A, PMP-ANS, Ba-ANS, Ba-A, Ba-N-ANS than those operated on before 4 years of age, and UCCLPs who had palatoplasty at 4-12 years had smaller Y-axis angle than those operated on before 4 years of age. The maxillary sagittal length increased gradually as von Langenbeck repair was delayed. UCCLPs who underwent palate repair using von Langenbeck technique at 4-12 years had a more protrusive maxilla and less clockwise rotated mandible than those repaired before 4 years. UCCLPs operated using the von Langenbeck technique at 4-12 years had better head-face morphology than those operated on before 4 years. There was no difference in facial morphology among UCCLPs with palate repair at 4-12 years. Copyright © 2012 European Assocation for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Oral Health Status of Individuals with Cleft Lip, Cleft Palate or Both in a Nigerian Population

    OpenAIRE

    Fadeyibi, I.O.; Sorunke, M E; Onigbinde, O O; Ogunbanjo, V O; Ogunbanjo, B O; Ademiluyi, S

    2011-01-01

    Background: Cleft lip and/ or palate (CL/P) deformities are congenital anomalies with fissures of either the lip, palate or both combined. The altered oral anatomy causes physiological changes and diminished self cleansing ability. The oral hygiene may thus not be properly maintained.Aim: A prospective study of the oral health status of individuals with these deformities in Lagos-Nigeria was carried out to determine the need, types, and extent of pre-operative dental management that these pat...

  1. Cleft Lip and Palate Repair Using a Surgical Microscope.

    Science.gov (United States)

    Kato, Motoi; Watanabe, Azusa; Watanabe, Shoji; Utsunomiya, Hiroki; Yokoyama, Takayuki; Ogishima, Shinya

    2017-11-01

    Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Surgical microscopy was demonstrated to be useful during cleft operations.

  2. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hiroshi

    1988-07-01

    Computed tomography was carried out in 65 patients of cleft lip and palate with continuous 2 mm slice scanning. The cleft lip and palate was classified by shape of the hard palate as normal, hypoplasia, and aplasia, depending on its developmental degree. The shape of alveolus was also grouped as circular, triangular, and asymmetric forms for the evaluation of maxillar development. The hard palatal development well correlated with the shape of the alveolus. Frequency of sinusitis and mastoiditis increased with the severity of hard palatal malformation. Evaluation of the hard palate by thin slice scanning is usefull standpoint of presumption of future maxillary development.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Meyer, Steffen; Pedersen, Kirsten Mølsted

    2013-01-01

    The objective was to assess the long-term outcome of secondary alveolar bone grafting (SABG) in cleft lip and palate patients and to examine relationships between preoperative and postoperative factors and overall long-term bone graft success. The records of 97 patients with cleft lip and palate...

  5. Techniques and outcome of repair of cleft of the secondary palate at ...

    African Journals Online (AJOL)

    Background: The technique adopted in the repair of cleft of the secondary palate must not just be based on the choice of the surgeon but on several factors which include the width of the cleft, length of palate and age of the patient. The aim of the article was to document our 4-year experience of the techniques and outcome ...

  6. Acquisition of Linguistic and Cognitive Skills by Children with Cleft Palate.

    Science.gov (United States)

    Broen, Patricia A.; Devers, Monica C.; Doyle, Shirley S.; Prouty, Jo McCauley; Moller, Karlind T.

    1998-01-01

    This study compared cognitive and linguistic development of young children with (N=28) and without (N=29) cleft palate. Children with cleft palate, although well within the normal range, performed significantly below the control group on cognitive and linguistic tests. Cognitive differences were linguistic in nature and were related to hearing…

  7. Cleft lip and palate: the Jos exprience | Orkar | East African Medical ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of occurrence of cleft lip/palate and the factors that may have influenced treatment outcome. Design: Descriptive Study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Subject: This study included 107 consecutive patients with cleft lip/palate managed between January 1991 and ...

  8. 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…

  9. The Impact of Early Intervention on Speech and Lexical Development for Toddlers with Cleft Palate: A Retrospective Look at Outcome

    Science.gov (United States)

    Hardin-Jones, Mary; Chapman, Kathy L.

    2008-01-01

    Purpose: The purpose of the present investigation was to examine the impact of early intervention on speech and lexical measures for toddlers with cleft palate. Method: Speech measures of ten 27-month-old toddlers with cleft palate who had been referred for therapy at 17 months of age were compared to those of 10 toddlers with cleft palate who had…

  10. Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan.

    Directory of Open Access Journals (Sweden)

    Hiroshi Koga

    Full Text Available To investigate malformations associated with cleft lip and cleft palate, we conducted surveys at neonatal intensive care units (NICUs and other non-NICU facilities and to determine whether there are differences among facilities. The regional survey investigated NICU facilities located in Oita Prefecture, including 92 patients with cleft lip and palate (CLP or cleft palate (CP that occurred between 2004 and 2013, and the national survey investigated oral surgery, plastic surgery, and obstetrics and gynecology facilities located in Japan, including 16,452 patients with cleft lip (CL, CLP, or CP that occurred since 2000. The incidence per 10,000 births was 4.2, 6.2, and 2.8 for CL, CLP, and CP, respectively, according to the national survey, and 6.3 and 2.9 for CLP and CP, respectively according to the regional survey. These results indicated comparable incidences between the two surveys. In contrast, when the survey results on malformations associated with CLP and CP according to the ICD-10 classification were compared between the national survey conducted at oral surgery or plastic surgery facilities and the regional survey conducted at NICU facilities, the occurrence of associated malformations was 19.8% vs. 41.3% for any types of associated malformation, 6.8% vs. 21.7% for congenital heart disease, and 0.5% vs. 16.3% for chromosomal abnormalities. These results indicated that the incidences of all of these associated malformations were significantly greater in the survey conducted at NICU facilities and similar to the findings from international epidemiological surveys. When comparing the survey conducted at obstetrics facilities vs. NICU facilities, the occurrence of associated malformations was similar results as above. The incidence of CLP and CP was not different between surveys conducted at NICU facilities vs. non-NICU facilities; however, when conducting surveys on associated malformations, it is possible to obtain accurate

  11. 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

  12. Velopharyngeal sphincter pathophysiologic aspects in the in cleft palat

    Directory of Open Access Journals (Sweden)

    Collares, Marcus Vinicius Martins

    2008-09-01

    Full Text Available Introduction: Cleft lip and palate are common congenital abnormalities with typical functional disorders on speech, deglutition and middle ear function. Objective: This article reviews functional labiopalatine disorders through a pathophysiological view. Method: We performed a literature search on line, as well as books and periodicals related to velopharyngeal sphincter. Our sources were LILACS, MEDLINE and SciELO databases, and we applied to the research Keywords of interest on the velopharyngeal pathophysiology, for articles published between 1965 and 2007. Conclusion: Velopharyngeal sphincter plays a central role in speech, swallowing and middle ear physiology in patients with labiopalatine cleft. At the end of our bibliographic review, pursuant to the velopharyngeal physiology in individuals with this disorder in the functional speech, deglutition and otologic function, we observed that although there is a great number of published data discussing this issue, further studies are necessary to completely understand the pathophysiology, due to the fact they have been exploited superficially.

  13. [Investigation of children with congenital cleft lip and palate by Eysenck personality questionnaire(Junior)

    Science.gov (United States)

    Zhang, H Z; Hu, J F

    1998-12-01

    OBJECTIVE: To approach the personality of the children suffering from congenital cleft lip and palate. METHODS: The subject were 50 children (aged 7 to 17) with congenital cleft lip and palate,and 50 normal children as control.Both groups were investigated by Eysenck personality questionnaire EPQ(Junior). RESULTS: According to the general quantitative table of EPQ(Junior),the abnormal cases in cleft group were significantly more than those in control(P<0.005),and also were the abnormal cases in the single quantitative or in the multiple quantitative tables of EPQ(Junior)(P<0.005) respectively. CONCLUSION: The poor personality in children with cleft lip and palate is correlated to the cleft condition.Therefore it is necessary to pay attention to the prevention of poor personality while the cleft lip and palate is treated.

  14. Long term follow up study of survival associated with cleft lip and palate at birth

    DEFF Research Database (Denmark)

    Christensen, Kaare; Juel, K.; Herskind, Anne Maria

    2004-01-01

    OBJECTIVE: To assess the overall and cause specific mortality of people from birth to 55 years with cleft lip and palate. DESIGN: Long term follow up study. SETTING: Danish register of deaths. PARTICIPANTS: People born with cleft lip and palate between 1943 and 1987, followed to 1998. MAIN OUTCOME...... MEASURES: Observed and expected numbers of deaths, summarised as overall and cause specific standardised mortality ratios. RESULTS: 5331 people with cleft lip and palate were followed for 170 421 person years. The expected number of deaths was 259, but 402 occurred, corresponding to a standardised...... of death. CONCLUSIONS: People with cleft lip and palate have increased mortality up to age 55. Children born with cleft lip and palate and possibly other congenital malformations may benefit from specific preventive health measures into and throughout adulthood....

  15. The Use of Postoperative Restraints in Children after Cleft Lip or Cleft Palate Repair: A Preliminary Report

    OpenAIRE

    Huth, Jennifer; Petersen, J. Dayne; Lehman, James A

    2013-01-01

    Purpose. This study examines whether the use of elbow restraints after cleft lip/palate repair has a relationship to postoperative complications. Methods. A comparative descriptive design was used to study a convenience sample of children undergoing repair of cleft lip/palate at Akron Children’s Hospital with Institutional Review Board approval. The children were randomized into intervention or control groups with use of elbow restraints considered the intervention. The study consists of two ...

  16. Lexical selectivity in Danish toddlers with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2013-01-01

    . 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 IPA and an individual consonant inventory was established for each participant. The video recordings were also analysed with respect to word...... 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...

  17. Dermatography as an adjunctive treatment for cleft lip and palate patients.

    Science.gov (United States)

    van der Velden, E M; van der Dussen, M F

    1995-01-01

    To investigate dermatography as a treatment for cleft lip and palate. The results of the treatment of 19 cleft lip patients with discoloration of scars and the vermillion border after secondary cleft lip and palate surgery by dermatography and intracicatricial keloidectomy are described. This group of patients has gained self-confidence after treatments, to the extent that their articulation has improved. Dermatography can be applied as an adjuvant treatment with good cosmetic and esthetic results.

  18. Do Cleft Lip/ And Or Palate Patients Need The Cardiologist Consultation Before The Surgery?

    OpenAIRE

    Miri S R; KianiA; Mehrabi V

    2003-01-01

    Ectomesenchimal cells, placed near the embryonal tube, migrate to down and share in facial and cardiac structures. Migration or differentiation disorders of these cell causes cleft lip/ or palate and congenital heart disease (CHD). This item was performed to determine co-appearing of cleft and CHD and to know adjutant factors to that for better management of these patient."nMaterials and Methods: Two hundered children with cleft lip and palate were registered. Finding was analyzed by fis...

  19. Feeding considerations in infants born with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    M Subramanya Shetty

    2016-01-01

    Full Text Available Infants born with the congenital deformity of cleft lip and or palate suffer from varieties of complications since the day 1 of their life. The most important of which is the feeding difficulty which leads to insufficient food intake and thereby causing deleterious effects on their overall development leading to malnutrition and death in some cases. However, research into the anatomical variations of these infants in the region of lip and palate has led to the development of several types of feeders and their modifications which would help them thrive well in the initial days and also for later. Hence, it is worth important to know about them in detail and help these infants and their families psychologically so that the infants do not suffer from feeding difficulties anymore.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. The role of magnetic resonance imaging in the prenatal diagnosis of cleft lip and palate.

    Science.gov (United States)

    Bekiesińska-Figatowska, Monika; Brągoszewska, Hanna; Romaniuk-Doroszewska, Anna; Duczkowska, Agnieszka; Jaczyńska, Renata; Maciejewski, Tomasz M

    2014-01-01

    Cleft lip and/or palate is the most common congenital craniofacial anomaly. Ultrasonography plays a key role in the early diagnosis of this anomaly and is completed by MRI. The purpose of this paper is to present and summarize the experience in diagnosis of cleft lip/palate by means of MRI. The material consists of 62 fetuses that required more detailed evaluation which was conducted with the use of a 1.5 T scanner in SSFSE/T2 sequence in the sagittal, transverse and coronal plane. The cleft was diagnosed in 15 fetuses: an isolated cleft lip in one case (6.7%), a cleft lip and alveolar process in 2 (13.3%), a cleft lip and palate in 12 (80%). In eight fetuses (53.3%) the defect was unilateral, in 6 (40%) on both sides, in one case (6.7%) - a bilateral cleft lip and unilateral cleft palate was diagnosed. In three cases (20%), the cleft lip and/or palate defect was isolated, in 12 (80%) - it coexisted with other fetal abnormalities. MRI was less useful than ultrasound in 1 case (6.7%), in 4 cases (26.7%) it did not add any significant new information, in the remaining 10 cases (66.6%) important additional information was obtained on MRI. MRI revealed more details of the cleft in 5 cases (33.3%). In 10 fetuses (66.7%), cleft diagnosis was based on ultrasound and MRI only confirmed it. In 47 cases MRI allowed to show normal fetal faces, while there were difficulties of visualisation on ultrasound. Prenatal MRI is a method supporting fetal ultrasound and is used to confirm/expand sonographic diagnosis, but can also change it. In the case of cleft lip and palate fetal MRI produces a better picture of the connections between the cavities, the degree of involvement of the secondary palate and cleft extent, and also helps to detect/assess other associated fetal abnormalities.

  2. The comparative study of craniofacial structural characteristic of individuals with different types of cleft palate.

    Science.gov (United States)

    Lu, Da-wei; Shi, Bing; Wang, Heng-jian; Zheng, Qian

    2007-10-01

    To compare craniofacial structural characteristic of individuals with different types of cleft palate and to lay a foundation for better treatment protocol for patients with cleft palate, we chose a sample consisting of 12 patients with Treacher Collin syndrome, 15 patients with Pierre Robin sequence, 40 patients with unilateral complete cleft lip and palate, and 40 patients with isolated cleft palate who met certain criteria. Lateral cephalometric radiographs were obtained from each subject. A total of 22 variables, comprising 11 angular, 9 linear, and 2 ratio measurements, were studied. The z-scores were analyzed during paired Student t test. The data showed us that there seems to be no difference in craniofacial structures between patients with isolated cleft palate and normal persons. Patients with unilateral complete cleft lip and palate who had only cleft lip repaired exhibit such characteristics as midface retrusion, relatively excessive lower facial height, and more obtuse gonial angle. The cranial base areas of individuals with Treacher Collin syndrome and Pierre Robin sequence are similar to those of normal persons. Mandibular hypoplasia in both vertical and horizontal dimensions and maxillary retrusion can be found in patients with Treacher Collin syndrome, while only mandibular hypoplasia in the horizontal dimension can be found in patients with Pierre Robin sequence. The developmental deficiency of craniofacial structures seems to be a separate deformity, not the direct outcome of cleft palate defect.

  3. 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.

  4. Key susceptibility locus for nonsyndromic cleft lip with or without cleft palate on chromosome 8q24.

    NARCIS (Netherlands)

    Birnbaum, S.; Ludwig, K.U.; Reutter, H.; Herms, S.; Steffens, M.; Rubini, M.; Baluardo, C.; Ferrian, M.; Almeida de Assis, N.; Alblas, M.A.; Barth, S.; Freudenberg, J.; Lauster, C.; Schmidt, G; Scheer, M.; Braumann, B.; Berge, S.J.; Reich, R.H.; Schiefke, F.; Hemprich, A.; Potzsch, S.; Steegers-Theunissen, R.P.M.; Potzsch, B.; Moebus, S.; Horsthemke, B.; Kramer, F.J.; Wienker, T.F.; Mossey, P.A.; Propping, P.; Cichon, S.; Hoffmann, P.; Knapp, M.; Nothen, Markus; Mangold, E.

    2009-01-01

    We conducted a genome-wide association study involving 224 cases and 383 controls of Central European origin to identify susceptibility loci for nonsyndromic cleft lip with or without cleft palate (NSCL/P). A 640-kb region at chromosome 8q24.21 was found to contain multiple markers with highly

  5. Key susceptibility locus for nonsyndromic cleft lip with or without cleft palate on chromosome 8q24

    NARCIS (Netherlands)

    Birnbaum, Stefanie; Ludwig, Kerstin U.; Reutter, Heiko; Herms, Stefan; Steffens, Michael; Rubini, Michele; Baluardo, Carlotta; Ferrian, Melissa; de Assis, Nilma Almeida; Alblas, Margrieta A.; Barth, Sandra; Freudenberg, Jan; Lauster, Carola; Schmidt, Guel; Scheer, Martin; Braumann, Bert; Berge, Stefaan J.; Reich, Rudolf H.; Schiefke, Franziska; Hemprich, Alexander; Poetzsch, Simone; Steegers-Theunissen, Regine P.; Poetzsch, Bernd; Moebus, Susanne; Horsthemke, Bernhard; Kramer, Franz-Josef; Wienker, Thomas F.; Mossey, Peter A.; Propping, Peter; Cichon, Sven; Hoffmann, Per; Knapp, Michael; Noethen, Markus M.; Mangold, Elisabeth

    We conducted a genome-wide association study involving 224 cases and 383 controls of Central European origin to identify susceptibility loci for nonsyndromic cleft lip with or without cleft palate (NSCL/P). A 640-kb region at chromosome 8q24.21 was found to contain multiple markers with highly

  6. A cephalometric study of the relationship between the level of velopharyngeal closure and the palatal plane in patients with repaired cleft palate and controls without clefts.

    Science.gov (United States)

    Satoh, K; Wada, T; Tachimura, T; Sakoda, S; Shiba, R

    1999-12-01

    To find out whether the palatal plane is a useful indicator for evaluating the level of velopharyngeal closure, we did a cross-sectional study from early childhood to puberty of the vertical relationship between the palatal plane and the level of velarpharyngeal contact during velopharyngeal functioning in 61 patients with repaired cleft palate (unilateral cleft lip and palate = cleft group) and 82 controls without clefts (control group). Measurements on the vertical dimension were derived from a coordinate system and landmarks on lateral cephalograms, and the significance of differences in measurements was analysed using Student's t-test. Changes in the points of velarpharyngeal contact in relation to the palatal plane with growth showed a consistent tendency though differed between the two groups. In the control group, the PPW (point where palatal plane extension intersects the posterior pharyngeal wall) was maintained at a level that did not differ significantly from the level of midpoint of velarpharyngeal contact during phonation of /a/, and was maintained at a level that did not differ significantly from the level of the inferior point of velarpharyngeal contact. In the cleft group, however, it was maintained at a level that was slightly higher than the superior point of velarpharyngeal contact both during phonation of /a/ and during blowing. These results suggest that the palatal plane is useful as an indicator for evaluating the level of velopharyngeal closure.

  7. A restricted test of single-word intelligibility in 3-year-old children with and without cleft palate

    National Research Council Canada - National Science Library

    Willadsen, Elisabeth; Poulsen, Mads

    2012-01-01

    In a previous study, children with cleft palate with hard palate closure at 12 months of age showed more typical phonological development than did children with an unrepaired hard palate at 36 months of age...

  8. 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

  9. 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.

  10. Un Futuro Prometedor para su Nino con Labio Hendido y Paladar Hendido. Edicion Refundida (Bright Promise for Your Child with Cleft Lip and Cleft Palate. Revised Edition).

    Science.gov (United States)

    McDonald, Eugene T.; Berlin, Asa J.

    The booklet, written in Spanish, is intended to help parents of babies with cleft lip and/or cleft palate. Topics covered include the sequence of prenatal development and the effects of birth defects, common misconceptions about what causes the conditions, possible hereditary and environmental causes, and what it means to have a cleft palate or a…

  11. Effects of retinoic acid on proliferation and gene expression of cleft and non-cleft palatal keratinocytes

    NARCIS (Netherlands)

    Mammadova, A.; Ackermans, M.M.; Bloemen, M.; Oostendorp, C.; Zhou, H.; Carels, C.E.L.; Hoff, J.W. Von den

    2014-01-01

    SUMMARY BACKGROUND: Retinoic acid (RA) is a key regulator of embryonic development and linked to several birth defects including cleft lip and palate (CLP). The aim was to investigate the effects of RA on proliferation and gene expression of human palatal keratinocytes (KCs) in vitro. METHODS: KCs

  12. [Orthognathic surgery for patients with cleft lip and palate].

    Science.gov (United States)

    Paulus, C

    2014-09-01

    Patients with cleft lip and palate frequently develop dento-facial deformity requiring orthognatic surgery. The origin of this deformity is therapeutic and surgeons are currently trying to prevent this iatrogenicity. The maxillary dento-facial deformity in these patients is a retrognathia with infragnathia, associated with endognathia, obliquity of the occlusal plane, with deviation of the superior incisive midline in case of unilateral clefts. The difficulties in the treatment of these skeletal deformities are due to the palatal, labial, and pterygomaxillary scar tissue. Orthognathic surgery is most of the time bimaxillary with a 3-dimensional movement of the jaws including maxillary advancement. The aims of surgery are occlusal, esthetic, and functional improvement. The first step is gingivoperiosteoplasty (ideally performed during childhood), orthodontic treatment including, if necessary, transversal maxillary distraction to obtain enough space to replace the lateral incisor; extraction of premolars should be avoided if possible. Planning and performing the treatment are difficult for the orthodontist and for the surgeon. Maxillary advancement by distraction may be an interesting alternative to prevent partial relapse. Obtaining normal oro-facial functions are required for a stable result. These should be monitored after the primary treatment by the whole staff, surgeons, speech therapist, and orthodontists. Performing Le Fort 1 osteotomy is more difficult than in other patients because of scar fibrosis than needs to be released. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Prevalence, pattern and perceptions of cleft lip and cleft palate among children born in two hospitals in Kisoro District, Uganda

    Science.gov (United States)

    2014-01-01

    Background Cleft lip with or without cleft palate is one of the most common congenital anomalies that affect the oro-facial region. The aim of the study was to determine the period prevalence, pattern and perceptions of cleft lip and cleft palate in children born between 2005 and 2010 in two hospitals in Kisoro District, Uganda. Methods The study involved a retrospective review of medical records of mothers who delivered live babies between January 2005 and December 2010 in Kisoro Hospital and St. Francis Hospital, Mutolere in Kisoro District. Key informant interviews of mothers (n = 20) of the children with cleft lip and/or clip palate and selected medical staff (n = 24) of the two hospitals were carried out. The data were analysed using descriptive statistics. Results Over the 6 year period, 25,985 mothers delivered live babies in Kisoro Hospital (n = 13,199) and St. Francis Hospital, Mutolere (n = 12,786) with 20 babies having oro-facial clefts. The overall period prevalence of the clefts was 0.77/1,000 live births. Sixty percent (n = 12) of children had combined cleft lip and palate and the same proportion had clefts on the left side of the face. More boys were affected than girls: 13 versus 7. About 45% of mothers were hurt on realizing that they had delivered a child with an oro-facial cleft. Forty percent of mothers indicated that a child with oro-facial cleft was regarded as an outcast. About 91.7% (n = 22) of the medical staff reported that these children were not accepted in their communities. Surgical intervention and psychosocial support were the management modalities advocated for by most respondents. Conclusion/recommendations The period prevalence of combined cleft lip and palate in two hospitals in Kisoro District was comparable to some findings elsewhere. Cleft lip and cleft palate are a medical and psychosocial problem in Kisoro District that calls for sensitization and counseling of the families and communities of the affected children

  14. 3D-Printed Models of Cleft Lip and Palate for Surgical Training and Patient Education.

    Science.gov (United States)

    Chou, Pang-Yun; Hallac, Rami R; Shih, Ellen; Trieu, Jenny; Penumatcha, Anjani; Das, Priyanka; Meyer, Clark A; Seaward, James R; Kane, Alex A

    2018-03-01

    Sculpted physical models and castings of the anatomy of cleft lip and palate are used for parent, patient, and trainee education of cleft lip and palate conditions. In this study, we designed a suite of digital 3-dimensional (3D) models of cleft lip and palate anatomy with additive manufacturing techniques for patient education. CT scans of subjects with isolated cleft palate, unilateral and bilateral cleft lip and palate, and a control were obtained. Soft tissue and bony structures were segmented and reconstructed into digital 3D models. The oral soft tissues overlying the cleft palate were manually molded with silicone putty and scanned using CT to create digital 3D models. These were then combined with the original model to integrate with segmentable soft tissues. Bone and soft tissues were 3D printed in different materials to mimic the rigidity/softness of the relevant anatomy. These models were presented to the parents/patients at our craniofacial clinic. Visual analog scale (VAS) surveys were obtained pertaining to the particular use of the models, to ascertain their value in parental education. A total of 30 parents of children with cleft conditions completed VAS evaluations. The models provided the parents with a better understanding of their child's condition with an overall evaluation score of 9.35 ± 0.5. We introduce a suite of 3D-printed models of cleft conditions that has a useful role in patient, parental, and allied health education with highly positive feedback.

  15. Cleft lip and palate repair: the experience from two West African sub-regional centres.

    Science.gov (United States)

    Onah, I I; Opara, K O; Olaitan, P B; Ogbonnaya, I S

    2008-08-01

    Compliance with primary surgical treatment in people with cleft lip and palate is a well-known problem, especially in developing countries fraught with poverty and ignorance. Different protocols of treatment exist. In this paper, we retrospectively review a cohort from two centres, with a discussion on the outcome and its implications. The records of all patients with cleft lip and palate seen in the National Orthopaedic Hospital, Enugu, Nigeria, from January 1993 to December 1999, were sought, and all available case notes reviewed retrospectively. This included new cases seen in the period, and also cases operated during this period. Follow up took place until January 2005, when the data were collated. The records of all such patients seen at Ladoke Akintola University Teaching Hospital Osogbo, Nigeria, from September 2004 to June 2006 were also collated and analysed. During this period, 102 patients were seen (93 at Enugu and nine at Osogbo). Fifteen had isolated cleft palate, 42 had isolated cleft lip and 45 had combined cleft lip and palate. Presentation time ranged from 1 day to 43 years. The palate was not repaired in 20 people after lip repair; two patients with cleft lip and palate completely defaulted; and only one person with isolated cleft palate failed to undergo surgery in this period. Two patients in Osogbo absconded. The West African sub-region has a high drop out rate after lip repair.

  16. The Effectiveness of Psychosocial Intervention for Individuals With Cleft Lip and/or Palate.

    Science.gov (United States)

    Norman, Alyson; Persson, Martin; Stock, Nicola; Rumsey, Nichola; Sandy, Jonathan; Waylen, Andrea; Edwards, Zoe; Hammond, Vanessa; Partridge, Lucy; Ness, Andy

    2015-05-01

    The aim of this review was to assess the effectiveness of different psychological interventions for children and adults with cleft lip and/or palate and their parents. We searched six databases including MEDLINE and EMBASE to June 2013 and checked bibliographies. We included research that evaluated any psychological intervention in studies in which at least 90% of the participants had cleft lip and/or palate or were parents of those with cleft lip and/or palate. Studies containing less than 90% were excluded unless they reported results separately for those with cleft lip and/or palate, or raw data were available upon request from the authors. Inclusion assessment, data extraction, and risk of bias assessment were carried out independently by two reviewers. Seven studies were identified as inclusions, with only two studies being included in the full data analysis (one of which failed to meet the full inclusion criteria). The five remaining studies were included only in a narrative synthesis because data were available for people or parents of those with cleft lip and/or palate only. This highlights a distinct dearth of research into psychological intervention within the field of cleft lip and/or palate. The review found no evidence to support any specific intervention. Key uncertainties need to be identified and addressed. Adequately powered, methodologically rigorous randomized controlled trials are needed to provide a secure evidence base for psychological intervention techniques in participants with cleft lip and/or palate and their parents.

  17. Cleft palate repair: description of an approach, its evolution, and analysis of post-operative fistulas.

    Science.gov (United States)

    Tse, Raymond W; Siebold, Babette

    2018-01-12

    Fistulas following cleft palate repair impair speech, health, and hygiene and occur in up to 35% cases. The purpose of this study was to (1) describe the evolution of a surgical approach to cleft palate repair; (2) assess the rates, causes, and predictive factors of fistulas; (3) assess the temporal association of modifications to fistula rates during six years of a single surgeon experience. Consecutive patients (N=146) undergoing cleft palate repair were included. The technique of repair was based on cleft type and a common surgical approach was used for all repairs. Modifications to the approach were made around specific anatomic features including peri-articular bony hillocks, maxilla-palatine suture, velopalatine pits, and tensor insertion. Fistula rate after primary repair was 2.4% (N=125) and after secondary repair was 0% (N=22). All complications occurred in patients with Type 3 or 4 clefts. Cleft width and cleft:total palatal width were associated with fistulas whereas syndromes, age, and adoption were not.Traumatic dissection and inadequate release were suspected in cases of delayed healing and flap necrosis during the first 2 years. Modifications were introduced following these complications. The fistula rate declined by one half in subsequent years. We describe a surgical approach to cleft palate repair and its evolution. Fistulas were rare but associated with increasing cleft severity (type, width).A reduction in frequency and severity of fistulas was consistent with a learning curve and may in part be associated with modifications to the surgical approach.

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

    Directory of Open Access Journals (Sweden)

    Taiwo O Abdurrazaq

    2013-01-01

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

  19. Automatic initial and final segmentation in cleft palate speech of Mandarin speakers

    Science.gov (United States)

    Liu, Yin; Yin, Heng; Zhang, Junpeng; Zhang, Jing; Zhang, Jiang

    2017-01-01

    The speech unit segmentation is an important pre-processing step in the analysis of cleft palate speech. In Mandarin, one syllable is composed of two parts: initial and final. In cleft palate speech, the resonance disorders occur at the finals and the voiced initials, while the articulation disorders occur at the unvoiced initials. Thus, the initials and finals are the minimum speech units, which could reflect the characteristics of cleft palate speech disorders. In this work, an automatic initial/final segmentation method is proposed. It is an important preprocessing step in cleft palate speech signal processing. The tested cleft palate speech utterances are collected from the Cleft Palate Speech Treatment Center in the Hospital of Stomatology, Sichuan University, which has the largest cleft palate patients in China. The cleft palate speech data includes 824 speech segments, and the control samples contain 228 speech segments. The syllables are extracted from the speech utterances firstly. The proposed syllable extraction method avoids the training stage, and achieves a good performance for both voiced and unvoiced speech. Then, the syllables are classified into with “quasi-unvoiced” or with “quasi-voiced” initials. Respective initial/final segmentation methods are proposed to these two types of syllables. Moreover, a two-step segmentation method is proposed. The rough locations of syllable and initial/final boundaries are refined in the second segmentation step, in order to improve the robustness of segmentation accuracy. The experiments show that the initial/final segmentation accuracies for syllables with quasi-unvoiced initials are higher than quasi-voiced initials. For the cleft palate speech, the mean time error is 4.4ms for syllables with quasi-unvoiced initials, and 25.7ms for syllables with quasi-voiced initials, and the correct segmentation accuracy P30 for all the syllables is 91.69%. For the control samples, P30 for all the syllables is 91

  20. Automatic initial and final segmentation in cleft palate speech of Mandarin speakers.

    Directory of Open Access Journals (Sweden)

    Ling He

    Full Text Available The speech unit segmentation is an important pre-processing step in the analysis of cleft palate speech. In Mandarin, one syllable is composed of two parts: initial and final. In cleft palate speech, the resonance disorders occur at the finals and the voiced initials, while the articulation disorders occur at the unvoiced initials. Thus, the initials and finals are the minimum speech units, which could reflect the characteristics of cleft palate speech disorders. In this work, an automatic initial/final segmentation method is proposed. It is an important preprocessing step in cleft palate speech signal processing. The tested cleft palate speech utterances are collected from the Cleft Palate Speech Treatment Center in the Hospital of Stomatology, Sichuan University, which has the largest cleft palate patients in China. The cleft palate speech data includes 824 speech segments, and the control samples contain 228 speech segments. The syllables are extracted from the speech utterances firstly. The proposed syllable extraction method avoids the training stage, and achieves a good performance for both voiced and unvoiced speech. Then, the syllables are classified into with "quasi-unvoiced" or with "quasi-voiced" initials. Respective initial/final segmentation methods are proposed to these two types of syllables. Moreover, a two-step segmentation method is proposed. The rough locations of syllable and initial/final boundaries are refined in the second segmentation step, in order to improve the robustness of segmentation accuracy. The experiments show that the initial/final segmentation accuracies for syllables with quasi-unvoiced initials are higher than quasi-voiced initials. For the cleft palate speech, the mean time error is 4.4ms for syllables with quasi-unvoiced initials, and 25.7ms for syllables with quasi-voiced initials, and the correct segmentation accuracy P30 for all the syllables is 91.69%. For the control samples, P30 for all the

  1. Automatic initial and final segmentation in cleft palate speech of Mandarin speakers.

    Science.gov (United States)

    He, Ling; Liu, Yin; Yin, Heng; Zhang, Junpeng; Zhang, Jing; Zhang, Jiang

    2017-01-01

    The speech unit segmentation is an important pre-processing step in the analysis of cleft palate speech. In Mandarin, one syllable is composed of two parts: initial and final. In cleft palate speech, the resonance disorders occur at the finals and the voiced initials, while the articulation disorders occur at the unvoiced initials. Thus, the initials and finals are the minimum speech units, which could reflect the characteristics of cleft palate speech disorders. In this work, an automatic initial/final segmentation method is proposed. It is an important preprocessing step in cleft palate speech signal processing. The tested cleft palate speech utterances are collected from the Cleft Palate Speech Treatment Center in the Hospital of Stomatology, Sichuan University, which has the largest cleft palate patients in China. The cleft palate speech data includes 824 speech segments, and the control samples contain 228 speech segments. The syllables are extracted from the speech utterances firstly. The proposed syllable extraction method avoids the training stage, and achieves a good performance for both voiced and unvoiced speech. Then, the syllables are classified into with "quasi-unvoiced" or with "quasi-voiced" initials. Respective initial/final segmentation methods are proposed to these two types of syllables. Moreover, a two-step segmentation method is proposed. The rough locations of syllable and initial/final boundaries are refined in the second segmentation step, in order to improve the robustness of segmentation accuracy. The experiments show that the initial/final segmentation accuracies for syllables with quasi-unvoiced initials are higher than quasi-voiced initials. For the cleft palate speech, the mean time error is 4.4ms for syllables with quasi-unvoiced initials, and 25.7ms for syllables with quasi-voiced initials, and the correct segmentation accuracy P30 for all the syllables is 91.69%. For the control samples, P30 for all the syllables is 91.24%.

  2. The effect of cleft palate repair on contractile properties of single permeabilized muscle fibers from congenitally cleft goat palates.

    Science.gov (United States)

    Hanes, Michael C; Weinzweig, Jeffrey; Panter, Kip E; McClellan, W Thomas; Caterson, Stefanie A; Buchman, Steven R; Faulkner, John A; Yu, Deborah; Cederna, Paul S; Larkin, Lisa M

    2008-02-01

    Inherent differences in the levator veli palatini (LVP) muscle of cleft palates before palatoplasty may play a role in persistent postrepair velopharyngeal insufficiency (VPI). Contractile properties of LVP muscle fibers were analyzed from young (2-month) normal (YNP), young congenitally cleft (YCP) and again on the same YCP subjects 6 months after palatoplasty, mature repaired palate (MRP). The cross-sectional area and rate of force development (ktr) were measured. Specific force (sF(0)) and normalized power (nP(max)) were calculated. Using k(tr) to determine fiber type composition, YNP was 44% type 1 and 56% type 2, while YCP was 100% type 2. Two MRP subjects shifted to 100% type 1; 1 demonstrated increased resistance to fatigue. No differences in sF(0) were observed. nP(max) increased with presence of type 2 fibers. The persistent state of type 2 fibers following palatoplasty leads to increased fatigue in the LVP of MRP subjects and may cause VPI symptoms.

  3. 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

  4. Follow-Up Association Studies of Chromosome Region 9q and Nonsyndromic Cleft Lip/Palate

    Science.gov (United States)

    Letra, Ariadne; Menezes, Renato; Govil, Manika; Fonseca, Renata F.; McHenry, Toby; Granjeiro, José M.; Castilla, Eduardo E.; Orioli, Iêda M.; Marazita, Mary L.; Vieira, Alexandre R.

    2010-01-01

    Cleft lip/palate comprises a large fraction of all human birth defects, and is notable for its significant lifelong morbidity and complex etiology. Several studies have shown that genetic factors appear to play a significant role in the etiology of cleft lip/palate. Human chromosomal region 9q21 has been suggested in previous reports to contain putative cleft loci. Moreover, a specific region (9q22.3-34.1) was suggested to present a ∼45% probability of harboring a cleft susceptibility gene. Fine mapping of fifty SNPs across the 9q22.3-34.11 region was performed to test for association with cleft lip/palate in families from United States, Spain, Turkey, Guatemala, and China. We performed family-based analysis and found evidence of association of cleft lip/palate with STOM (rs306796) in Guatemalan families (P=0.004) and in all multiplex families pooled together (P=0.002). This same SNP also showed borderline association in the US families (P=0.04). Under a nominal value of 0.05, other SNPs also showed association with cleft lip/palate and cleft subgroups. SNPs in STOM and PTCH genes and nearby FOXE1 were further associated with cleft phenotypes in Guatemalan and Chinese families. Gene prioritization analysis revealed PTCH and STOM ranking among the top fourteen candidates for cleft lip/palate among 339 genes present in the region. Our results support the hypothesis that the 9q22.32-34.1 region harbors cleft susceptibility genes. Additional studies with other populations should focus on these loci to further investigate the participation of these genes in human clefting. PMID:20583170

  5. Maternal Risk Factors Associated with the Development of Cleft Lip and Cleft Palate in Mexico: A Case-Control Study.

    Science.gov (United States)

    Angulo-Castro, Emmanuel; Acosta-Alfaro, Luis F; Guadron-Llanos, Alma M; Canizalez-Román, Adrian; Gonzalez-Ibarra, Fernando; Osuna-Ramírez, Ignacio; Murillo-Llanes, Joel

    2017-07-01

    Cleft lip and palate, the most common developmental deformity, is seen worldwide and the etiology involves a combination of genetic and environmental factors. The purpose of this study was to determine the maternal risk factors associated with the development of cleft lip and cleft palate. We conducted a case control study at the Women's Hospital in Culiacan, Mexico. Medical records were analyzed, including patients who delivered babies with and without cleft lip and cleft palate from January 2010 to December 2015. Multiple variables were analyzed, including gestational age, weight at birth, the use of folic acid and multivitamins during pregnancy, smoking, alcohol abuse, the use of recreational drugs, history of sexually transmitted infections, marital status, socioeconomic status, education, and nutritional status. We found that the maternal risk factors with the strongest association for the development of cleft lip and cleft palate were the following: patients who were not taking folic acid during pregnancy [OR 3.27, 95% CI 1.32-8.09], P=0.00; patients who were not taking vitamin supplementation during pregnancy [OR 2.6, 95% CI 1.19-7.27], P=0.02; smoking during pregnancy [OR 2.05, 95% CI 1.23-3.41], P=0.01; and alcohol abuse during pregnancy [OR 1.90, 95% CI 1.17-3.08], P=0.03. The main risk factors associated with the development of cleft lip and cleft palate in a Mexican population at the Women's hospital in Culiacan, Sinaloa, Mexico were smoking, alcohol abuse, and patients not taking folic acid and multivitamins during pregnancy.

  6. Fetal genetic risk of isolated cleft lip only versus isolated cleft lip and palate: A subphenotype analysis using two population-based studies of orofacial clefts in scandinavia

    DEFF Research Database (Denmark)

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

    2010-01-01

    BACKGROUND: Cleft lip only (CLO) and cleft lip and palate (CLP) are commonly regarded as variants of the same defect and are traditionally combined to form the single group of cleft lip with or without cleft palate (CL/P) prior to analysis. However, recent data have suggested that at least...... a subgroup of isolated CLO may be etiologically distinct from isolated CLP. METHODS: To explore fetal genetic risk of isolated CLO separately from isolated CLP, we performed a subphenotype analysis using two population-based studies of clefts in Scandinavia. One hundred twenty-one isolated CLO, 190 isolated...... CLP, and 592 control triads were available from Norway (1996-2001), and a further 76 isolated CLO and 107 isolated CLP triads were available from Denmark (1991-2001). Genotypes for 1315 SNPs in 334 autosomal cleft candidate genes were analyzed using two complementary statistical methods, Triad Multi...

  7. Alternative of pedicle buccal fat pad for reconstruction defect in cleft palate patient

    Directory of Open Access Journals (Sweden)

    Nur Hidayat

    2016-06-01

    Full Text Available Various surgical techniques have been employed for closure of the defect in the oral cavity. The type and size of defects in the oral cavity determine the techniques to use. Pedicle Buccal Fat Pad (BFP is one alternative tissue graft for defect reconstruction in oral cavity. The objective of this paper is to determine an alternative defect reconstruction in cleft palate using pedicle BFP. In conclusion, the use of BFP for the defect reconstruction in cleft palate patients shows satisfactory results with good healing. BFP can be an alternative method in the treatment of cleft palate defect.

  8. Ectrodactyly, ectodermal dysplasia, and cleft lip/palate syndrome: A case report of "Incomplete syndrome"

    Directory of Open Access Journals (Sweden)

    P K Shivaprakash

    2012-01-01

    Full Text Available Ectrodactyly, ectodermal dysplasia, and cleft lip/palate (EEC is a rare syndrome having ectrodactyly, ectodermal dysplasia, and cleft lip/palate. So far, very few cases have been reported in literature. However, we report a case of incomplete EEC syndrome having ectrodactyly and cleft lip and palate with absence of signs of ectodermal dysplasia with no other systemic anomalies. Other feature noted is the syndactyly of toes which is reported rarely in this syndrome. A multidisciplinary approach for treatment is needed which is co-ordinated by pedodontist or pediatrician.

  9. Nonsyndromic cleft lip with or without cleft palate: New BCL3 information

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C.; Hecht, J.T. [Univ. of Texas Medical School, Houston, TX (United States); Gasser, D. [Univ. of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    1996-09-01

    We did not previously provide LOD scores for linkage assuming heterogeneity, as suggested by Ott for the linkage analysis of cleft lip with or without cleft palate (CL/P) and BCL3, ApoC2, and D19S178 in the paper by Stein et al. The results from analysis using the HOMOG program, allowing for heterogeneity under the reduced penetrance model, gave a maximum LOD score of 1.85 for ApoC2, 0.41 for BCL3, 0.03 for D19S178, and 1.72 for multipoint analysis in the interval. For the affecteds-only model, the values are 1.96 for ApoC2, 0.41 for BCL3, 0.01 for D19S178, and 1.44 for the multipoint analysis. 8 refs.

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

    DEFF Research Database (Denmark)

    Semb, Gunvor; Enemark, Hans; Friede, Hans

    2017-01-01

    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. METHOD: Ten established national or regional......BACKGROUND AND AIMS: 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...... 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...

  11. 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

    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. Method: Ten established national or regional......Background and aims: 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...... 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...

  12. Bilateral vertical segmental distraction in a patient with bilateral cleft of lip, alveolus, and palate.

    Science.gov (United States)

    Pichelmayer, Margit; Zemann, Wolfgang

    2012-05-01

    In cases of bilateral clefts of lip and palate there is often a vertical and transversal deficit of the cleft segments. Ideally these problems can be solved orthodontically. In severe cases there is a need of surgical support. Distraction osteogenesis allows the correction of transversal, horizontal, and vertical deficits. A case of a 13-year-old girl with a bilateral cleft of lip and palate is presented. The patient had a severe deficit of the distal cleft segments concerning the vertical and transversal dimension. Osteotomy of the segments was performed and a vertical distraction followed by a transpalatal distraction procedure was used to correct the discrepancies.

  13. Does the interaction between maternal folate intake and the methylenetetrahydrofolate reductase polymorphisms affect the risk of cleft lip with or without cleft palate?

    NARCIS (Netherlands)

    Vermeij-Keers, C.; Kluijtmans, L.A.J.; Ocke, M.C.; Zielhuis, G.A.; Goorhuis-Brouwer, S.M.; Biezen, J.J. van der; Kuijpers-Jagtman, A.M.; Steegers-Theunissen, R.P.M.

    2003-01-01

    Periconceptional folic acid supplementation may reduce the risk of cleft lip with or without cleft palate (CL(P)). Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene reduce availability of 5-methyltetrahydrofolate, the predominant circulating form of folate. To determine the

  14. 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)

  15. Factors prognostic for phonetic development after cleft palate repair.

    Science.gov (United States)

    Lee, Joon Seok; Kim, Jae Bong; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

    2015-10-01

    Palatoplasty is aimed to achieve normal speech, improve food intake, and ensure successful maxillary growth. However, the velopharyngeal function is harder to control than other functions. Therefore, many studies on the prognostic factor of velopharyngeal insufficiency have been conducted. This study aimed to evaluate the relationships between speech outcomes and multimodality based on intraoral and preoperative three-dimensional computerized tomographic (CT) findings. Among 73 children with cleft palate who underwent palatoplasty between April 2011 and August 2014 at Kyungpook National University Hospital (KNUH), 27 were retrospectively evaluated. The 27 cases were non-syndromic, for which successful speech evaluation was conducted by a single speech-language pathologist (Table 1). Successful speech evaluation was defined as performing the test three times in 6-month intervals. Three intraoral parameters were measured before and immediately after operation (Fig. 1). On axial- and coronal-view preoperative facial CT, 5 and 2 different parameters were analyzed, respectively (Figs. 2 and 3). Regression analysis (SPSS IBM 22.0) was used in the statistical analysis. Two-flap palatoplasty and Furlow's double opposing Z-plasty were performed in 15 and 12 patients, respectively. The operation was performed 11 months after birth on average. Children with a higher palatal arch and wider maxillary tuberosity distance showed hypernasality (p palate width and height, rather than initial diagnosis, treatment method, or palate length. Therefore, a more active intervention is needed, such as orthopedic appliance, posterior pharyngeal wall augmentation, or early speech training. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  17. Influence analysis of cleft type and supernumerary teeth eruption in the prognosis of bone graft in patients with cleft palate.

    Science.gov (United States)

    Gaujac, Cristiano; de Souza Faco, Eduardo Francisco; Shinohara, Elio Hitoshi; de Souza Faco, Renato Andre; Pereira, Flávia Priscila; Assunção, Wirley Gonçalves

    2014-09-01

    The aim of this study was to investigate the influence of cleft type and supernumerary tooth eruption on the treatment of palatal clefts with alveolar bone grafts. In this article, medical records of 40 patients with palatal clefts and associated supernumerary teeth who were treated with alveolar bone grafting in the Hospital for Craniofacial Anomalies Rehabilitation were assessed. The patients were studied to assess the influence of supernumerary teeth and the cleft severity on the prognosis of the alveolar bone graft. Forty medical records were included in the assessment. When the teeth in the cleft had an anatomic shape close to canine, we called them precanine. When they were very small or malformed, we called them anomalous lateral incisors. The teeth studied showed good prognoses and were more expressive in the preforaminal clefts (87.5%) than in the transforaminal ones (62.5%). Moreover, the transforaminal clefts presented a higher percentage in satisfactory and poor prognoses (37.5%). The authors found that supernumerary teeth influenced the maintenance of alveolar bone graft height and that transforaminal clefts presented a worse prognosis than preforaminal clefts.

  18. Long-Term Otologic and Audiometric Outcomes in Patients with Cleft Palate.

    Science.gov (United States)

    Imbery, Terence E; Sobin, Lindsay B; Commesso, Emily; Koester, Lindsey; Tatum, Sherard A; Huang, Danning; Wang, Dongliang; Nicholas, Brian D

    2017-10-01

    Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.

  19. Patterns of orofacial clefting in the facial morphology of bats: a possible naturally occurring model of cleft palate.

    Science.gov (United States)

    Orr, David J A; Teeling, Emma C; Puechmaille, Sébastien J; Finarelli, John A

    2016-11-01

    A normal feature of the facial anatomy of many species of bat is the presence of bony discontinuities or clefts, which bear a remarkable similarity to orofacial clefts that occur in humans as a congenital pathology. These clefts occur in two forms: a midline cleft between the two premaxillae (analogous to the rare midline craniofacial clefts in humans) and bilateral paramedian clefts between the premaxilla and the maxillae (analogous to the typical cleft lip and palate in humans). Here, we describe the distribution of orofacial clefting across major bat clades, exploring the relationship of the different patterns of clefting to feeding mode, development of the vomeronasal organ, development of the nasolacrimal duct and mode of emission of the echolocation call in different bat groups. We also present the results of detailed radiographic and soft tissue dissections of representative examples of the two types of cleft. The midline cleft has arisen independently multiple times in bat phylogeny, whereas the paramedian cleft has arisen once and is a synapomorphy uniting the Rhinolophidae and Hipposideridae. In all cases examined, the bony cleft is filled in by a robust fibrous membrane, continuous with the periosteum of the margins of the cleft. In the paramedian clefts, this membrane splits to enclose the premaxilla but forms a loose fold laterally between the premaxilla and maxilla, allowing the premaxilla and nose-leaf to pivot dorsoventrally in the sagittal plane under the action of facial muscles attached to the nasal cartilages. It is possible that this is a specific adaptation for echolocation and/or aerial insectivory. Given the shared embryological location of orofacial clefts in bats and humans, it is likely that aspects of the developmental control networks that produce cleft lip and palate in humans may also be implicated in the formation of these clefts as a normal feature in some bats. A better understanding of craniofacial development in bats with and

  20. 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

  1. 20 years of cleft lip and palate missions

    Science.gov (United States)

    Lambrecht, J. Thomas; Kreusch, Thomas; Marsh, Jeff L.; Schopper, Christian

    2014-01-01

    Volunteer missions for cleft lip and palate (CLP) care in Indonesia (1991-1992), India (1994-2003), Bhutan (2005-2010), and Kenya (2011), took place always at the same Hospital in each country. Altogether over a thousand patients were operated using a conservative protocol: Safety first - no experiments. Five months and 5 kg were the basic rules. For the native doctors, training help for self-help was priority. In the announcements, patients with CLP were primarily addressed. Burns, contractions, tumors, and trauma-cases were the second priority. Fresh trauma was done in night shifts with the local surgeons in order not to interfere. Besides facial esthetics speech was the number one issue, following priorities fell into place. Cultural aspects played a certain role in the different countries and continents. PMID:25593861

  2. Candidate Genes for Nonsyndromic Cleft Palate Detected by Exome Sequencing.

    Science.gov (United States)

    Hoebel, A K; Drichel, D; van de Vorst, M; Böhmer, A C; Sivalingam, S; Ishorst, N; Klamt, J; Gölz, L; Alblas, M; Maaser, A; Keppler, K; Zink, A M; Dixon, M J; Dixon, J; Hemprich, A; Kruse, T; Graf, I; Dunsche, A; Schmidt, G; Daratsianos, N; Nowak, S; Aldhorae, K A; Nöthen, M M; Knapp, M; Thiele, H; Gilissen, C; Reutter, H; Hoischen, A; Mangold, E; Ludwig, K U

    2017-10-01

    Nonsyndromic cleft palate only (nsCPO) is a facial malformation that has a livebirth prevalence of 1 in 2,500. Research suggests that the etiology of nsCPO is multifactorial, with a clear genetic component. To date, genome-wide association studies have identified only 1 conclusive common variant for nsCPO, that is, a missense variant in the gene grainyhead-like-3 ( GRHL3). Thus, the underlying genetic causes of nsCPO remain largely unknown. The present study aimed at identifying rare variants that might contribute to nsCPO risk, via whole-exome sequencing (WES), in multiply affected Central European nsCPO pedigrees. WES was performed in 2 affected first-degree relatives from each family. Variants shared between both individuals were analyzed for their potential deleterious nature and a low frequency in the general population. Genes carrying promising variants were annotated for 1) reported associations with facial development, 2) multiple occurrence of variants, and 3) expression in mouse embryonic palatal shelves. This strategy resulted in the identification of a set of 26 candidate genes that were resequenced in 132 independent nsCPO cases and 623 independent controls of 2 different ethnicities, using molecular inversion probes. No rare loss-of-function mutation was identified in either WES or resequencing step. However, we identified 2 or more missense variants predicted to be deleterious in each of 3 genes ( ACACB, PTPRS, MIB1) in individuals from independent families. In addition, the analyses identified a novel variant in GRHL3 in 1 patient and a variant in CREBBP in 2 siblings. Both genes underlie different syndromic forms of CPO. A plausible hypothesis is that the apparently nonsyndromic clefts in these 3 patients might represent hypomorphic forms of the respective syndromes. In summary, the present study identified rare variants that might contribute to nsCPO risk and suggests candidate genes for further investigation.

  3. The Bacteriology of Children before Primary Cleft Lip and Palate Surgery

    National Research Council Canada - National Science Library

    Chuo, C. B; Timmons, M. J

    2005-01-01

    Objective Bacterial infections can complicate any surgery. Knowledge of potentially pathogenic bacterial flora in children with cleft lip and palate allows appropriate risk management, including the need for prophylactic antibiotics...

  4. Outpatient dental treatment under general anesthesia in children with cleft lip palate: case report

    National Research Council Canada - National Science Library

    Ana Clara Suplicy Diogo Santos; Kimberlly Tennylle Vonsovicz; Sheila de Carvalho Stroppa; Juliana Yassue Barbosa da Silva

    2016-01-01

    Introduction and Objective: This study aimed to report the case of an eight-year-old patient with cleft lip and palate associated with undiagnosed syndrome presenting high level of carious lesions, difficulty on oral hygiene...

  5. A Case of Ectrodactyly, Ectodermal Dysplasia, Cleft Lip and Palate Syndrome Associated with Hydrocephaly

    Directory of Open Access Journals (Sweden)

    Buket Uysal Aladag

    2013-06-01

    Full Text Available Ectrodactyly, ectodermal dysplasia, cleft lip, and palate syndrome (EEC is a genetic developmental disorder characterized by ectrodactyly, ectodermal dysplasia and orofacial clefts (cleft lip/ palate. A few cases have been reported in literature. The cardinal components of the syndrome are ectrodactyly and syndactyly of the hands and feet, cleft lip with or without cleft palate, and abnormalities ectodermal structures including skin (i.e. hypopigmented and dry skin, hyperkeratosis, skin atrophy, hair (sparse hair and eye brows, teeth (small, absent or dysplastic teeth, nails (nail dystrophy and exocrine glands (reduction/ absence of sweat, sebaceous and salivary glands. A multidisciplinary approach for treatment is needed which is co-ordinated by orthopedic, plastic, dental surgeons, ophthalmologist, dermatologists and speech therapists, psychologists. We presented EEC syndrome case with hydrocephaly by the literature. [Cukurova Med J 2013; 38(3.000: 531-535

  6. Prevalence of Associated Anomalies in Cleft Lip and/or Palate Patients

    Directory of Open Access Journals (Sweden)

    Shahin Abdollahi Fakhim

    2016-03-01

    Full Text Available Introduction: Orofacial clefts are among the most common congenital anomalies. Patients presenting with orofacial clefts often require surgery or other complex procedures. A cleft lip or palate can be a single anomaly or a part of multiple congenital anomalies. The reported prevalence of cleft disease and associated anomalies varies widely across the literature, and is dependent on the diagnostic procedure used. In this study we determined the prevalence of associated anomalies in patients with a cleft lip and/or palate, with a specific focus on cardiac anomalies. Materials and Methods: In this cross-sectional study, 526 patients with a cleft lip and /or palate admitted to the children’s referral hospital between 2006 and 2011 were evaluated. All associated anomalies were detected and recorded. Patient information collected included age, gender, type and side of cleft, craniofacial anomalies and presence of other anomalies, including cardiac anomalies. Data were analyzed using SPSS version 16.   Results: Of the 526 patients enrolled in the study, 58% (305 were male and 42% (221 were female. In total, 75% of patients (396 were aged between 4 and 8 years and 25% (130 were aged less than 4 years. The most common cleft type in our study was bilateral cleft palate. The most commonly associated anomaly among cleft patients, in 12% of cleft patients, was a cardiac anomaly. The most common cardiac anomaly was atrial septal defect (ASD.   Conclusion:  The prevalence of associated anomalies among orofacial cleft patients is high. The most common associated anomaly is cardiac anomaly, with ASD being the most common cardiac anomaly. There are no significant relationships between type of cleft and associated cardiac anomalies.

  7. 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...

  8. Telemedicine as a Means of Effective Speech Evaluation for Cleft Palate Patients

    OpenAIRE

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

    2012-01-01

    Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not previously been studied. We looked at determining whether a speech evaluation performed by a Speech-Language Pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting ...

  9. Tympanogram findings in patients with cleft palates aged six months to seven years

    Science.gov (United States)

    Yanti, A.; Widiarni, D.; Alviandi, W.; Tamin, S.; Mansyur, M.

    2017-08-01

    Cleft palate is one of the most common congenital craniofacial deformities. Otitis media with effusion (OME) is a middle ear disease having a prevalence of almost 90% in patients with cleft palates. Tympanometry is a fast, safe, non-invasive, and easy tool for diagnosing middle ear disease qualitatively and quantitatively. Studies have been conducted using tympanometry to detect middle ear conditions in patients with cleft palates, but no research has studied tympanogram findings in patients with cleft palates in Indonesia. The aim of this study is to determine the tympanogram findings in Indonesian children aged six months to seven years with cleft palates. This is a cross-sectional study of 30 patients (17 males and 13 females) with Veau classification of palatal clefts aged six months to seven years (median 26.5 months) who underwent tympanometry examinations using a 226 Hztympanometer. Tympanograms were classified using the Jerger/Liden classification. Examinations of 58 ears found that type B tympanograms occurred most frequently (70.7%). The quantitative values of tympanometry analyzed included SAA (0.1-0.2 cm3), TPP value (-197.2-(-146.8 daPa)), Vec value (0.5-0.6 cm3), and gradient value (0.03-0.07 cm3). Using the Fisher test, a significant relationship was found between age and type of tympanogram (p = 0.0039) with the risk of type B and C tympanograms in infants (6-60 months) as high as 4.8 times that of children without cleft palates. The type B tympanogram was most frequently seen in patients with cleft palates aged six months to seven years old with the quantitative values of tympanometry lower than the normal values. Therefore, there was a significant difference in the type of tympanogram seen with age.

  10. A new technique of impression making for an obturator in cleft lip and palate patient

    Directory of Open Access Journals (Sweden)

    Ravichandra K

    2010-01-01

    Full Text Available Cleft lip and palate is a birth defect occurring in the orofacial region. One of the immediate problems to be addressed in a newborn with this defect would be to aid in suckling and swallowing. Here we present a case of a 5-day-old infant with unilateral cleft lip and palate for whom feeding obturator was made by using a simplified impression technique to facilitate feeding.

  11. Alternative of pedicle buccal fat pad for reconstruction defect in cleft palate patient

    OpenAIRE

    Nur Hidayat; Muhammad Ruslin

    2016-01-01

    Various surgical techniques have been employed for closure of the defect in the oral cavity. The type and size of defects in the oral cavity determine the techniques to use. Pedicle Buccal Fat Pad (BFP) is one alternative tissue graft for defect reconstruction in oral cavity. The objective of this paper is to determine an alternative defect reconstruction in cleft palate using pedicle BFP. In conclusion, the use of BFP for the defect reconstruction in cleft palate patients shows satisfactory ...

  12. Safe sleeping positions: practice and policy for babies with cleft palate

    OpenAIRE

    Davies, Karen; Bruce, Iain; Bannister, Patricia; Callery, Peter

    2017-01-01

    Guidance recommends ?back to sleep? positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) dec...

  13. Implications of Untreated Cleft Palate in the Developing World: Adaptation of an Outcome Measure

    OpenAIRE

    Rees, J.; Muskett, TA; Enderby, P.; Stackhouse, J.

    2016-01-01

    Objectives: To identify the implications of living with untreated cleft palate and develop an outcome measure which reflects the broad impact of surgery but is sensitive to the physical impact, speech changes, and psychosocial implications of late intervention. Design, Participants, Setting: Focus groups and individual interviews were used to gather information on the implications of living with untreated cleft palate and the impact of subsequent surgery. Participants included 11 individuals ...

  14. Production and application of autologous epithelial equivalents for the recovery of cleft palate in a patient

    OpenAIRE

    Franco González, Lina María; Restrepo-Múnera, Luz Marina

    2014-01-01

    Introduction: this research paper stems from the project entitled “Production of oral mucosae equivalents for cleft lip and palate patients” undertaken by the “Tissue engineering and cell therapy” research group of the Universidad de Antioquia. One of the most frequent alterations in the oral cavity is the cleft lip and palate (cl/p) defect. Depending on the proportion and extension of the damage, conventional surgical procedures are often only partially successful. The problems are mainly du...

  15. Orthodontic and prosthodontic management of an adult patient with unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Sapna Singla

    2016-01-01

    Full Text Available Cleft lip and palate is a common congenital malformation. Individuals born with this type of deformity, face number of challenges such as facial esthetics, hearing impairment, anatomical deformities to name a few. These patients require various treatments involving a multidisciplinary team such as prosthodontists, orthodontists, cosmetic dentists and surgeons. This report describes a case of orthodontic and prosthetic rehabitilation of an adult patient with unilateral cleft lip and palate.

  16. First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasound.

    Science.gov (United States)

    Martinez-Ten, P; Adiego, B; Illescas, T; Bermejo, C; Wong, A E; Sepulveda, W

    2012-07-01

    To determine whether systematic examination of primary and secondary palates using three-dimensional (3D) ultrasound aids in the identification of orofacial clefts in the first trimester. 3D datasets were acquired prospectively from women undergoing first-trimester ultrasound screening for aneuploidy. Multiplanar mode display was used for offline analysis of (1) the primary palate in the coronal plane at the base of the retronasal triangle and (2) the secondary palate by virtual navigation in the axial plane. In addition, 3D datasets from three fetuses with a cleft palate diagnosed in the first trimester were retrospectively identified and included randomly in the study group. A total of 240 3D datasets from 237 pregnancies (including three sets of twins), 89% of which were obtained transabdominally and 11% transvaginally, were examined independently by three operators. The quality of the 3D datasets was classified subjectively as good, fair and poor in 76%, 20% and 4% of cases, respectively. Seven fetuses had an orofacial cleft; all involved both the primary palate and the secondary palate. Using 3D offline analysis, the primary palate was classified as intact in 229 (95%), cleft in nine (4%) and indeterminate in two (1%). Seven of the nine fetuses suspected to have a cleft affecting the primary palate had the cleft confirmed at birth or at postmortem examination (false-positive rate 0.9% (2/231)). The secondary palate was classified as intact in 217 (90%), cleft in six (3%) and indeterminate in 17 (7%). Clefts of the secondary palate were confirmed in all six suspected cases and missed in one, which was diagnosed at 16 weeks. The visualization rate was affected by the quality of the 3D dataset (P palate and 86% of cases involving the secondary palate were visualized using 3D ultrasound with a satisfactory false-positive rate. Virtual navigation of the fetal palate using the multiplanar mode display seems to be useful in the diagnosis of clefting in the first

  17. Hearing outcomes in children with cleft palate and referred newborn hearing screen.

    Science.gov (United States)

    Jordan, Victoria A; Sidman, James D

    2014-09-01

    To determine the prevalence of long-term hearing loss in patients with cleft palate who fail their universal newborn hearing screen. The study is a retrospective chart review from a tertiary pediatric center and tertiary children's hospital. Newborns with cleft palate born between January 2002 and July 2012 were identified from a pediatric otolaryngology practice database. This cohort was then reduced to include only those patients who referred their universal newborn hearing screen. Postpressure equalization tube audiology results, follow-up audiology results, type of cleft, and comorbid conditions were collected for each patient who was both born with a cleft palate and referred their universal newborn hearing screen. A total of 317 newborns presented to the pediatric otolaryngology practice for cleft palate, with 89 (28%) having documented referred universal newborn hearing screen. At the time of data collection, 67 (75%) of 89 had normal hearing results, whereas 22 (25%) of 89 did not yet have normal hearing results. Fourteen patients had permanent hearing loss, and all 14 had a comorbid condition. Type of cleft and presence of a comorbid condition were correlated to hearing outcomes. Newborns with cleft palate who refer their universal newborn hearing screen could postpone diagnostic hearing testing until after placement of pressure equalization tubes, unless there is a clue to permanent hearing loss such as a comorbid condition. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Evaluation of the cephalometric changes of Tweed triangle in patients with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mohsen Shirazi

    2015-12-01

    Full Text Available Background and Aims: Cleft lip and palate patients require orthodontic treatments during their childhood and adolescence. Tweed diagnostic triangle as well as cephalometric assessments provides important data regarding the skeletal patterns for the treatment and diagnostic purposes. The present study determined the cephalometric changes of Tweed triangle in the cleft lip and palate patients compared to normal patients. Materials and Methods: In total, 101 cleft and palate patients as well as 95 normal individuals with the balanced age, gender and race were evaluated. All the cleft and palate patients had similar treatment histories. Radiographic clichés were obtained from both groups and the images were traced after identifying the anatomic landmarks. The studied landmarks included points, lines, and plans as well as dental and skeletal angles and distance ratios measured in radiographic images. The landmarks were statistically analyzed using Student t test. Results: Significant differences were found between the cleft lip and palate patients and normal individuals regarding craniofacial complex morphology (P0.05. Conclusion: In total, significant differences were observed between normal and cleft lip and palate individuals regarding Tweed diagnostic triangle area. These differences were decreased IMPA and increased FMA and FMIA angles. No significant differences were found in terms of other indices.

  19. Spelling Processes of Children With Nonsyndromic Cleft Lip and/or Palate: A Preliminary Study.

    Science.gov (United States)

    Lee, Karen Shi Mei; Young, Selena Ee-Li; Liow, Susan Jane Rickard; Purcell, Alison Anne

    2015-01-01

    Objective :  To compare the cognitive-linguistic processes underlying spelling performance of children with cleft lip and/or palate with those of typically developing children. Design :  An assessment battery including tests of hearing, articulation, verbal short-term and working memory, and phonological awareness, as well as word and nonword spelling, was administered to both groups. Participants :  A total of 15 children with nonsyndromic cleft lip and/or palate were case-matched by age and sex to 15 typically developing children. The children were aged between 6 and 8 years and were bilingual, with English the dominant language. Results :  Wilcoxon signed-rank tests revealed that the performance of children with cleft lip and/or palate was significantly poorer on phoneme deletion and nonword spelling (P spelling measures for the cleft lip and/or palate and typically developing groups. Conclusions :  Children with cleft lip and/or palate underachieve in phonological awareness and spelling skills. To facilitate early intervention for literacy problems, speech-language pathologists should routinely assess the cognitive-linguistic processing of children with cleft lip and/or palate, especially phonological awareness, as part of their case management protocols.

  20. A Metabonomic Approach to Analyze the Dexamethasone-Induced Cleft Palate in Mice

    Directory of Open Access Journals (Sweden)

    Jinglin Zhou

    2011-01-01

    Full Text Available Mice models are an important way to understand the relation between the fetus with cleft palate and changes of maternal biofluid. This paper aims to develop a metabonomics approach to analyze dexamethasone-induced cleft palate in pregnant C57BL/6J mice and to study the relationship between the change of endogenous small molecular metabolites in maternal plasma and the incidence of cleft palate. To do so, pregnant mice were randomly divided into two groups. The one group was injected with dexamethasone. On E17.5th day, the incident rates of cleft palate from embryos in two groups were calculated. The H1-NMR spectra from the metabolites in plasma in two groups was collected at same time. Then the data were analyzed using metabonomics methods (PCA and SIMCA. The results showed that the data from the two groups displayed distinctive characters, and the incidence of cleft palate were significantly different (P<.005. To conclude, this study demonstrates that the metabonomics approach is a powerful and effective method in detecting the abnormal metabolites from mother in the earlier period of embryos, and supports the idea that a change from dexamethasone induced in maternal metabolites plays an important role in the incidence of cleft palate.

  1. Speech characteristics after palatal closure in subjects with isolated clefts: an exploration in Uganda

    NARCIS (Netherlands)

    Anke Luyten

    2014-01-01

    Cleft lip and/or palate (CL/P) is a congenital craniofacial defect that arises on average in 1.7 per 1000 live births. This anomaly causes atypical facial appearance, hearing problems, malocclusions and speech disorders. Outcomes in terms of speech are influenced by timing of surgical cleft closure.

  2. Identification of novel candidate genes associated with cleft lip and palate using array comparative genomic hybridisation.

    NARCIS (Netherlands)

    Osoegawa, K.; Vessere, G.M.; Utami, K.H.; Mansilla, M.A.; Johnson, M.K.; Riley, B.M.; L'Heureux, J.; Pfundt, R.P.; Staaf, J.; Vliet, W.A. van der; Lidral, A.C.; Schoenmakers, E.F.P.M.; Borg, A.; Schutte, B.C.; Lammer, E.J.; Murray, J.C.; Jong, PJ de

    2008-01-01

    AIM AND METHOD: We analysed DNA samples isolated from individuals born with cleft lip and cleft palate to identify deletions and duplications of candidate gene loci using array comparative genomic hybridisation (array-CGH). RESULTS: Of 83 syndromic cases analysed we identified one subject with a

  3. Tooth agenesis patterns in unilateral cleft lip and palate in humans

    NARCIS (Netherlands)

    Bartzela, T.N.; Carels, C.E.L.; Bronkhorst, E.M.; Jagtman, A.M.

    2013-01-01

    OBJECTIVE: To characterize tooth agenesis patterns and their overall prevalence in patients with complete unilateral cleft lip and palate (CUCLP). DESIGN: Panoramic radiographs of 115 non-syndromic patients (78 males and 37 females) with CUCLP (85 patients had a cleft on the left and 30 on the

  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. Basal sphenoethmoidal encephalocele in association with midline cleft lip and palate: case report

    Energy Technology Data Exchange (ETDEWEB)

    Holanda, Maurus Marques de Almeida; Rocha, Artur Bastos; Santos, Rayan Haquim Pinheiro [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil); Furtado, Paulo Germano Cavalcanti [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil). Dept. de Pediatria e Genetica

    2011-11-15

    Association of basal sphenoethmoidal encephalocele with midline cleft lip and palate is extremely rare. The authors report the case of a nine-year-old girl presenting a midline facial cleft with meningocele that was noticeable through the palatine defect as a medial intranasal pulsatile mass. An analysis of clinical and radiological findings of the present case of cranial dysraphism is carried out. (author)

  6. TGFA and IRF6 Contribute to the Risk of Nonsyndromic Cleft Lip with or without Cleft Palate in Northeast China

    OpenAIRE

    Yongping Lu; Qiang Liu; Wei Xu; Zengjian Li; Miao Jiang; Xuefu Li; Ning Zhao; Wei Liu; Yu Sui; Chao Ma; Wenhua Feng; Weitian Han; Jianxin Li

    2013-01-01

    Nonsyndromic cleft lip with or without cleft palate (NSCL/P) are common birth defects with a complex etiology. Multiple interacting loci and possible environmental factors influence the risk of NSCL/P. 12 single nucleotide polymorphisms (SNPs) in 7 candidate genes were tested using an allele-specific primer extension for case-control and case-parent analyses in northeast China in 236 unrelated patients, 185 mothers and 154 fathers, including 128 complete trios, and 400 control individuals. TG...

  7. 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.

  8. SISL (ScreeningsInstrument Schisis Leuven): assessment of cleft palate speech, resonance and myofunction.

    Science.gov (United States)

    Breuls, M; Sell, D; Manders, E; Boulet, E; Vander Poorten, V

    2006-01-01

    This paper presents an assessment protocol for the evaluation and description of speech, resonance and myofunctional characteristics commonly associated with cleft palate and/or velopharyngeal dysfunction. The protocol is partly based on the GOS.SP.ASS'98 and adapted to Flemish. It focuses on the relevant aspects of cleft type speech necessary to facilitate assessment, adequate diagnosis and management planning in a multi-disciplinary setting of cleft team care.

  9. 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)

  10. Comparison of facial morphology in two populations with complete unilateral cleft lip and palate from two different centers.

    NARCIS (Netherlands)

    Daskalogiannakis, J.; Dijkman, G.E.H.M.; Kuijpers-Jagtman, A.M.; Ross, R.B.

    2006-01-01

    OBJECTIVE: To identify differences in craniofacial morphology of two populations with a history of complete unilateral cleft lip and palate (UCLP) treated under different protocols. DESIGN: Retrospective longitudinal cohort study. SETTING: Cleft Center of the University of Nijmegen, The Netherlands,

  11. Post-operative outcomes after cleft palate repair in syndromic and non-syndromic children: a systematic review protocol

    OpenAIRE

    Zhang, Zach; Stein, Michael; Mercer, Nigel; Malic, Claudia

    2017-01-01

    Background There is a lack of high-level evidence on the surgical management of cleft palate. An appreciation of the differences in the complication rates between different surgical techniques and timing of repair is essential in optimizing cleft palate management. Method A comprehensive electronic database search will be conducted on the complication rates associated with cleft palate repair using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Two independent review...

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

    Directory of Open Access Journals (Sweden)

    Azimi C

    2010-02-01

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

  13. Speech Production in 3-Year-Old Internationally Adopted Children with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Larsson, AnnaKarin; Schölin, Johnna; Mark, Hans; Jönsson, Radi; Persson, Christina

    2017-01-01

    Background: In the last decade, a large number of children with cleft lip and palate have been adopted to Sweden. A majority of the children were born in China and they usually arrive in Sweden with an unoperated palate. There is currently a lack of knowledge regarding speech and articulation development in this group of children, who also have to…

  14. Disruption of epithelial cell migration as a potential mechanism of cleft palate induction

    Science.gov (United States)

    Cleft palate occurs in about one in seven hundred births per year, making it the most prevalent craniofacial birth defect in the world. During embryonic development, tissue fusion is a critical step in the formation of the palate, cornea, urethra, and neural tube. Epithelial cell...

  15. Autosomal dominant syndrome of mental retardation, hypotelorism, and cleft palate resembling Schilbach-Rott syndrome

    NARCIS (Netherlands)

    Shkalim, Vered; Baris, Hagit N.; Gal, Gavriel; Gleiss, Ruth; Calderon, Shlomo; Wessels, Marja; Maat-Kievit, Anneke; Menten, Björn; de Baere, Elfride; Hennekam, Raoul C. M.; Schirmacher, Anja; Bale, Sherri; Shohat, Mordechai; Willems, Patrick J.

    2009-01-01

    We present a family segregating for an autosomal dominant syndrome of hypotelorism, cleft palate/uvula, high-arched palate and mild mental retardation. Although these findings may suggest a form of holoprosencephaly, no holoprosencephaly was found on MRI of the proposita. Results of genetic studies

  16. Speech and language therapy interventions for children with cleft palate: a systematic review.

    Science.gov (United States)

    Bessell, Alyson; Sell, Debbie; Whiting, Penny; Roulstone, Sue; Albery, Liz; Persson, Martin; Verhoeven, Andrea; Burke, Margaret; Ness, Andy R

    2013-01-01

    Objective :  (1) To examine the evidence for the effectiveness of differences in timing and type of speech and language therapy for children with cleft palate with or without a cleft lip and (2) to identify types of interventions assessed. Design :  Nine databases, including MEDLINE and EMBASE, were searched between inception and March 2011 to identify published articles relating to speech and language therapy for children with cleft palate with or without cleft lip. Studies that included at least 10 participants and reported outcome measures for speech and/or language measures were included. Studies where the experimental group had less than 90% of children with cleft palate with or without cleft lip were excluded. Two reviewers independently completed inclusion assessment, data extraction, and risk of bias assessment for all studies identified. Results :  A total of 17 papers were evaluated: six randomized control trials and 11 observational studies. Studies varied widely on risk of bias, intervention used, and outcome measures reported. None of the studies had a low risk of bias. In terms of intervention approaches, seven studies evaluated linguistic approaches and 10 evaluated motor approaches. Outcomes measures did not support either approach over the other, and based on data reported it was difficult to ascertain which approach is more effective for children with cleft palate with or without cleft lip. Conclusions :  The review found little evidence to support any specific intervention. Key uncertainties need to be identified and adequately powered, methodologically rigorous studies conducted to provide a secure evidence base for speech-language therapy practice in children with cleft palate with or without cleft lip.

  17. Epidemiology of cleft lip and palate among Jews and Bedouins in the Negev.

    Science.gov (United States)

    Silberstein, Eldad; Silberstein, Tali; Elhanan, Emil; Bar-Droma, Eitan; Bogdanov-Berezovsky, Alexander; Rosenberg, Lior

    2012-06-01

    Clefts of the lip and palate are the most common significant congenital birth anomaly of the orofacial region. The condition may vary from a minor easily correctable cleft to a significant functional and cosmetic incapacitation. This is the first epidemiological study of orofacial clefts in the Negev region in Israel. To establish the frequency of cleft lip and palate in the population of the Negev, characterize the demographic features of affected individuals and find possible risk factors, compare the risk in two major population groups: Bedouin and Jewish in a well-defined geographic area, and determine whether there is a change overtime in the birth of babies with facial clefts. We conducted a retrospective survey of the Soroka Medical Center archives. The sample population comprised all 131,218 babies born at Soroka during the 11 year period 1 January 1996 to 31 December 2006. Statistical tests used Pearson's chi-square test, Student's t-test and Spearman's correlation coefficient test according to the type of parameter tested. During the study period 140 babies were born with orofacial cleft. The overall incidence of cleft lip and palate was 1.067/1000. The incidence of facial clefts was 1.54/1000 among Bedouins and 0.48/1000 among Jews (P Cleft palate was significantly more frequent in female than male babies (P = 0.002). Over the study years we found a significant decrease in the incidence of facial clefts in the Bedouin population, with Spearman's correlation coefficient rank -0.9 (P clefts among Bedouin. This change may be attributed to prenatal care in the Bedouin Negev population as part of social and health-related behavior changes. The reduction in rates of congenital malformations, however, does not mean a reduction in the number of cases in a growing population. Also, with a modern western lifestyle, the expectancy and demand for reconstructive facial surgery and comprehensive care for these children are on the rise.

  18. Anthropometric profile evaluation of the midface in patients with cleft lip and palate.

    Science.gov (United States)

    Chaisrisookumporn, N; Stella, J P; Epker, B N

    1995-08-01

    This study was done to determine those profile anthropometric measurements that are abnormal in the midface profile in patients with cleft lip and palate. The sample population consisted of 30 randomly selected skeletally mature white patients with cleft lip and palate who had been treated by the same team who were accredited by the American Cleft Palate-Craniofacial Association. Twenty patients had unilateral and 10 had bilateral complete clefts. None of these patients had previously undergone orthognathic surgery or definitive rhinoplasty surgery. Fifteen facial anthropometric features were measured on each person's face. The result from this study showed that in patients with cleft lip and palate right versus left side differences did not exist and only four statistically significant differences existed between the unilateral and bilateral cases. However, in all patients, four of these esthetic facial features were consistently and significantly abnormal: obtuse nasofrontal angle: obtuse nasomental angle; a posteriorly positioned infraorbitale relative to globe; and an obtuse general facial angle. Several other features were abnormal in a high percentage of persons in this study. These were lack of supratip break, flat to concave paranasal contour, increased subnasale-alargroove:subnasale-pronasale ratio, decreased nasal protrusion:nasal length ratio, decreased nasolabial angle ratio, decreased maxillary length ratio, increased nasal bridge projection:nasal protrusion ratio, and deficient cheek contour. This data indicates that the major deformity in persons with adult cleft lip and palate exist in the nose and secondarily in other components of the midface.

  19. 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.

  20. Cleft lip and palate genetics and application in early embryological development

    Directory of Open Access Journals (Sweden)

    Yu Wenli

    2009-10-01

    Full Text Available The development of the head involves the interaction of several cell populations and coordination of cell signalling pathways, which when disrupted can cause defects such as facial clefts. This review concentrates on genetic contributions to facial clefts with and without cleft palate (CP. An overview of early palatal development with emphasis on muscle and bone development is blended with the effects of environmental insults and known genetic mutations that impact human palatal development. An extensive table of known genes in syndromic and non-syndromic CP, with or without cleft lip (CL, is provided. We have also included some genes that have been identified in environmental risk factors for CP/L. We include primary and review references on this topic.

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

    Science.gov (United States)

    Nagarajan, Roopa; Savitha, V. H.; Subramaniyan, B.

    2009-01-01

    The need for an interdisciplinary approach in the comprehensive management of individuals with cleft lip and palate is well recognized. This article provides an introduction to communication disorders in individuals with cleft lip and palate for members of cleft care teams. The speech pathologist is involved in identifying those infants who are at risk for communication disorders and also for initiating early intervention to prevent or mitigate communication disorders caused by the cleft. Even with early cleft repair, some children exhibit ‘cleft palate speech’ characterized by atypical consonant productions, abnormal nasal resonance, abnormal nasal airflow, altered laryngeal voice quality, and nasal or facial grimaces. These manifestations are evaluated to identify those that (a) are developmental, (b) can be corrected through speech therapy alone, and, (c) those that may require both surgery and speech therapy. Speech is evaluated perceptually using several types of stimuli. It is important to identify compensatory and obligatory errors in articulation. When velopharyngeal dysfunction is suspected, the assessment should include at least one direct measure such as nasoendoscopy or videofluoroscopy. This provides information about the adequacy of the velopharyngeal valve for speech production, and is useful for planning further management of velopharyngeal dysfunction. The basic principle of speech therapy in cleft lip and palate is to establish the correct placement of the articulators and appropriate air flow. Appropriate feedback is important during therapy for establishing the correct patterns of speech. PMID:19884669

  2. Associated syndromes and other genetic variations at a South African cleft lip and palate clinic

    Directory of Open Access Journals (Sweden)

    H.J.S. van den Berg

    2009-09-01

    Full Text Available A retrospective study was done of data on all patients registered at one of the largest cleft lip and palate clinics in South Africa (n = 3174. The associated syndromes and other genetic variations [(abbreviation: ASGV] found in the population of persons suffering from facial cleft deformities (FCD were analysed. 832 (26.2% cleft lip and/ or palate patients presented with ASGV. Fifty-seven different types of syndromes were recorded of which the Fairbaim-Robin appearance (FRA (or Pierre Robin sequence 169 (5.3%, the Demarque-van der Woude syndrome 40 (1.3%, and the holoprosencephaly sequence cases 32 (1.0% were the three most common ones. The three most common genetic variations found in the non-syndromic patients, were heart involvement 53(1.7%, club foot 42 (1.3% and various eye problems 39 (1.2%. The main facial cleft deformity, namely the cleft lip, alveolus and palate (CLAP, was found in 26.2% of the ASGV-group. This particular cleft deformity was recorded at 39.7% in the FCD clinic. On the other hand, the hard and soft palate cleft (hPsP group was found in 32.9% of patients who also had ASGV; in the total group of patients registered at the clinic, it accounted for only 16.6%. This means that ASGV occur less commonly in the CLAP group of patients, than in the hPsP group of patients.

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

    Directory of Open Access Journals (Sweden)

    Nagarajan Roopa

    2009-10-01

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

  4. [Bilateral labio-maxillo-palatal clefts. Therapeutic evaluation].

    Science.gov (United States)

    Raphaël, B; Morand, B; Bettega, G; Lesne, V; Lesne, C; Lebeau, J

    2001-06-01

    The wide diversity of bilateral facial clefts makes it most difficult to assess surgical success, particularly in terms of long-term outcome. The aim of this work was to examine the rationale for the current protocol used for cleft surgery at the Grenoble University Hospital. In a first group of 28 children, a 3-step surgical protocol was applied. The first two steps were performed between 4 and 8 months with at least 3 months between each procedure. Skoog's unilateral cheilo-rhino-uranoplasty was used, associated with a periosteal tibial graft. The third step, performed between 10 and 12 months, was for staphylorraphy. Outcome was analyzed at 15 years and evidenced the deleterious effect of excessive and asymmetrical premaxillary scars, of the 2-step cheiloplasty and of columella lengthenings from the lip. The frequency of secondary revision of the superior labial vestibule and the medial labial tubercule (43%) was considered to be high; this procedure should be re-examined as should be osteotomy (32% revision). Palatine closure, acquired in 82% of the cases and premaxillary stability, achieved in 86%, would appear to favor use of the periosteal tibial graft. The osteogenic capacity of this graft tissue was less satisfactory after a second harvesting (from the same tibia three months later). These results have led us to modify our protocol, favoring early and total closure of the bony palate and continued use of the periosteal tibial graft. We now use the following operative protocol: premaxillary alignment using an active orthopedic plate at 2 months, lip adhesion associated with staphylorraphy and passive palatine contention plate at 3 months, definitive bilateral cheilo-uranoplasty associated with a single periosteal graft at 7 months. The preliminary results with this protocol in a group of 12 children have shown better quality scars, more harmonious maxillary arches, an excellent occlusion of the deciduous dentition, and preservation of the positive results

  5. The Folate Pathway and Nonsyndromic Cleft Lip and Palate

    Science.gov (United States)

    Blanton, Susan H.; Henry, Robin R.; Yuan, Quiping; Mulliken, John B.; Stal, Samuel; Finnell, Richard H.; Hecht, Jacqueline T.

    2013-01-01

    Nonsyndromic cleft lip with or without cleft palate (NSCLP) is a common birth malformation caused by genetic, environmental and gene-environment interactions. Periconceptional supplementation with folic acid, a key component in DNA synthesis and cell division, has reduced the birth prevalence of neural tube defects (NTDs) and may similarly reduce the birth prevalence of other complex birth defects including NSCLP. Past studies investigating the role of two common methylenetetrahydrofolate reductase (MTHFR) SNP polymorphisms, C677T (rs1801133) and A1298C (rs1801131), in NSCLP have produced conflicting results. Most studies of folate pathway genes have been limited in scope, as few genes/SNPs have been interrogated. In this study, we asked whether variations in a more comprehensive group of folate pathway genes were associated with NSCLP and, if so, were there detectable interactions between these genes and environmental exposures. In addition, we evaluated the data for a sex effect. Fourteen folate metabolism related genes were interrogated using eighty-nine SNPs in multiplex and simplex non-Hispanic White (NHW) (317) and Hispanic (128) NSCLP families. Evidence for a risk association between NSCLP and SNPs in nitrous oxide 3 (NOS3) and thymidylate synthetase (TYMS) was detected in the NHW group, whereas associations with methionine synthase (MTR), betaine-homocysteine methyltransferase (BHMT2), MTHFS and SLC19A1 were detected in the Hispanic group. Evidence for over-transmission of haplotypes and gene interactions in the methionine arm was detected. These results suggest that perturbations of the genes in the folate pathway may contribute to NSCLP. There was evidence for an interaction between several SNPs and maternal smoking, and for one SNP with sex of the offspring. These results provide support for other studies that suggest that high maternal homocysteine levels may contribute to NSCLP and should be further investigated. PMID:21254359

  6. Dentocraniofacial morphology of 21 patients with unilateral cleft lip and palate: a cephalometric study.

    Science.gov (United States)

    Corbo, Miranda; Dujardin, Thierry; de Maertelaer, Viviane; Malevez, Chantal; Glineur, Régine

    2005-11-01

    To assess the skeletal and dental craniofacial proportions of unilateral cleft lip and palate patients who were operated upon using the Malek technique, and compare them with a normal group to highlight the effect of surgical correction on craniofacial development during growth. Retrospective. The cleft palate was closed using the Malek technique in a single operation at 3 months for 11 patients (complete closure of lip and palate) and in a two-stage operation for 10 patients (soft palate at 3 months, lip and hard palate at 6 months). Comparisons were made with a normal control group. Angular and linear measurements of anterior and posterior dimensions of the upper and lower compartments of the face were measured in the 7th and 12th years. No significant differences were observed between the two groups of palate technique repair, although significant differences were observed between craniofacial dimensions of normal versus cleft lip and palate patients. At a skeletal level, the maxilla and mandible were retrusive relative to the cranial base in the cleft lip and palate group. In fact, there was a backward rotation of the palatal plane with repercussions on the maxillo-mandibular complex position. Furthermore, the maxilla was shorter than in normal patients, whereas the mandible was normally shaped. The upper incisors were retroclined and they locked the lower incisors in linguoversion. There was a posterior skeletal deficit of the respiratory compartment, compensated by more marked posterior maxillary alveolar growth. Facial growth in cleft lip and palate patients followed the same pattern, but was delayed compared with normal patients.

  7. [Electromyography of perioral muscles in the cleft lip and palate patients with crossbite].

    Science.gov (United States)

    Li, W R; Lin, J X; Fu, M K

    1994-11-01

    In this study, twenty-nine cleft lip and palate patients with anterior crossbite were chosen as study group and twenty-eight normal children, twenty-seven patients with anterior crossbite as the control groups. All subjects were examined with EMG, and found some characters of the perioral muscles activity of the cleft patients. (1) The electromyographic amplitude of the upper lip and chin muscles was higher in cleft patients than that of other two groups during swallowing of saliva (2) Activity of chin muscle in cleft patients and crossbite patients in rest position were higher than that of normal occlusion (3) The Asymmetry index of the activity of upper lip muscle in every functional positions of the cleft patients are higher than ther groups. The abnormal activity of perioral muscles of the cleft patients demonstrate that functional repairment of cleft lip and needed lip bumper are necessary.

  8. A novel approach for prosthodontic management of patient with cleft of palate

    Directory of Open Access Journals (Sweden)

    Shalini Goyal

    2017-01-01

    Full Text Available Nutrition is important in every stage of child development. A child born with cleft lip and palate may experience difficulties while feeding due to the lack of seal of the oral cavity due to incomplete facial and palatal structures. Difficulty in feeding leads to inadequate nutrition and affects the health. Children with cleft lip and palate need certain modifications to thrive and grow. Feeding difficulties should be assessed and intervened as early as possible, as they are an important aspect of multidisciplinary team approach in management and may have an impact on long-term outcome. This case report presents fabrication of feeding appliance in 6-month-old infant with cleft palate with ethylene vinyl acetate.

  9. Palate dimensions in six-year-old children with unilateral cleft lip and palate: a six-center study on dental casts.

    Science.gov (United States)

    Koželj, Vesna; Vegnuti, Miljana; Drevenšek, Martina; Hortis-Dzierzbicka, Maria; Gonzalez-Landa, Gonzalo; Hanstein, Siiri; Klimova, Irena; Kobus, Kazimierz; Kobus-Zaleśna, Katarzyna; Semb, Gunvor; Shaw, Bill

    2012-11-01

    To compare palatal dimensions in 6-year-old children with unilateral cleft lip and palate (UCLP) treated by different protocols with those of noncleft children. Retrospective intercenter outcome study. Patients : Upper dental casts from 129 children with repaired UCLP and 30 controls were analyzed by the trigonometric method. Six European cleft centers. Main outcome measures : Sagittal, transverse, and vertical dimensions of the palate were observed. Palate variables were analyzed with descriptive methods and nonparametric tests. Regarding several various characteristics measured on a relatively small number of subjects, hierarchical, k-means clustering, and principal component analyses were used. Mean values of the observed dimensions for five cleft groups differed significantly from the control (p cleft differed significantly from all other cleft groups in most variables (p palate. A similar number of treated children were classified into each cluster, while all children without clefts were classified in the same cluster. The percentage of treated children from a particular group that fit this cluster ranged from 0% to 70% and increased with age at palatal closure and number of primary surgical procedures. At 6 years of age, children with stepwise repair and hard palate closure after the age of two more frequently result in palatal dimensions of noncleft control than children with earlier palatal closure and one-stage cleft repair.

  10. Australian children with cleft palate achieve age-appropriate speech by 5 years of age.

    Science.gov (United States)

    Chacon, Antonia; Parkin, Melissa; Broome, Kate; Purcell, Alison

    2017-12-01

    Children with cleft palate demonstrate atypical speech sound development, which can influence their intelligibility, literacy and learning. There is limited documentation regarding how speech sound errors change over time in cleft palate speech and the effect that these errors have upon mono-versus polysyllabic word production. The objective of this study was to examine the phonetic and phonological speech skills of children with cleft palate at ages 3 and 5. A cross-sectional observational design was used. Eligible participants were aged 3 or 5 years with a repaired cleft palate. The Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest and a non-standardised list of mono- and polysyllabic words were administered once for each child. The Profile of Phonology (PROPH) was used to analyse each child's speech. N = 51 children with cleft palate participated in the study. Three-year-old children with cleft palate produced significantly more speech errors than their typically-developing peers, but no difference was apparent at 5 years. The 5-year-olds demonstrated greater phonetic and phonological accuracy than the 3-year-old children. Polysyllabic words were more affected by errors than monosyllables in the 3-year-old group only. Children with cleft palate are prone to phonetic and phonological speech errors in their preschool years. Most of these speech errors approximate typically-developing children by 5 years. At 3 years, word shape has an influence upon phonological speech accuracy. Speech pathology intervention is indicated to support the intelligibility of these children from their earliest stages of development. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Safe sleeping positions: practice and policy for babies with cleft palate.

    Science.gov (United States)

    Davies, Karen; Bruce, Iain A; Bannister, Patricia; Callery, Peter

    2017-05-01

    Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate. A qualitative descriptive study used data from a national survey with clinical nurse specialists from 12 regional cleft centres in the UK to investigate current practice. Data were collected using semi-structured telephone interviews and analysed using content analysis. Over half the regional centres used lateral sleep positioning based on clinical judgement of the infants' respiratory effort and upper airway obstruction. Assessment relied upon clinical judgement augmented by a range of clinical indicators, such as measures of oxygen saturation, heart rate and respiration. Specialist practitioners face a clinical dilemma between adhering to standard 'back to sleep' guidance and responding to clinical assessment of respiratory effort for infants with cleft palate. In the absence of clear evidence, specialist centres rely on clinical judgement regarding respiratory problems to identify what they believe is the most appropriate sleeping position for infants with cleft palate. Further research is needed to determine the best sleep position for an infant with cleft palate. What is Known • Supine sleep positioning reduces the risk of sudden infant death in new born infants. • There is uncertainty about the benefits or risks of lateral sleep positioning for infants with upper airway restrictions arising from cleft palate. What is New • Variability exists in the information

  12. Population-Based Study of Prevalence of Cleft Lip/Palate in Southern Thailand.

    Science.gov (United States)

    Jaruratanasirikul, Somchit; Chicharoen, Vichai; Chakranon, Manunya; Sriplung, Hutcha; Limpitikul, Wannee; Dissaneevate, Pathikan; Intharasangkanawin, Nitthakarn; Tantichantakarun, Pongsak; Sattapanyo, Atchara

    2016-05-01

    Oral cleft is a common craniofacial birth defect that leads to long-lasting adverse outcomes. In Thailand, there have been two studies of the prevalence of oral clefts using data from university hospitals during 1969 through 1978 and 1988 through 1999, which found prevalence rates of 1.23 and 1.22 per 1000 live births, respectively. The primary outcome was to assess the prevalence of oral clefts from the birth defects registry during 2009 through 2013 in three provinces in southern Thailand. The secondary outcomes were to correlate the risk of oral cleft and maternal age. Population-based study. Four hundred sixty-seven hospitals in three provinces in southern Thailand. Oral cleft cases and maternal data-including live births, stillbirths, and termination of pregnancy following a prenatal diagnosis-were collected from the birth defects registry. Of the total 186,393 births, there were 269 oral cleft cases, giving an average prevalence of 1.44 per 1000 births (95% CI, 1.22-1.63). The most common cleft type was cleft lip and palate (45.0%), followed by cleft palate (29.0%), with 15.6% syndromic cleft. The mean maternal age was 28.0 ± 6.4 years. There were no differences in prevalence of oral clefts among the different maternal age groups. However, advanced maternal age 35+ years was associated with syndromic cleft children. The prevalence of oral clefts was 1.44 per 1000 live births, with 15% of cases having an associated congenital anomaly or a recognized syndrome. Increased maternal age was associated with a higher prevalence of syndromic cleft.

  13. Nonsyndromic cleft lip and palate: No evidence of linkage to HLA or factor 13A

    Energy Technology Data Exchange (ETDEWEB)

    Hecht, J.T.; Yaping Wang; Connor, B.; Daiger, S.P. (Univ. of Texas, Houston (United States)); Blanton, S.H. (Univ. of Texas, Houston (United States) Univ. of Virginia, Charlottesville (United States))

    1993-06-01

    Nonsyndromic cleft lip with or without cleft palate (CLP) is a common craniofacial anomaly, the etiology of which is not known. Population studies have shown that a large proportion of cases occur sporadically. Recently, segregation analyses applied to CLP families have demonstrated that an autosomal dominant/codominant gene(s) may cause clefting in cases. Associations of autosomal dominant CLP and nonsyndromic cleft palate (CP) with HLA and F13A genes on chromosome 6p have been suggested previously. Linkage to these two areas on chromosome 6p were tested in 12 autosomal dominant families with CLP. With a LOD score of [minus]2 or less for exclusion, no evidence of linkage was found to four chromosome 6p markers. Multipoint analysis showed no evidence of a clefting locus in this region spanning 54 cM on chromosome 6p in these CLP families. 30 refs., 2 figs., 1 tab.

  14. Timing of cleft palate closure should be based on the ratio of the area of the cleft to that of the palatal segments and not on age alone.

    NARCIS (Netherlands)

    Berkowitz, S.; Duncan, R.; Evans, C.; Friede, H.; Kuijpers-Jagtman, A.M.; Prahl-Anderson, B.; Rosenstein, S.

    2005-01-01

    BACKGROUND: Retrospective and prospective serial spatiotemporal investigations were carried out primarily to determine whether the ratio of the size of the posterior cleft space relative to the palatal surface area limited laterally by the alveolar ridges can be used to select the appropriate time

  15. X-chromosome inactivation patterns in monozygotic twins and sib pairs discordant for nonsyndromic cleft lip and/or palate

    DEFF Research Database (Denmark)

    Kimani, Jane W; Shi, Min; Daack-Hirsch, Sandra

    2007-01-01

    Nonsyndromic clefts of the lip and/or palate are common birth defects with a strong genetic component. Based on unequal gender ratios for clefting phenotypes, evidence for linkage to the X chromosome and the occurrence of several X-linked clefting syndromes, we investigated the role of skewed X...... of XCI was defined as the deviation in inactivation pattern from a 50:50 ratio. Our analysis revealed no significant difference in the degree of skewing between twin pairs (P = 0.3). However, borderline significant differences were observed in the sister pairs (P = 0.02), with the cleft lip with cleft......, particularly cleft lip and palate....

  16. Mutations in PHF8 are associated with X linked mental retardation and cleft lip/cleft palate

    NARCIS (Netherlands)

    Laumonnier, F; Holbert, S; Ronce, N; Faravelli, F; Lenzner, S; Schwartz, CE; Lespinasse, J; Van Esch, H; Lacombe, D; Goizet, C; Tuy, FPD; van Bokhoven, H; Fryns, JP; Chelly, J; Ropers, HH; Moraine, C; Hamel, BCJ; Briault, S

    2005-01-01

    Truncating mutations were found in the PHF8 gene ( encoding the PHD finger protein 8) in two unrelated families with X linked mental retardation (XLMR) associated with cleft lip/ palate (MIM 300263). Expression studies showed that this gene is ubiquitously transcribed, with strong expression of the

  17. Mutations in PHF8 are associated with X linked mental retardation and cleft lip/cleft palate.

    NARCIS (Netherlands)

    Laumonnier, F.; Holbert, S.; Ronce, N.; Faravelli, F.; Lenzner, S.; Schwartz, C.; Lespinasse, J.; Esch, H. van; Lacombe, D.; Goizet, C.; Phan-Dinh Tuy, F.; Bokhoven, J.H.L.M. van; Fryns, J.P.; Chelly, J.; Ropers, H.H.; Moraine, C.; Hamel, B.C.J.; Briault, S.

    2005-01-01

    Truncating mutations were found in the PHF8 gene (encoding the PHD finger protein 8) in two unrelated families with X linked mental retardation (XLMR) associated with cleft lip/palate (MIM 300263). Expression studies showed that this gene is ubiquitously transcribed, with strong expression of the

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

    Science.gov (United States)

    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.

  19. Histomorphologic analysis of the soft palate musculature in prenatal cleft and noncleft A/Jax mice.

    Science.gov (United States)

    Trotman, C A; Hou, D; Burdi, A R; Cohen, S R; Carlson, D S

    1995-11-01

    The two specific aims of this study were as follows: to evaluate the appropriateness of the A/Jax mouse model in the investigation of the key cellular stages in prenatal soft palate morphogenesis and myogenesis; and to describe structural differences in the histomorphology of the soft palate anatomy from cleft and noncleft mice prior to, during, and after palatogenesis. Cleft-induced and control groups of A/Jax mouse embryos from timed pregnancies were harvested sequentially on gestational days 15 to 19. Embryos were weighed and staged for external body morphology. The heads were removed and fixed for light microscopy, sectioned serially in the frontal plane at 10 microns and stained with hematoxylin-eosin to characterize and compare the soft palate musculature. All observations were made at the head depth of the trigeminal ganglion in both age- and stage-matched embryos. The following findings were made: (1) the A/Jax mouse is a suitable animal model for the study of soft palate myogenesis; (2) there were no discernible morphologic differences between the soft palate muscles in cleft and noncleft A/Jax mice when viewed under light microscopy; (3) the soft palate and related muscles were identifiable as muscle fields, in both the cleft and noncleft fetuses, as early as gestational day 15 and as specific muscles at gestational day 18; (4) in both the cleft and noncleft A/Jax fetuses, the soft palate muscles appeared in a sequential anatomic fashion (the palatine aponeurosis appeared first, next the tensor palatini, and then the levator palatini muscles); and (5) in the cleft palate fetuses, both pterygoid plates were angulated and displaced laterally.

  20. Assessment of folic acid and DNA damage in cleft lip and cleft palate

    Directory of Open Access Journals (Sweden)

    Sivakumar Brooklyin

    2014-03-01

    Full Text Available Studies have identified the risk factors like folic acid deficiency during gestational period, family history for orofacial clefts, drugs like antiepileptic, vitamin A. But, the data regarding the folic acid status in children with cleft lip/palate is hardly evaluated in depth. Here, an assessment of folic acid and DNA damage were carried out in children with orofacial anomalies. Folic acid level and DNA damage were evaluated by folic acid assay (direct chemiluminescent technology and single cell gel electrophoresis or comet assay method respectively. The mean value of plasma folic acid by direct chemiluminescent technology was 6.5±3.6 nmol/L and the normal value in children ranges from 11.3 to 47.6 nmol/L. The amount of damaged DNA, measured as the tail length of the comet in cases, was 19.4±8.9 ?m and the mean percentage of DNA in tail was 16.5±3.7. Folic acid deficiency could be the reason for DNA damage.

  1. Cleft lip with or without cleft palate in Shanghai, China: Evidence for an autosomal major locus

    Energy Technology Data Exchange (ETDEWEB)

    Marazita, M.L. (Virginia Commonwealth Univ., Richmond, VA (United States)); Hu, Dan-Ning; Liu, You-E. (Zhabei Eye Institute, Shanghai (China)); Spence, A. (Univ. of California, Los Angeles, CA (United States)); Melnick, M. (Univ. of Southern California, Los Angeles, CA (United States))

    1992-09-01

    Orientals are at higher risk for cleft lip with our without cleft palate (CL[+-] P) than Caucasians or blacks. The authors collected demographic and family data to study factors contributing to the etiology of CL[+-]P in Shanghai. The birth incidence of nonsyndromic CL[+-]P (SHanghai 1980-87) was 1.11/1,000, with a male/female ratio of 1.42. Almost 2,000 nonsyndromic CL[+-]P probands were ascertained from individuals operated on during the years 1956-83 at surgical hospitals in Shanghai. Detailed family histories and medical examinations were obtained for the probands and all available family members. Genetic analysis of the probands' families were performed under the mixed model with major locus (ML) and multifactorial (MFT) components. The hypothesis of no familial transmission and of MFT alone could be rejected. Of the ML models, the autosomal recessive was significantly most likely and was assumed for testing three complex hypothesis: (1) ML and sporadics; (2) ML and MFT; (3) ML, MFT, and sporadics. None of the complex models were more likely than the ML alone model. In conclusion, the best-fitting, most parsimonious model for CL[+-]P in Shanghai was that of an autosomal recessive major locus. 37 refs., 1 tab.

  2. Outcome of treatment regarding articulation, resonance and voice in Flemish adults with unilateral and bilateral cleft palate.

    Science.gov (United States)

    Van Lierde, Kristiane M; De Bodt, Marc; Baetens, Isabelle; Schrauwen, Valentine; Van Cauwenberge, Paul

    2003-01-01

    The purpose of this study was to evaluate the outcome regarding speech intelligibility, articulation, nasalance, nasality and voice in adult cleft palate patients. An additional objective of this study was to delineate the impact of a unilateral versus bilateral cleft lip and palate on speech outcome and to compare the nasalance and nasality patterns of cleft palate adults with data from non-cleft subjects. Objective (nasalance values obtained by the Nasometer, mirror-fogging test according to Glatzel and the determination of the dysphonia severity index, DSI) and subjective assessment techniques (perceptual evaluation of speech, nasality and voice, the Bzoch tests and the Gutzmann test) were used. All 14 subjects with a complete unilateral or bilateral cleft lip and palate consulted the same craniofacial team, followed an identical surgical protocol, completed the surgical cleft palate treatments and followed speech therapy. Most of the patients had a fairly satisfactory outcome with normal speech intelligibility, but three types of articulation errors seemed to predominate. More than one half of the subjects demonstrated hypernasality. In comparison with the non-cleft normative data, statistically higher nasalance values were obtained in the cleft group. The subjects had a DSI score that corresponds with a normal or slightly impaired voice quality. No significant differences regarding speech outcome were found between subjects with a unilateral or bilateral cleft lip and palate. The results provide important information for speech-language pathologists to evaluate and improve speech outcome in cleft palate patients. Copyright 2003 S. Karger AG, Basel

  3. Speech nasality and nasometry in cleft lip and palate.

    Science.gov (United States)

    Larangeira, Fabiane Rodrigues; Dutka, Jeniffer de Cássia Rillo; Whitaker, Melina Evangelista; de Souza, Olívia Mesquita Vieira; Lauris, José Roberto Pereira; da Silva, Mariana Jales Felix; Pegoraro-Krook, Maria Inês

    2016-01-01

    Perceptual evaluation is considered the gold standard to evaluate speech nasality. Several procedures are used to collect and analyze perceptual data, which makes it susceptible to errors. Therefore, there has been an increasing desire to find methods that can improve the assessment. To describe and compare the results of speech nasality obtained by assessments of live speech, the Test of Hypernasality (THYPER), assessments of audio recorded speech, and nasometry. A retrospective study consisting of 331 patients with operated unilateral cleft lip and palate. Speech nasality was assessed by four methods of assessment: live perceptual judgement, THYPER, audio-recorded speech sample judgement by multiple judges, and nasometry. All data were collected from medical records of patients, with the exception of the speech sample recording assessment, which was carried out by multiple judges. The results showed that the highest percentages of absence of hypernasality were obtained from judgements performed live and from the THYPER, with equal results between them (79%). Lower percentages were obtained from the recordings by judges (66%) and from nasometry (57%). The best results among the four speech nasality evaluation methods were obtained for the ones performed live (live nasality judgement by a speech pathologist and THYPER). Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Social motivation in individuals with isolated cleft lip and palate.

    Science.gov (United States)

    van der Plas, Ellen; Koscik, Timothy R; Conrad, Amy L; Moser, David J; Nopoulos, Peg

    2013-01-01

    Social isolation is common among individuals with isolated cleft lip and palate (ICLP), but the available data on why this may be are mixed. We present a novel theory relating to reduced social motivation in ICLP, called the social abulia hypothesis. Based on this hypothesis, we predicted that reduced social motivation would lead to reduced responsiveness to negative social feedback, in terms of both explicit responses and noncontrolled, psychophysiological responses. Twenty males with ICLP and 20 normal comparison males between 13 and 25 years old participated in the study. Social motivation was examined by measuring participants' response to negative social feedback (social exclusion). Additionally, psychophysiological reactivity to positive and negative social stimuli was measured. In order to rule out other potential contributors to social isolation, we tested basic social perception, emotion recognition, and social anxiety. In line with the social abulia hypothesis, we show that negative social feedback had less of an effect on males with ICLP than on healthy male peers, which was evident in explicit responses and noncontrolled, psychophysiological responses to negative social feedback. Our results could not be attributed to problems in social perception, a lack of understanding facial expressions, or increased social anxiety, as groups did not differ on these constructs. This study suggests that current views on social isolation in ICLP may need to be reconsidered to include the possibility that isolation in this population may be the direct result of reduced social motivation.

  5. Living with cleft lip and palate: the treatment journey.

    Science.gov (United States)

    Alansari, Reem; Bedos, Christophe; Allison, Paul

    2014-03-01

    To better understand how individuals with cleft lip and palate (CLP) perceive and experience their treatment process and how these perceptions and experiences change over the life course. Qualitative in-depth semistructured interviews with 11 adults with nonsyndromal complete CLP. Individuals from three Canadian cities were recruited by convenience and theoretical sampling through AboutFace International. The number of participants was determined by the principle of theoretical saturation. The experience of individuals with CLP through the treatment process changes over the life course. In childhood and early adolescence, most individuals experience stigma, negative self-perception, and as a result were more prone to perceiving the treatment process not only as unbearably burdensome but also as fueling their feeling of "defectiveness." In adulthood, participants' self-perception improved, partly because of definitive surgical correction, leading them to realize treatment benefits and reappraise the treatment process as satisfactory rather than burdensome. Subsequently, some individuals pursued further surgeries hoping for additional psychological gains, in lieu of psychosocial interventions addressing the underpinnings of residual feelings of "defectiveness." This led to dissatisfaction and frustration when the procedures did not lead to the hoped-for psychological gains. The results emphasize the importance of self-perception in determining how participants perceive several important aspects of the treatment experience throughout the life course. Further studies should focus on how to incorporate self-perception as an important variable and outcome in the treatment process.

  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

    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...... and mandibular growth velocity (mm/year) was calculated. Cleft width was measured on the casts at 2 months of age. Results: Mean mandibular length and posterior height were significantly smaller in isolated cleft palate and Robin sequence, compared with unilateral incomplete cleft lip. Mandibular length in Robin...

  7. Medical Sequencing of Candidate Genes for Nonsyndromic Cleft Lip and Palate.

    Directory of Open Access Journals (Sweden)

    2005-12-01

    Full Text Available Nonsyndromic or isolated cleft lip with or without cleft palate (CL/P occurs in wide geographic distribution with an average birth prevalence of 1/700. We used direct sequencing as an approach to study candidate genes for CL/P. We report here the results of sequencing on 20 candidate genes for clefts in 184 cases with CL/P selected with an emphasis on severity and positive family history. Genes were selected based on expression patterns, animal models, and/or role in known human clefting syndromes. For seven genes with identified coding mutations that are potentially etiologic, we performed linkage disequilibrium studies as well in 501 family triads (affected child/mother/father. The recently reported MSX1 P147Q mutation was also studied in an additional 1,098 cleft cases. Selected missense mutations were screened in 1,064 controls from unrelated individuals on the Centre d'Etude du Polymorphisme Humain (CEPH diversity cell line panel. Our aggregate data suggest that point mutations in these candidate genes are likely to contribute to 6% of isolated clefts, particularly those with more severe phenotypes (bilateral cleft of the lip with cleft palate. Additional cases, possibly due to microdeletions or isodisomy, were also detected and may contribute to clefts as well. Sequence analysis alone suggests that point mutations in FOXE1, GLI2, JAG2, LHX8, MSX1, MSX2, SATB2, SKI, SPRY2, and TBX10 may be rare causes of isolated cleft lip with or without cleft palate, and the linkage disequilibrium data support a larger, as yet unspecified, role for variants in or near MSX2, JAG2, and SKI. This study also illustrates the need to test large numbers of controls to distinguish rare polymorphic variants and prioritize functional studies for rare point mutations.

  8. Treatment outcome after two-stage palatal closure in unilateral cleft lip and palate: a comparison with Eurocleft.

    Science.gov (United States)

    Nollet, Pieter J P M; Katsaros, Christos; van 't Hof, Martin A; Semb, Gunvor; Shaw, William C; Kuijpers-Jagtman, Anne Marie

    2005-09-01

    To evaluate dental arch relationships of patients with unilateral cleft lip and palate (UCLP) treated with a two-stage palatal closure and to compare them with the six centers from the Eurocleft study that used various treatment protocols. Repeated-measures study. Cleft Palate Craniofacial Unit of Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. Records of 9-year-old children with complete unilateral cleft lip and palate (n = 43) were included. The dental arch relationships of these patients were assessed by applying the Goslon Yardstick and subsequently compared with the Goslon outcome of the six-center Eurocleft study. Statistics of intra- and interexaminer agreement. For the Nijmegen UCLP group, 9% of dental arch relationships had a Goslon score of 1, 52% had a score of 2, 30% has a score of 3, 9% had a score of 4, and none had a score of 5. The mean Nijmegen Goslon score showed no significant differences with Eurocleft centers A, B, and E, which achieved the best treatment results, but did significantly differ from Goslon outcomes of Eurocleft centers D (p palatal closure was comparable with the results of the Eurocleft centers with the best outcome. Treatment protocol could not explain differences in the quality of treatment results.

  9. Permanent Tooth Agenesis and Maxillary Hypoplasia in Patients with Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Antonarakis, Gregory S; Fisher, David M

    2015-11-01

    Maxillary growth in patients with clefts is highly variable. The authors' aim was to investigate whether severity of maxillary hypoplasia is associated with the presence of permanent tooth agenesis in children with complete unilateral cleft lip and palate. Fifty children with complete unilateral cleft lip and palate were divided into two groups of 25 children. One group had tooth agenesis of the cleft maxillary lateral incisor, whereas the other did not. Panoramic radiographs, lateral cephalometric radiographs, and dental casts were available for all children in the mixed dentition phase before preparation for alveolar bone grafting. The Modified Huddart/Bodenham scoring system was used to determine dental arch relationships on dental casts. Lateral cephalometric radiographs were traced and analyzed. Differences between groups were investigated using independent samples t tests. Children with complete unilateral cleft lip and palate and tooth agenesis presented with more negative Modified Huddart/Bodenham scores (-12.4 ± 5.2) than those without tooth agenesis (-5.4 ± 3.5) (p cleft lip and palate and tooth agenesis demonstrate more deficient maxillary growth than those without tooth agenesis. This is evident in both the sagittal and vertical dimensions, and when looking at the dentoalveolar intermaxillary relationships. Risk, II.

  10. Craniofacial characteristics in unilateral complete cleft lip and palate patients with congenitally missing teeth.

    Science.gov (United States)

    Wu, Ting-Ting; Ko, Ellen Wen-Ching; Chen, Philip Kuo-Ting; Huang, Chiung-Shing

    2013-09-01

    Congenitally missing permanent teeth are common in patients with clefts. This retrospective study was conducted to evaluate the craniofacial characteristics in patients with unilateral complete cleft lip and palate with congenitally missing permanent teeth. A series of 73 consecutive patients with nonsyndromic unilateral complete cleft lip and palate were enrolled. Evaluation of congenitally missing permanent teeth was based on the panoramic films taken from 7 to 11 years of age. The cephalometric films taken around 9 years of age were used to compare the craniofacial morphology in patients with no congenitally missing permanent teeth (n = 20) and 1 (n = 25), 2 (n = 18), and 3 (n = 10) congenitally missing permanent teeth. The Spearman correlation coefficient was used to assess the association of increased numbers of congenitally missing permanent teeth with each cephalometric parameter. Anterior facial height, distance from the maxillary incisor and first molar to the palatal plane, and overjet decreased as the number of congenitally missing permanent teeth increased in patients with unilateral cleft lip and palate. Unilateral cleft lip and palate patients with congenitally missing permanent teeth have a unique craniofacial morphology with a reduced vertical dimension. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Achieving Consensus in the Measurement of Psychological Adjustment to Cleft Lip and/or Palate.

    Science.gov (United States)

    Stock, Nicola Marie; Hammond, Vanessa; Owen, Tina; Kiff, James; Shanly, Angela; Rumsey, Nichola

    2016-07-01

    Psychological adjustment to cleft lip/palate is multifaceted and can fluctuate over time and across different situations. Consequently, a comprehensive understanding of adjustment is difficult to capture, and the challenge of achieving consensus among researchers and clinicians regarding key constructs and processes is considerable. Numerous measures have been used in research and clinical audit, resulting in conflicting findings and difficulties in evidencing the value of psychological intervention. The launch of the world's largest cleft lip/palate cohort study has provided an opportunity to standardize data collection across the United Kingdom. To describe the collaborative process used to achieve consensus in the academic and clinical measurement of psychological adjustment to cleft lip/palate. Extensive work based on existing literature and clinical experience has resulted in a conceptual framework comprising six domains of adjustment and corresponding risk/protective factors that are measureable across key developmental time points. Driven by this framework, a core pack of standardized measures has been selected according to psychometric properties, clinical utility, and pragmatic considerations. To date, these measures have been implemented within a UK-wide longitudinal cohort study (at diagnosis, 18 months, 3 years, 5 years, and 8 years) and adopted into the national routine clinical audit protocol for cleft lip/palate at age 5. Further data collection points will follow as the cohorts age. Over time, consistency in data collection will allow researchers to address some of the key unanswered questions in relation to psychological adjustment to cleft lip/palate.

  12. The effectiveness of mentoring speech and language pathology students when they face patients with cleft palate.

    Science.gov (United States)

    Pamplona, María del Carmen; Ysunza, Pablo Antonio; Sarre, Pilar; Morales, Santiago; Sterling, Mariana

    2015-10-01

    Mentoring programs can boost Speech & Language (SL) pathologists' satisfaction about their clinical skills, increasing their professional competence. A quality induction program provides a bridge for an efficient and comfortable transition between theoretical knowledge and clinical practice in front of clients. This transition can be especially difficult when the SL pathologist confronts patients with cleft palate. To study whether a mentoring program can improve SL Pathology students' performance for treating patients with cleft palate. 18 SL Pathology students coursing the third year of a SL Pathology graduate program volunteered for participating in the study. The students were divided in two groups. All SL students from both groups were equally supervised. The students were followed for two semesters during their participation in the SL Pathology intervention for patients with cleft palate. The only difference between the students from each group was that one group (active group) was mentored by an experienced SLP who had previously received specific training to become a mentor. All SL students were assessed at the onset and at the end of the study. The assessment was performed through an analysis according to a previously validated scale (Learning Continuum of Speech & Language pathologists). A Wilcoxon test demonstrated a significant improvement (Pintervention in cleft palate patients from an integral stand point is not easy for SL students. The support and guidance of an experienced mentor seems to enhance self-confidence and improve students' performance confronting patients with cleft palate. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Retronasal triangle: a sonographic landmark for the screening of cleft palate in the first trimester.

    Science.gov (United States)

    Sepulveda, W; Wong, A E; Martinez-Ten, P; Perez-Pedregosa, J

    2010-01-01

    To describe a new first-trimester sonographic landmark, the retronasal triangle, which may be useful in the early screening for cleft palate. The retronasal triangle, i.e. the three echogenic lines formed by the two frontal processes of the maxilla and the palate visualized in the coronal view of the fetal face posterior to the nose, was evaluated prospectively in 100 consecutive normal fetuses at the time of routine first-trimester sonographic screening at 11 + 0 to 13 + 6 weeks' gestation. In a separate study of five fetuses confirmed postnatally as having a cleft palate, ultrasound images, including multiplanar three-dimensional views, were analyzed retrospectively to review the retronasal triangle. None of the fetuses evaluated prospectively was affected by cleft lip and palate. During their first-trimester scan, the retronasal triangle could not be identified in only two fetuses. Reasons for suboptimal visualization of this area included early gestational age at scanning (11 weeks) and persistent posterior position of the fetal face. Of the five cases with postnatal diagnosis of cleft palate, an abnormal configuration of the retronasal triangle was documented in all cases on analysis of digitally stored three-dimensional volumes. This study demonstrates the feasibility of incorporating evaluation of the retronasal triangle into the routine evaluation of the fetal anatomy at 11 + 0 to 13 + 6 weeks' gestation. Because fetuses with cleft palate have an abnormal configuration of the retronasal triangle, focused examination of the midface, looking for this area at the time of the nuchal translucency scan, may facilitate the early detection of cleft palate in the first trimester.

  14. 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

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

    Science.gov (United States)

    ... throat, hearing, dentistry, speech, oral surgery, nursing, and psychology among others. You can obtain the names of ... of the cleft team, particularly the psychologist and social worker. Interaction with other adults with clefts, through ...

  16. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning, 2

    Energy Technology Data Exchange (ETDEWEB)

    Uchiyama, Mayuki; Tanaka, Hiroshi; Harada, Junta (Jikei Univ., Tokyo (Japan). School of Medicine)

    1992-06-01

    Computed tomography was performed on 104 patients with cleft lip and palate by continuous 2 mm slice scanning. The type of hard palate was classified as normal, hypoplasia and aplasia, depending on its developmental degree. The shape of alveolus was also classified as circular, triangular and asymmetric forms for the evaluation of the maxillary development. The hard palate development correlated with the shape of the alveolus, the diameter of maxillary and mandibular bone, and frequency of sinusitis and otitis media. Evaluation of the hard palate by thin slice scanning is useful in presumption of future fecial development. (author).

  17. Post-operative outcomes after cleft palate repair in syndromic and non-syndromic children: a systematic review protocol.

    Science.gov (United States)

    Zhang, Zach; Stein, Michael; Mercer, Nigel; Malic, Claudia

    2017-03-09

    There is a lack of high-level evidence on the surgical management of cleft palate. An appreciation of the differences in the complication rates between different surgical techniques and timing of repair is essential in optimizing cleft palate management. A comprehensive electronic database search will be conducted on the complication rates associated with cleft palate repair using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Two independent reviewers with expertise in cleft pathology will screen all appropriate titles, abstracts, and full-text publications prior to deciding whether each meet the predetermined inclusion criteria. The study findings will be tabulated and summarized. The primary outcomes will be the rate of palatal fistula, the incidence and severity of velopharyngeal insufficiency, and the rate of maxillary hypoplasia with different techniques and also the timing of the repair. A meta-analysis will be conducted using a random effects model. The evidence behind the optimal surgical approach to cleft palate repair is minimal, with no gold standard technique identified to date for a certain type of cleft palate. It is essential to appreciate how the complication rates differ between each surgical technique and each time point of repair, in order to optimize the management of these patients. A more critical evaluation of the outcomes of different cleft palate repair methods may also provide insight into more effective surgical approaches for different types of cleft palates.

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

    NARCIS (Netherlands)

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

    2016-01-01

    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

  19. 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).

  20. Infant orthopedics and facial growth in complete unilateral cleft lip and palate until six years of age (Dutchcleft)

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Prahl-Andersen, B.; Bronkhorst, E.M.; Prahl, C.; Ongkosuwito, E.M.; Borstlap, W.A.; Kuijpers-Jagtman, A.M.

    2009-01-01

    Objective: To evaluate longitudinally the effect of infant orthopedics (IO) on dentofacial cephalometric variables in unilateral cleft lip and palate (UCLP) patients from 4 to 6 years of age. Design: Prospective two-arm randomized controlled clinical trial in three cleft palate centers in The

  1. Infant orthopedics and facial growth in complete unilateral cleft lip and palate until six years of age (dutchcleft).

    NARCIS (Netherlands)

    Bongaarts, C.A.M.; Prahl-Andersen, B.; Bronkhorst, E.M.; Prahl, C.; Ongkosuwito, E.M.; Borstlap, W.A.; Kuijpers-Jagtman, A.M.

    2009-01-01

    OBJECTIVE: To evaluate longitudinally the effect of infant orthopedics (IO) on dentofacial cephalometric variables in unilateral cleft lip and palate (UCLP) patients from 4 to 6 years of age. DESIGN: Prospective two-arm randomized controlled clinical trial in three cleft palate centers in The

  2. 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).

  3. 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

  4. EPIDEMIOLOGICAL SURVEY OF TOOTH DECAY IN YOUNG CHILDREN WITH CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Liliana-Gabriela HALIŢCHI

    2017-03-01

    Full Text Available Aim. Evaluation of the extension of caries risk and incidence of decays of temporary teeth in children with cleft lip and palate. Materials and methods. The study was conducted on a sample of 64 children with various types of cleft lip and palate (31 children with unilateral cleft lip and palate, 18 children with bilateral cleft lip and palate, 5 children with cleft lip and 10 children with cleft palate, aged between 3 and 6 years, investigated in the Orthodontics Clinic of „Apollonia” University. The tooth surfaces were examined with the probe and the mirror, incipient caries and tooth decay with manifest cavities detectable by probing being identified. The gingival status was examined, whichever the inflammatory signs from the free gingival margin and papillae. Oral hygiene was rated by the presence/absence of dental biofilm after examining the buccal and lingual surfaces of the teeth. Statistical analysis was based on the non-parametric Pearson correlation, frequency analysis and linear regression method for determining the functional interrelationships between variables. Results and discussion. In children with cleft lip and palate, the highest incidence of caries occurs on the upper deciduous central incisors and first molars. Carious lesions of the central and lateral incisors tend to increase and decrease in frequency symmetrically and have a strong causal relationship. In 80.6% of cases, the decay of central incisors causes caries on the lateral incisors. Mean number of teeth affected by caries in temporary dentition at ages between 4-6 years is 7.27. The average ratio of dmft is 8.6136, a quite higher value, compared with the normal values registered in normal children, evidencing a faster and more rapid development of dental caries. Poor oral hygiene is associated with cleft and number of caries. It seems that the parents of children with cleft lip and palate have difficulties in implementing an effective brushing technique, given

  5. A Innovative Technique - Modified Feeding Bottle for a Cleft Palate Infant.

    Science.gov (United States)

    Hiremath, Vinuta Siddayya; Lingegowda, Ashwini Budunur; Rayannavar, Sounyala; Kumari, Nirmala

    2016-04-01

    Cleft lip and cleft palate are one of the most common craniofacial anomalies. Infants suffer a lot of difficulty in sucking during the initial few days after birth. There is even psychological stress to the parents due to improper feeding and the infants lose weight and are prone to nutritional insufficiency. Due to recent advancement in the medical field, there is a total repair of cleft lip and cleft palate and these procedures are performed in the later stages of infants. It is the multidisciplinary approach which includes pedodontist, oral surgeon, prosthodontist and speech therapist. In this article, the technique is highlighted to fulfill the feeding problem of infants in the early stages of birth with a modified feeding bottle.

  6. A numerical classification system for cleft lip and palate in the dog.

    Science.gov (United States)

    Moura, E; Pimpão, C T

    2017-11-01

    An easy-to-use classification that enables an accurate record of canine cleft lip and palate is fundamental for effective communication between professionals and researchers and optimal use of published information. Here we present how a classification system for human cleft lip and palate can be used to register spontaneous cases in dogs, highlighting its advantages. This system is based on four topographic areas with a numerical representation of the severity of the cleft in each area. The use of spontaneous cases has the advantage of providing clefts that are naturally similar to their human counterparts for surgical, genetic and genomic studies and, furthermore, will reduce the need for experimental models of this condition. © 2017 British Small Animal Veterinary Association.

  7. A Relationship between nasolabial appearance and self-esteem in adolescent with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center.

    Science.gov (United States)

    Patjanasoontornm, Niramol; Wongniyom, Kusalapom; Pradubwong, Suteera; Piyavhakul, Navanant; Chowchuen, Bowornsilp

    2014-10-01

    To examine levels of self-esteem of adolescents with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center and its correlation with nasolabial appearance. Across-sectional survey of 93 adolescents with repaired cleft lip and palate. A total nasolabial appearance score was 2.8 +/- 0.36 (fair to good). The mean of the total self-esteem score for all respondents was 20.11 +/- 3.27 (maximum 30). There was no-significant correlation between nasolabial appearance and self esteem (Pearson product-moment correlation coefficiency (r) = 0.18, p = 0.08. The self-esteem scores of good, fair and poor appearance were 20.5 +/- 0.98, 19.8 +/- 0.32, 19 +/- 2.09 respectively. The nasolabial appearance of repaired cleft lip and palate not be the only factor but other psychosocialfactors also may play a role in their self-esteem. The analysis of this study found no relationship between self-esteem and appearance.

  8. Adopted children with cleft lip and/or palate: a unique and growing population.

    Science.gov (United States)

    Swanson, Jordan W; Smartt, James M; Saltzman, Babette S; Birgfeld, Craig B; Hopper, Richard A; Gruss, Joseph S; Tse, Raymond

    2014-08-01

    Standard clinical pathways are well established for children with cleft lip and/or palate. Treatment of internationally adopted children differs because of the late age at presentation, a newly evolving child-family relationship, and variable extent and quality of previous treatment. The authors characterized the presentation and treatment patterns of all internationally adopted children with clefts at their institution between 1997 and 2011. Among 1841 children with clefts, 216 (12 percent) were internationally adopted: 78 percent had cleft lip and palate, 18 percent had cleft lip, and 4 percent had cleft palate. Patients originated predominantly from China (80 percent). Median age at presentation was 31 months, and the rate of new presentations increased five-fold during the study period. Eighty-two percent presented with prior cheiloplasty, and revision was recommended for 64 percent of them. Thirty-seven percent of patients had prior palatoplasty, of which 34 percent presented with a palatal fistula. Secondary palatoplasty/pharyngoplasty was performed more frequently for patients who underwent primary palatoplasty before adoption than after adoption (95 percent CI, 0.20 to 0.77). Overall, adoptees required secondary surgery more often than nonadoptees (49 percent versus 28 percent) regardless of where their primary surgery was performed. Changes in adoptee growth indices suggested improvements in systemic health following adoption. Internationally adopted children with clefts have unique treatment challenges. Children with unrepaired clefts undergo surgery late, and children with prior repairs frequently undergo revision. Compared with nonadoptees, adoptees require more revisions and have a higher fistula rate. Further detailed study is important to optimize care.

  9. Phenotypic discordance in a family with monozygotic twins and non-syndromic cleft lip and palate

    Energy Technology Data Exchange (ETDEWEB)

    Wyszynski, D.F. [Johns Hopkins Univ., Baltimore, MD (United States)]|[National Center for Human Genome Research, Bethesda, MD (United States); Lewanda, A.F. [Johnson Hopkins Hospital, Baltimore, MD (United States)]|[Children`s National Medical Center, Washington, DC (United States); Beaty, T.H. [Johns Hopkins Univ., Balitomre, MD (United States)

    1996-12-30

    Despite considerable research, the cause of non-syndromic cleft lip with or without cleft palate (NSCLP) is still an enigma. Case-control and cohort studies have searched for environmental factors that might influence the development of this common malformation, such as maternal cigarette smoking, periconceptional supplementation of folic acid and multivitamins, agricultural chemical use, and place of residence, among others. However, these studies are subject to numerous biases, and their results have often been contradictory and inconclusive. 41 refs., 1 fig.

  10. Electrophysiological assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

    OpenAIRE

    Xiaoran Ma; Bradley McPherson; Lian Ma

    2016-01-01

    Objectives Cleft lip and/or palate is a common congenital craniofacial malformation found worldwide. A frequently associated disorder is conductive hearing loss, and this disorder has been thoroughly investigated in children with non-syndromic cleft lip and/or palate (NSCL/P). However, analysis of auditory processing function is rarely reported for this population, although this issue should not be ignored since abnormal auditory cortical structures have been found in populations with cleft ...

  11. Evaluation of fecal microorganisms of children with cleft palate before and after palatoplasty

    Directory of Open Access Journals (Sweden)

    Narciso Almeida Vieira

    2013-09-01

    Full Text Available This study isolated and quantified intestinal bacteria of children with cleft palate before and after palatoplasty. A prospective study was conducted from May 2007 to September 2008 on 18 children with cleft palate, aged one to four years, of both genders, attending a tertiary cleft center in Brazil for palatoplasty, to analyze the effect of surgical palate repair on the concentration of anaerobes Bacteroides sp, Bifidobacterium sp and microaerophiles Lactobacillus sp in feces of infants with cleft palate before and 24 hours after treatment with cefazolin for palatoplasty. There was significant reduction of Lactobacillus sp (p < 0.002, Bacteroides sp (p < 0.001 and Bifidobacterium sp (p = 0.021 after palatoplasty, revealing that surgery and utilization of cefazolin significantly influenced the fecal microbiota comparing collections before and after surgery. However, due to study limitations, it was not possible to conclude that other isolated factors, such as surgical stress, anesthetics and other medications used in palatoplasty might have a significant influence on the microbiota. Considering the important participation of the intestinal microbiota on both local and systemic metabolic and immunological activities of the host, professionals should be attentive to the possible influence of these changes in patients submitted to cleft repair.

  12. The need for orthognathic surgery in nonsyndromic patients with repaired isolated cleft palate.

    Science.gov (United States)

    Antonarakis, Gregory S; Watts, Guy; Daskalogiannakis, John

    2015-01-01

    To determine the frequency of need for orthognathic surgery among nonsyndromic patients with isolated cleft palate repaired during infancy at The Hospital for Sick Children in Toronto, Canada. Retrospective cohort study. PATIENTS with nonsyndromic isolated cleft palate born between 1970 and 1997 with available records including a lateral cephalometric radiograph taken at ≥15 years of age. PATIENTS who had undergone or were being prepared for orthognathic surgery were automatically counted as requiring surgery. For the remaining patients, lateral cephalometric radiographs were traced and analyzed. Arbitrarily set cephalometric criteria were used to identify the "objective" need for orthognathic surgery. Of the 189 patients identified with nonsyndromic isolated cleft palate and for whom records were available, 25 (13.2%) were deemed to require orthognathic surgery. Of the surgical cohort, 92% required surgical correction for a Class III malocclusion. Similar percentages of males and females required orthognathic surgery. An apparently greater proportion of patients of Asian background (18.5%) than of white background (10.6%) required surgery, but this difference was not significant (P = .205). The current results suggest that approximately one in eight patients at our institution with nonsyndromic isolated cleft palate requires orthognathic surgery. There is a tendency for this to be higher in patients of Asian descent and lower in patients of white descent. Variability in extent, severity, and phenotype of the cleft, which may be attributed largely to genetics, may play an important role in dictating the need for orthognathic surgery.

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

    OpenAIRE

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vijaya Prasad Kamavaram Ellore

    2012-01-01

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

  15. MEGALENCEPHALY, POLYMICROGYRIA, POLYDACTYLY AND HYDROCEPHALUS (MPPH) SYNDROME: A NEW CASE WITH OCCIPITAL ENCEPHALOCELE AND CLEFT PALATE.

    Science.gov (United States)

    Demir, N; Peker, E; Gülşen I; Kaba, S; Tuncer, O

    2015-01-01

    The megalencephaly, polymicrogyria, polydactyly, and hydrocephalus (MPPH) syndrome is quite rarely seen. The four main findings in this syndrome may be accompanied by severe psychomotor retardation, blindness, hypotonia, convulsions, and facial dysmorphism. In this paper, we present a female newborn at 39 weeks gestational age born to parents who are first degree cousins. Beside the facial dysmorphism and four main features of the MPPH syndrome, the findings on the physical examination of the patient were, hypertonicity, occipital encephalocele, cleft palate, and multiple polyps in the tongue. The presence of occipital encephalocele, cleft palate, and polyps in the tongue in this patient was not reported previously in the literature.

  16. Search for Genomic Alterations in Monozygotic Twins Discordant for Cleft Lip and/or Palate

    DEFF Research Database (Denmark)

    Kimani, Jane W; Yoshiura, Koh-Ichiro; Shi, Min

    2009-01-01

    consisting of 1,536 SNPs, to scan for genomic alterations in a sample of monozygotic twin pairs with discordant cleft lip and/or palate phenotypes. Paired analysis for deletions, amplifications and loss of heterozygosity, along with sequence verification of SNPs with discordant genotype calls did not reveal...... any genomic discordance between twin pairs in lymphocyte DNA samples. Our results demonstrate that postzygotic genomic alterations are not a common cause of monozygotic twin discordance for isolated cleft lip and/or palate. However, rare or balanced genomic alterations, tissue-specific events...

  17. 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...

  18. CLEFT LIP, ALVEOLUS AND PALATE IN AFRICAN NATIVES: AN UPDATE ON DEMOGRAPHICS AND MANAGEMENT OUTCOME

    Science.gov (United States)

    Akintububo, O.B.; Ojo, E.O.; Kokong, DD; Adamu, S.A.; Nnadozie, U.U; Yunusa-Kaltungo, Z; Jalo, I; Dauda, A.M

    2015-01-01

    Background Development of craniofacial structures is a complex process and disruption of any of the numerous steps can lead to development of oro-facial clefts. This is a surgically amenable anomaly as from early life that has had conflicting pattern of demographics reported by various researchers globally. There are several factors that are critical to the surgical outcome. Objective Study the demographics and the management outcome of cleft lip, alveolus and palate and highlight factors responsible for improved care in recent time. Design Descriptive cohort study. Setting Tertiary health institution Method All consecutive patients managed for cleft lip, alveolus and palate (CLAP) over 7years and 10months were studied. Outcome Cleft lip, alveolus and palate repair was performed on 149 patients, January 1, 2001– December 31, 2008 with an incidence of 2.1/1000 live births. From this, 27 patients, averaging 4.5 patients per year were operated for the first 6 1/3 years while the remaining 122(81.9%) the next 1 1/2 years, averaging 81.6 patients yearly. Their ages ranged from 3 months – 60 years with 77 (51.7%) males and 72 (48.3.0%) females. Cleft lip was the main presentation in 108(72.5%) of which 72(66.7%) were left sided. Bilateral cleft lip were14 (9.4%). Five (3.4%) patients had associated anomalies out of which 3(60.0%) had CLAP while 2(40.0%) isolated cleft lip or palate. The technique for cleft lip repair was Millard’s and Noordhoof’s while palatal cleft was the two-flap palatoplasty with intravelar veloplasty. Success was recorded in 142(95.3%) with complication observed in 7(4.7%) patients. Conclusion The rarity of cleft lip, alveolus and/or palate in the African native documented previously may no longer be tenable as observe in this study. Management outcome has improved owing to the collaboration with SmileTrain, USA, along with multidisciplinary approach. PMID:26709327

  19. A status report on management of cleft lip and palate in India.

    Science.gov (United States)

    Gopalakrishna, A; Agrawal, Karoon

    2010-01-01

    This national survey on the management of cleft lip and palate (CLP) in India is the first of its kind. To collect basic data on the management of patients with CLP in India for further evaluation. A proforma was designed and sent to all the surgeons treating CLP in India. It was publicized through internet, emails, post and through personal communication. 293 cleft surgeons representing 112 centers responded to the questionnaire. Most of the forms were filled up by personal interview. The cleft workload of the participating centers is between 10 and 2000 surgeries annually. These centers collectively perform 32,500-34,700 primary and secondary cleft surgeries every year. The responses were analyzed using Microsoft excel and 112 as the sample size. Most surgeons are repairing cleft lip between 3-6 months and cleft palate between 6 months to 1 year. Millard and Tennison repairs form the mainstay of lip repair. Multiple techniques are used for palate repair. Presurgical orthopedics, lip adhesion, nasendoscopy, speech therapy, video-fluoroscopy and orthognathic surgery were not always available and in some cases not availed of even when available. Management of CLP differs in India. Primary surgical practices are almost similar to other studies. There is a lack of interdisciplinary approach in majority of the centers, and hence, there is a need for better interaction amongst the specialists. A more comprehensive study with an improved questionnaire would be desirable.

  20. A status report on management of cleft lip and palate in India

    Directory of Open Access Journals (Sweden)

    Gopalakrishna A

    2010-01-01

    Full Text Available Introduction: This national survey on the management of cleft lip and palate (CLP in India is the first of its kind. Objective: To collect basic data on the management of patients with CLP in India for further evaluation. Materials and Methods: A proforma was designed and sent to all the surgeons treating CLP in India. It was publicized through internet, emails, post and through personal communication. Subjects: 293 cleft surgeons representing 112 centers responded to the questionnaire. Most of the forms were filled up by personal interview. Results: The cleft workload of the participating centers is between 10 and 2000 surgeries annually. These centers collectively perform 32,500-34,700 primary and secondary cleft surgeries every year. The responses were analyzed using Microsoft excel and 112 as the sample size. Most surgeons are repairing cleft lip between 3-6 months and cleft palate between 6 months to 1 year. Millard and Tennison repairs form the mainstay of lip repair. Multiple techniques are used for palate repair. Presurgical orthopedics, lip adhesion, nasendoscopy, speech therapy, video-fluoroscopy and orthognathic surgery were not always available and in some cases not availed of even when available. Conclusion: Management of CLP differs in India. Primary surgical practices are almost similar to other studies. There is a lack of interdisciplinary approach in majority of the centers, and hence, there is a need for better interaction amongst the specialists. A more comprehensive study with an improved questionnaire would be desirable.

  1. Selection bias in genetic-epidemiological studies of cleft lip and palate

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, K.; Holm, N.V.; Kock, K. (Odense Univ. (Denmark)); Olsen, J. (Aarhus Univ. (Denmark)); Fogh-Anderson, P.

    1992-09-01

    The possible impact of selection bias in genetic and epidemiological studies of cleft lip and palate was studied, using three nationwide ascertainment sources and an autopsy study in a 10% sample of the Danish population. A total of 670 cases were identified. Two national record systems, when used together, were found suitable for ascertaining facial cleft in live births. More than 95% ascertainment was obtained by means of surgical files for cleft lip (with or without cleft palate) without associated malformations/syndromes. However, surgical files could be a poor source for studying isolated cleft palate (CP) (only a 60% and biased ascertainment), and they cannot be used to study the prevalence of associated malformations or syndromes in facial cleft cases. The male:female ratio was 0.88 in surgically treated cases of CP and was 1.5 in nonoperated CP cases, making the overall sex ratio for CP 1.1 (95% confidence limits 0.86-1.4) The sex ratio for CP without associated malformation was 1.1 (95% confidence limits 0.84-1.6). One of the major test criteria in CP multifactorial threshold models (higher CP liability among male CP relatives) must be reconsidered, if other investigations confirm that a CP sex-ratio reversal to male predominance occurs when high ascertainment is achieved. 24 refs., 1 fig., 4 tabs.

  2. Evaluation of Delayed Puberty in Adolescents With Cleft Lip/Palate.

    Science.gov (United States)

    Crês, Maria Cristina; Marques, Ilza Lazarini; Bettiol, Heloisa

    2016-07-01

    To assess the frequency of delayed puberty in adolescents with cleft lip and/or cleft palate (CL/P). This was a cross-sectional study of 203 patients with CL/P and no associated syndromes treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. We evaluated boys aged 14-19 years and girls aged 13-18 years. The patients were classified according to Tanner stages of sexual development. The age of menarche was recorded. Patients were assigned to three groups according to cleft type: isolated cleft lip (CL), cleft lip and palate (CLP), and isolated cleft palate (CP). The results were expressed as frequencies and averages and compared with pubertal changes described for typically developing adolescents as reported in the literature. Subjects were 115 boys and 88 girls. All boys in the CL group and the CP group had already started puberty, and two boys in the CLP group (2.3%) had delayed puberty. All girls had started puberty. The average age at menarche was 12.3 years in the CL group, 12.1 years in the CLP group, and 12.5 years in the CP group. The frequency of delayed puberty and the average age at menarche in adolescents with CL/P and no associated genetic syndromes or anomalies were within the expected range for typically developing adolescents (i.e., those without CL/P) in the same age group.

  3. 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.

  4. Exclusion of linkage between cleft lip with or without cleft palate and markers on chromosomes 4 and 6

    Energy Technology Data Exchange (ETDEWEB)

    Blanton, S.H. [Univ. of Virginia, Charlottesville, VA (United States); Malcolm, S.; Winter, R. [Institute of Child Health, London (United Kingdom)] [and others

    1996-01-01

    Nonsyndromic cleft lip with or without associate cleft palate (CLP) is a common craniofacial defect, occurring in {approximately}1/1,000 live births. While the defect generally occurs sporadically, multiplex families have been reported. Segregation analyses have demonstrated that, in some families, CLP is inherited as an autosomal dominant/codominant disorder with low penetrance. Several clefting loci have been proposed on multiple chromosomes, including 6p24, 4q, and 19q13.1. Association studies and linkage studies suggested a locus that mapped to 6p24. We were unable to confirm this in a linkage study of 12 multigenerational families. A subsequent linkage study by Carinci et al., however, found evidence for linkage to this region in 14 of 21 clefting families. Additionally, Davies et al. studied the chromosomes of three individuals with cleft lip and palate, all of whom had a rearrangement involving 6p24. Their investigation supported a locus at 6p24. Carinci et al. reported that the most likely position for a clefting locus was at D6S89, which is centromeric to EDN1. This is in contrast to the findings of Davies et al., who suggested a placement telomeric to EDN1. F13A, which had been implicated in the initial association studies, is telomeric to EDN1. Thus, the region between F13A and D6S89 encompasses the regions proposed by both Davies et al. and Carinci et al. A second clefting locus, at 4q, was proposed by Beiraghi et al., who studied a single multigenerational family by linkage analysis. Their data suggested a locus near D4S175 and D4S192. 10 refs., 1 tab.

  5. The parental craniofacial morphological features in Chinese patients with sporadic nonsyndromic cleft lip with or without palate.

    Science.gov (United States)

    Lu, Da-wei; Shi, Bing; Chen, Huai-qing; Li, Yu; Meng, Tian; He, Xing; Zheng, Qian

    2009-09-01

    To evaluate the parental craniofacial morphology in Chinese patients with sporadic nonsyndromic cleft lip with or without palate. A total of 98 parental pairs of nonsyndromic unilateral incomplete cleft lip children, 207 parental pairs of nonsyndromic complete cleft lip and palate children, and 206 normal persons from Sichuan University were involved in this study. A conventional cephalometric analysis was used to measure angles, linear distances, and their ratios. Two-sample Student's t tests and a multivariate discriminant analysis were applied to the data. Data indicate that the unaffected parents of nonsyndromic cleft lip children had on average significantly more acute cranial base angle (Angle N-S-Ba) and larger nasal width (NC-NC') (p cleft lip and palate children consistently displayed a more acute cranial base angle (Angle N-S-Ba), shorter palatal length (A- PNS) and maxillary length (PNS-ANS), a more obtuse gonial angle (Angle Me-Go-Ar), and a larger y-axis length (S-Gn) and nasal width (NC-NC') (p cleft lip with or without palate show distinct characteristics in craniofacial morphology. These parental craniofacial features are more obvious in patients with cleft lip with palate than those with cleft lip only. In general, the characteristics seem to be more distinct in the fathers than in the mothers of cleft patients.

  6. Enamel defects in permanent first molars and incisors in individuals with cleft lip and/or palate

    Directory of Open Access Journals (Sweden)

    Vivian Patricia Saldias-Vargas

    2014-10-01

    Full Text Available Background. Enamel defects are common in deciduous and permanent maxillary incisors of individuals with lip and palate cleft, and their occurrence has been associated with the cleft, especially when the alveolus is affected. Objective. To compare the prevalence of enamel defects in permanent maxillary and mandibular central incisors and first molars of individuals with cleft lip and palate, cleft palate, and without clefts. Materials and methods. The study analyzed the case of 150 individuals -50 with cleft lip and palate, 50 with cleft palate and 50 without clefts-, of both genders and aged 6 to 12 years. The frequency, extent, and location of enamel alterations on the buccal aspect of teeth were evaluated by the modified DDE index. Results. There was a greater manifestation of enamel defects in maxillary incisors and molars in groups with clefts, with statistically significant difference compared with the noncleft group. Conclusions. The occurrence of enamel defects was common in permanent incisors and molars and was significantly associated with clefts.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Cyclic neutropenia in a cleft lip and palate patient: a case report.

    Science.gov (United States)

    Desai, Anil; Gopalkrishnan, K; Joshi, V K; Rao, C Bhasker

    2011-11-01

    Cleft lip and palate is the most common congenital anomaly. Its association with hematologic disorders is rarely reported. Cyclic neutropenia is a rare blood disorder that may occur spontaneously or has a genetic predisposition. Periodicity/recurrence of cyclic neutropenia has a cyclical pattern reoccurring in multiples of 7 days, usually at 21- or 28-day intervals between attacks, with the patient being fairly asymptomatic. There is no case in the literature that has reported the presence of cyclic neutropenia in cleft patients. We report a case of cleft patient associated with cyclic neutropenia. The clinical features, diagnosis, and course of management are described.

  9. Three-dimensional tooth crown size symmetry in cleft lip and cleft palate.

    Science.gov (United States)

    Akcam, M Okan; Aydemir, Halise; Özer, Levent; Özel, Berna; Toygar-Memikoğlu, T Ufuk

    2014-07-01

    To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. Dental casts of 72 individuals with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], and 18 unilateral right [URCLP]) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P central incisor and first premolar (ULCLP, P central incisor (BLCLP, P < .01), mandibular canine and first premolar (ULCLP, P < .01), and first molar (ULCLP, P < .05). Tooth crown size asymmetries were also recorded in the Class I group. Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group.

  10. Cleft lip and palate: current status from the literature and our experience.

    Science.gov (United States)

    Manna, Francesco; Pensiero, Stefano; Clarich, Gabriella; Guarneri, Gianni Franco; Parodi, Pier Camillo

    2009-09-01

    Many years after surgical correction, a complete unilateral or bilateral cleft is inclined to show an inaesthetism often associated with functional defects. This sequela disturbs the facial growth during childhood. Across the world, each surgical school uses its own protocol, but which is the best surgical protocol for patients with cleft? The aim of this study was to present a review of international literature concerning surgical techniques for the repair of cleft lip and palate (CLP) in children and to report our personal surgical techniques in this field. We focus on the main role of the primary surgery and propose a personalized protocol therapy, depending on the severity of the cleft. On 36 patients, most of them showed unilateral CLP at birth; only 4 showed bilateral cleft. In this study, we used 36 patients without cleft but with class I occlusion for comparison purposes. Analysis of the 2 groups regarding the development of the maxillary arch and the evaluation of palatal morphology was carried out using lateral cephalograms and dental casts. The main result showed 28 patients with acceptable teeth occlusion and speech quality, a valid nasal function, and a proper aesthetic aspect. Controversy still exists regarding the optimum timing and surgical technique for CLP repair. We propose the creation of a scientific database on internationally recognized protocol as a starting point depending on the severity of the cleft, thus avoiding controversies in CLP therapeutic treatment.

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

    Directory of Open Access Journals (Sweden)

    Daniela Gamba Garib

    2015-10-01

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

  12. Do Cleft Lip/ And Or Palate Patients Need The Cardiologist Consultation Before The Surgery?

    Directory of Open Access Journals (Sweden)

    Miri S R

    2003-11-01

    Full Text Available Ectomesenchimal cells, placed near the embryonal tube, migrate to down and share in facial and cardiac structures. Migration or differentiation disorders of these cell causes cleft lip/ or palate and congenital heart disease (CHD. This item was performed to determine co-appearing of cleft and CHD and to know adjutant factors to that for better management of these patient."nMaterials and Methods: Two hundered children with cleft lip and palate were registered. Finding was analyzed by fisher's exact text and chi-square tests."nResults: CHD is ten times of normal population in this research (p< 0.01 and odd ratio 10.39 and incidence of CHD in cleft is high in cleft patient if another congenital animalies were presented (p< 0.001, odd ratio 5.18."nConclusion: By attention to higher incidence of CHD in cleft patients, it is advised to cardiologist consulting before cleft surgery for better managing."n"n"n 

  13. 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.

  14. 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 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.

  15. Grommets and speech at three and six years in children born with total cleft or cleft palate.

    Science.gov (United States)

    Ezzi, Oumama El; Herzog, Georges; Broome, Martin; Trichet-Zbinden, Chantal; Hohlfeld, Judith; Cherpillod, Jacques; de Buys Roessingh, Anthony S

    2015-12-01

    Grommets may be considered as the treatment of choice for otitis media with effusion (OME) in children born with a cleft. But the timing and precise indications to use them are not well established. The aim of the study is to compare the results of hearing and speech controls at three and six year-old in children born with total cleft or cleft palate in the presence or not of grommets. This retrospective study concerns non syndromic children born between 1994 and 2006 and operated for a unilateral cleft lip palate (UCLP) or a cleft palate (CP) alone, by one surgeon with the same schedule of operations (Malek procedure). We compared the results of clinical observation, tympanometry, audiometry and nasometry at three and six year-old. The Borel-Maisonny classification was used to evaluate the velar insufficiency. None of the children had preventive grommets. The Fisher Exact Test was used for statistical analysis with p<0.05 considered as significant. Seventy-seven patients were analyzed in both groups. Abnormal hearing status was statistically more frequent in children with UCLP compared to children with CP, at three and six years (respectively, 80-64%, p<0.03 and 78-60%, p<0.02), with the use of grommets at six years in 43% of cases in both groups. Improvement of hearing status between three and six year-old was present in 5% of children with UCLP and 9% with CP, without the use of grommets. The use of grommets between three and six year-old was not associated to any improvement of hearing status or speech results children with UCLP or with CP, with a low risk of tympanosclerosis. These results favor the use of grommets before the age of three, taking into account the risk of long term tympanosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Cone-Beam Computed Tomography Assessment of Lower Facial Asymmetry in Unilateral Cleft Lip and Palate and Non-Cleft Patients with Class III Skeletal Relationship: e0130235

    National Research Council Canada - National Science Library

    Yifan Lin; Gui Chen; Zhen Fu; Lian Ma; Weiran Li

    2015-01-01

      Introduction 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...

  17. Further evidence of a relationship between the retinoic acid receptor alpha locus and nonsyndromic cleft lip with or without cleft palate (CL [+-] P)

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, D.; Field, L. (Univ. of Calgary (Canada)); Ray, A. (Univ. of Toronto (Canada)); Marazita, M. (Medical College of Virginia, Richmond, VA (United States))

    1993-11-01

    Chenevix-Trench et al. (1992) reported a significant difference between nonsyndromic cleft lip with or without cleft palate (CL [+-] P) cases and unrelated controls in the frequency of alleles at the retinoic acid receptor alpha (RARA) PstI RFLP located at 17q21.1. They also observed borderline significant (P = .055) differences between allele frequencies in subjects with cleft lip and palate (CL + P) compared with those with cleft lip only (CL). Retinoic acid (RA) is a known teratogen capable of producing cleft palate in rodents (Abbott and Birnbaum 1990). Chenevix-Tench et al. (1992) hypothesized that variation in susceptibility to the effects of RA in humans may result from alterations at the RARA locus. We have investigated association and linkage between CL [+-] P and a microsatellite marker (D17S579) located at 17q21 (Hall et al. 1992), selected for its proximity to RARA, in 14 extended multiplex families from rural West Bengal, India.

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

    Science.gov (United States)

    Tinano, Mariana Maciel; Martins, Milene Aparecida Torres Saar; Bendo, Cristiane Baccin; Mazzieiro, Ênio

    2015-01-01

    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. 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. 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 Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

  19. Incidental findings on cone beam computed tomography scans in cleft lip and palate patients

    NARCIS (Netherlands)

    Kuijpers, Mette A. R.; Pazera, Andrzej; Admiraal, Ronald J.; Berge, Stefaan J.; Vissink, Arjan; Pazera, Pawel

    Cone beam computed tomography (CBCT) is frequently used in treatment planning for alveolar bone grafting (ABG) and orthognathic surgery in patients with cleft lip and palate (CLP). CBCT images may depict coincident findings. The aim of this study was to assess the prevalence of incidental findings

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

    Directory of Open Access Journals (Sweden)

    Yllka DECOLLI

    2015-09-01

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

  1. Incidental findings on cone beam computed tomography scans in cleft lip and palate patients

    NARCIS (Netherlands)

    Kuijpers, M.A.R.; Pazera, A.; Admiraal, R.J.C.; Berge, S.J.; Vissink, A.; Pazera, P.

    2014-01-01

    OBJECTIVES: Cone beam computed tomography (CBCT) is frequently used in treatment planning for alveolar bone grafting (ABG) and orthognathic surgery in patients with cleft lip and palate (CLP). CBCT images may depict coincident findings. The aim of this study was to assess the prevalence of

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

    NARCIS (Netherlands)

    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.

    2017-01-01

    Objective 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. Methods Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a

  3. Adolescent and adult cleft lip and palate, in Ile-Ife, Nigeria

    African Journals Online (AJOL)

    2011-12-17

    Dec 17, 2011 ... Introduction: Congenital cleft lip and palate (CLP) defects usually present in childhood, especially in places with available and affordable care. In Nigeria, their incidence is low but late presentation in Adult life have been reported. This article aims at reviewing adolescent and adult CLP patients in our center ...

  4. 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...

  5. An Outreach Experience With Cleft Lip/Palate Surgery in selected ...

    African Journals Online (AJOL)

    zation with regional offices in Nairobi Kenya. The fol- lowing centers were included: St Elizabeth Mission Hos- pital Mukumu, St FrancisMission Hospital Mwiki,Embu. Povincial Gen Hospital, Isiolo district Hospital and Al- upe Subdistrict Hospital. All files for patients operated on for cleft lips/palates between January 2005 and ...

  6. 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...

  7. Case Report: Bilateral absence of fifth ray in feet, cleft palate ...

    African Journals Online (AJOL)

    Background: Miller syndrome is one of the acrofacial dysostosis syndromes, which are characterized by malformations of the craniofacial region and limbs. Case report: A 26 month old male child, the product of healthy nonconsanguineous parents has many typical features of Miller syndrome. He has cleft lip and palate, ...

  8. Bilateral absence of fifth ray in feet, cleft palate, malformed ears, and ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-01-04

    Jan 4, 2014 ... characterized by malformations of the craniofacial region and limbs. Case report: A 26 month old male child, the product of healthy nonconsanguineous parents has many typical features of Miller syndrome. He has cleft lip and palate, malar hypoplasia, left crum- pled cup shaped ear, and prominent nose ...

  9. Nutritional and haematological parameters of cleft lip and/or palate ...

    African Journals Online (AJOL)

    Introduction: Cleft Lip and Palate (CLP) deformities are the most common congenital abnormalities of the orofacial structures. The deformity is associated with certain peculiar problems including feeding disorders and recurrent infections. These may combine to affect the nutritional status of the patients. This study was ...

  10. Adolescent and adult cleft lip and palate, in Ile-Ife, Nigeria | Oladele ...

    African Journals Online (AJOL)

    Introduction: Congenital cleft lip and palate (CLP) defects usually present in childhood, especially in places with available and affordable care. In Nigeria, their incidence is low but late presentation in Adult life have been reported. This article aims at reviewing adolescent and adult CLP patients in our center, with the advent ...

  11. Cleft lip and palate in northern Nigerian children | Adeola | Annals of ...

    African Journals Online (AJOL)

    There was no involvement of the orthopaedic and plastic surgeon, orthodontist or speech therapist in patients' management. Conclusion: Though management of cleft lip and palate was successful within our limits, there is need to increase public awareness of the treatment possibilities available and to adopt a team ...

  12. Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Perceptual Outcomes of Velopharyngeal Function

    Science.gov (United States)

    Pereira, Valerie J.; Sell, Debbie; Tuomainen, Jyrki

    2013-01-01

    Background: Abnormal facial growth is a well-known sequelae of cleft lip and palate (CLP) resulting in maxillary retrusion and a class III malocclusion. In 10-50% of cases, surgical correction involving advancement of the maxilla typically by osteotomy methods is required and normally undertaken in adolescence when facial growth is complete.…

  13. Nasolabial aesthetics correlates poorly with skeletal symmetry in unilateral cleft lip and palate

    NARCIS (Netherlands)

    Urbanova, W.; Brudnicki, A.; Strydom, H.; Bronkhorst, E.M.; Katsaros, C.; Fudalej, P.S.

    2013-01-01

    OBJECTIVE: To evaluate the correlation between symmetry of the craniofacial skeleton and aesthetics of the nose and upper lip in children with complete unilateral cleft lip and palate (CUCLP). MATERIAL AND METHODS: Craniofacial symmetry was evaluated on postero-anterior (PA) cephalograms of 54

  14. Hearing process in children with cleft lip and palate with or without history of otitis

    Directory of Open Access Journals (Sweden)

    Moraes, Tamyne Ferreira Duarte de

    2011-10-01

    Full Text Available Introduction: Considering that hearing loss and otologic complications can interfere in the maturation process of central nervous system, this study aimed to check the performance of children with cleft lip and palate with or without the history of otitis media in the evaluation of the hearing process. Method: Prospective study. Were evaluated 20 children with operated cleft lip and palate, aged between 7 to 10 years old, divided into group I - 10 children with cleft lip and palate with history of otitis - and group II - with 10 children with cleft lip and palate with no history of otitis. Were performed diotic, monotic and dichotic tests. Results: All the children presented a bad performance in at least one dichotic test. In these diotic tests, children of group I had the worst performance, while in the monotic tests the worst performance was of group II. Conclusion: All the children with history of otitis and all the children with no history have presented a bad performance in the processing tests,in other words, some kind of central alteration was found in 100% of the children studied in both groups.

  15. Cephalometric analysis of craniofacial morphology and growth in unrepaired isolated cleft palate patients

    NARCIS (Netherlands)

    Xu, Y.; Yang, C.; Schreuder, W.H.; Shi, J.; Bing, S.; Zheng, Q.; Wang, Y.

    2014-01-01

    Objective The aim of this study is to analyze the craniofacial morphology in patients with unrepaired isolated cleft palate (UICP) at childhood, adolescence and adulthood, in order to assess the influence of nonsurgical factors on the craniofacial growth in these patients. Material and methods

  16. 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...... in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. TRIAL REGISTRATION: ISRCTN29932826....

  17. Evaluation of speech errors in Putonghua speakers with cleft palate: a critical review of methodology issues.

    Science.gov (United States)

    Jiang, Chenghui; Whitehill, Tara L

    2014-04-01

    Speech errors associated with cleft palate are well established for English and several other Indo-European languages. Few articles describing the speech of Putonghua (standard Mandarin Chinese) speakers with cleft palate have been published in English language journals. Although methodological guidelines have been published for the perceptual speech evaluation of individuals with cleft palate, there has been no critical review of methodological issues in studies of Putonghua speakers with cleft palate. A literature search was conducted to identify relevant studies published over the past 30 years in Chinese language journals. Only studies incorporating perceptual analysis of speech were included. Thirty-seven articles which met inclusion criteria were analyzed and coded on a number of methodological variables. Reliability was established by having all variables recoded for all studies. This critical review identified many methodological issues. These design flaws make it difficult to draw reliable conclusions about characteristic speech errors in this group of speakers. Specific recommendations are made to improve the reliability and validity of future studies, as well to facilitate cross-center comparisons.

  18. Nature of feeding practices among children with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    A Goyal

    2012-01-01

    Full Text Available Objective: To find out the nature of feeding practices among children with cleft lip and palate. Materials and Methods: A total of 155 subjects of less than 2 years of age with cleft lip and palate were chosen and divided into three groups according to their chronological age. Group I included 47 subjects (M=35, F=12 who were <6 months old, Group II included 56 subjects (M=36, F=20 aged between 6 months and 1 year, and Group III included 52 subjects (M=28, F=24 of age between 1 and 2 years. Both the parents of the subjects with cleft lip and palate were interviewed and the details of the existing feeding practice were recorded on a standard proforma. Chi-square test was applied to find out any significant difference in the feeding method between males and females. Results: Spoon feeding was found as the most common feeding practice method. Breast feeding was the second most common feeding practice method among Group I subjects, whereas bottle feeding was the second most common feeding practice method among Group II and III subjects. The difference in the feeding practice between male and female subjects in all the three groups was very negligible and statistically not significant. Conclusion: Spoon feeding was found as the most common feeding method practiced by the parents of children with cleft lip and palate.

  19. Fordyce Happiness Program and Happiness in Mothers of Children with a Cleft Lip and Palate.

    Science.gov (United States)

    Hemati, Zeinab; Mosavi Asl, Fatemeh-Sadat; Abbasi, Samira; Ghazavi, Zohre; Kiani, Davood

    2016-11-01

    Facial deformities and aesthetic and functional anomalies in children may be a cause of real distress in families. Problems faced by parents in coping with a child's anomaly can be upsetting and lead parents to exhibit over-severe behavior. The present study was conducted in order to study the effect of happiness program on the happiness of the mothers of children with a cleft lip and palate. In this semi-experimental study, 64 mothers of children with a cleft lip and palate enrolled by convenience random sampling were assigned to an intervention or control group based on a simple random sampling. Then, a program of happiness training was implemented consisting of 10 sessions of 2 hours each. A demographic questionnaire and the Oxford Happiness Questionnaire were completed prior to and 2 months after the last session of intervention. The data were analyzed using descriptive and analytical statistics, consisting of a paired t-test, independent t-test and Chi-square test using SPSS version 20. The independent t-test indicated a significant difference in mean happiness score after training between the intervention and control groups (Pintervention group, although the difference was not statistically significant for the control group (P>0.05). In light of the efficacy of happiness training on the promotion of happiness in the mothers of children with a cleft lip and palate, this model is recommended as a healthcare intervention to decrease stress in mothers following the birth of an infant with a cleft lip and palate.

  20. [Effects of an early psychological intervention on parents of children with cleft lip/palate].

    Science.gov (United States)

    Wang, Yangyang; Xin, Yanhua; Ma, Jian; Xin, Xiuhong; Shi, Bing; Huang, Yongqing

    2013-08-01

    To provide basis for effects of an early psychological intervention on parents of children with cleft lip/palate, and investigate the effects of an early psychological intervention to them. One self-administered questionnaire (SCL-90) was applied in 102 parents of children with cleft lip/palate, compared to 126 parents of healthy individuals on the day of admission. They were given the psychological intervention during hospitalization and 3 months after discharge. The questionnaire (SCL-90) was again applied to them on the day of discharge and 3 months after discharge. Using the questionnaire (SCL-90), the answer scores of somatization, obsessive-compulsive, depression and anxiety etc. were significantly higher than those of the control group (P 0.05). There were no statistical differences on the day of admission and on the day of discharge (P > 0.05), but there were statistical difference on the day of admission and 3 months after discharge (P cleft lip/palate is poor. It's important and greatly significant that we conduct early psychological intervention to parents of children with cleft lip/palate and to the children's psychosomatic health.

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

    NARCIS (Netherlands)

    N. Roche; J. Plettinck; K. van Lierde; K. Bettens; K. Bonte; Anke Luyten; H. Vermeersch

    2014-01-01

    PURPOSE: 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

  2. An Outreach Experience With Cleft Lip/Palate Surgery in selected ...

    African Journals Online (AJOL)

    Objective To describe the presentation and surgical care of patients managed for cleft lips and palates during a surgical outreach program.. Study design. A five year retrospective chart study of the patients operated on between January 2005 to the 31st December 2009 in selected hospitals in Kenya. Setting

  3. International Research Symposium on Ankyloblepharon-Ectodermal Defects-Cleft Lip/Palate (AEC) syndrome.

    NARCIS (Netherlands)

    Fete, M.; Bokhoven, J.H.L.M. van; Clements, S.E.; McKeon, F.; Roop, D.R.; Koster, M.I.; Missero, C.; Attardi, L.D.; Lombillo, V.A.; Ratovitski, E.; Julapalli, M.; Ruths, D.; Sybert, V.P.; Siegfried, E.C.; Bree, A.F.

    2009-01-01

    Ankyloblepharon-ectodermal defects-cleft lip/palate (AEC) syndrome (Hay-Wells syndrome, MIM #106220) is a rare autosomal dominant ectodermal dysplasia syndrome. It is due to mutations in the TP63 gene, known to be a regulatory gene with many downstream gene targets. TP63 is important in the

  4. Relationship of the IRF6 gene with the occurrence of cleft lip and palat

    Directory of Open Access Journals (Sweden)

    Marcos Roberto Tovani Palone

    2015-06-01

    Full Text Available Cleft lip and palate is considered a change in embryonic development. This phenotype occurs as a result of the interaction of genetic and environmental factors, suggesting a multifactorial inheritance pattern. Among the candidate genes for this phenotype, the IRF6 appears as one of the most important.

  5. Parental adjustment to cleft lip and palate anomaly: a preliminary study

    African Journals Online (AJOL)

    ... decision on having more children, parental relationship and feeding difficulty was made among parents/caregivers of infants with cleft lip/palate anomaly who were less than 6 months of age in the University College Hospital, Ibadan. Frequencies and percentages of variables were reported. Chi square test was used to ...

  6. Bilingual Children with Nonsyndromic Cleft Lip and/or Palate: Language and Memory Skills

    Science.gov (United States)

    Young, Selena Ee-Li; Purcell, Alison Anne; Ballard, Kirrie Jane; Liow, Susan Jane Rickard; Ramos, Sara Da Silva; Heard, Robert

    2012-01-01

    Purpose: Research shows that monolingual children with cleft lip and/or palate (CLP) have a higher incidence of cognitive-linguistic deficits, but it is not clear whether bilingual preschool children with CLP are especially vulnerable because they need to acquire 2 languages. We tested the hypothesis that bilingual children with CLP score lower…

  7. Starting a Family: The Experience of Parents With Cleft Lip and/or Palate.

    Science.gov (United States)

    Stock, Nicola Marie; Rumsey, Nichola

    2015-07-01

    One of the key challenges facing young adults with cleft lip and/or palate is making decisions about starting a family, because there is an increased likelihood of their own child being diagnosed with cleft lip and/or palate. Should this occur, a second key challenge is how to deal with their child's diagnosis and subsequent treatment. To explore the views, experiences and possible support needs of this unique group of parents in order to inform the services provided by nonspecialist Health Professionals, cleft teams, and genetic counselors. Individual telephone interviews eliciting qualitative data. Qualitative thematic analysis identified five themes. Accessing accurate information and appropriate support around heritability presented a significant challenge. Parents described feelings of responsibility and distress at their child's diagnosis, as well as a number of factors that had helped or hindered their adjustment. Parents also described ways in which their own experiences had impacted their parenting style and how becoming a parent had changed the way they felt about their own cleft. Young adults' understanding of what it means to grow up with cleft lip and/or palate may impact their decision to start a family and their experiences of having children. Possible methods of supporting prospective parents through this potentially difficult stage will be discussed.

  8. Incidence of Le Fort Surgery in a Mature Cohort of Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Dalle Ore, Cecilia; Schoenbrunner, Anna; Brandel, Michael; Kronstadt, Nicola; McIntyre, Joyce; Jones, Marilyn; Gosman, Amanda

    2017-05-01

    Primary repair of cleft lip and palate occurs early in life, but ideal timing of these interventions remains controversial. Prior research has indicated that a later palate repair may improve patients' midfacial growth long term, whereas optimal timing of lip repair to maximize midfacial growth has not been identified.The purpose of this study is to analyze a large, diverse cohort of patients with cleft lip and palate to determine whether timing of primary palate repair and primary lip repair contributed significantly to subsequent orthognathic surgery. Seventy-one nonsyndromic patients with cleft lip and/or palate were followed until age 23 years, and data regarding original diagnosis, surgical procedures, and dates were collected. Within our patient cohort, 12 patients (16.9%) underwent orthognathic surgery. Binary logistic regressions, Fisher exact tests, and Mann-Whitney U tests were used to determine whether timing of primary palate repair and primary lip repair contributed significantly to subsequent orthognathic surgery. In our cohort, the association of early lip repair with later orthognathic surgery trended toward significance (P = 0.080). Timing of primary palate repair was not significantly associated with later orthognathic surgery (P= 0.291). When correcting for sex, race, diagnosis, location of care, incidence of lip adhesions, and incidence of lip revisions, patient age at primary lip procedure was a significant predictor of later orthognathic surgery (P = 0.041). Inconsistent with prior research, age at primary palate repair in our cohort was not correlated with incidence of orthognathic surgery. Delayed primary lip repair was associated with a significant decrease in the rate of subsequent orthognathic surgery.

  9. Initial counselling for cleft lip and palate: parents' evaluation, needs and expectations.

    Science.gov (United States)

    Kuttenberger, J; Ohmer, J N; Polska, E

    2010-03-01

    During the first counselling after the birth of a child with cleft lip and palate (CLP) information about the malformation should be delivered and a long-standing relationship between the cleft team and the affected family must be established. The present study was conducted to evaluate the parents' experiences, needs and expectations with this first consultation. A questionnaire was sent to 105 parents at the cleft clinic, which could be answered anonymously. It collected demographic data, data on the parents' pre-existing level of information and the parents' assessment of the counselling at the cleft centre. Seventy percent of the questionnaires were returned. In 16% the clefts were diagnosed prenatally, in 32% there were relatives with clefts. Seventy-one percent of the parents received detailed counselling, 89% of which occurred in the first week. The parents requested that information about surgery (80%), feeding the child (63%) and the aetiology of clefts (44%) should be given. The quality of the consultation was rated very good or good by 87% of families. This study confirms the importance of initial counselling for CLP. The exceptional psychological situation of the family has to be considered and a close collaboration between cleft centre and maternity hospitals is mandatory.

  10. Long-term stability of alveolar bone grafts in cleft palate patients.

    Science.gov (United States)

    Toscano, Dominique; Baciliero, Ugo; Gracco, Antonio; Siciliani, Giuseppe

    2012-09-01

    Many authors have examined the surgical bone treatment of cleft palate patients, but no study has emphasized the role of orthodontic therapy. The aims of this study were to evaluate the long-term stability of bone grafts when using an orthodontic-surgical protocol, to determine the success of bone grafts in minor vs severe clefts, and to develop a qualitative method for assessing the success of bone grafting. Forty-nine patients were included in this study. Occlusal x-rays were taken before (T0), immediately after (T1), and at least 1 year after bone grafting (T2). Two radiographic parameters were analyzed adjacent to the cleft side: the vertical bone level (Bergland scale) and the horizontal bone level (Witherow-derived scale). The bone graft success at T2 was 91.84% (95% confidence interval, 84.55-96.41). The severity of the cleft before grafting was not statistically correlated with success at T2 (P cleft, lateral incisor agenesis) were not statistically correlated (P protocol to treat cleft lip and palate patients, prevent postoperative bone resorption, and guarantee correct positioning of the teeth. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Chinese children with nonsyndromic cleft lip/palate: Factors associated with hearing disorder.

    Science.gov (United States)

    Ma, Xiaoran; Li, Yue Wing; Ma, Lian; McPherson, Bradley

    2016-09-01

    This study examined the auditory status of Chinese children with nonsyndromic cleft lip/palate (NSCL/P), investigated factors associated with peripheral hearing loss and compared results with earlier studies in western countries. Case history profiles and audiological data from 148 Chinese children with NSCL/P, aged between 6 and 15 years, who attended the Cleft Lip and Palate Clinic Center in a major Chinese urban hospital from July 2012 to September 2013 were acquired. The audiological status of the participants was reviewed, based on the results of their pure tone audiometry, tympanometry and acoustic reflex thresholds assessments. Factors including age, gender, cleft type, residential locality and school achievement were examined in relation to auditory status. Findings revealed that 17% of the Chinese children with NSCL/P had hearing impairment at the time of assessment. Unilateral hearing loss was noted in 12% of children and in 5% of cases bilateral hearing loss was noted. In the majority of cases the hearing loss was slight and conductive in nature. Age, gender, residential locality and school achievement were found to have no relationship with severity of hearing loss. Children with cleft lip showed a lower degree of hearing impairment than children with cleft palate or cleft lip and palate. Similar to studies for western children, Chinese children with CL/P associated with no known syndrome are at risk of peripheral hearing loss, generally of conductive type. However, the prevalence of peripheral hearing loss appears to be less than in western children with NSCL/P. Ethnic/racial factors may be a major contributing factor accounting for the discrepancies between the current results and western studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Grommets for otitis media with effusion in children with cleft palate: a systematic review.

    Science.gov (United States)

    Kuo, Chin-Lung; Tsao, Yuan-Heng; Cheng, Hao-Min; Lien, Chiang-Feng; Hsu, Chyong-Hsin; Huang, Chii-Yuan; Shiao, An-Suey

    2014-11-01

    No consensus has yet been reached with regard to the link between otitis media with effusion (OME), hearing loss, and language development in children with cleft palate. The objective of this study was to address the effectiveness of ventilation tube insertion (VTI) for OME in children with cleft palate. A dual review process was used to assess eligible studies drawn from PubMed, Medline via Ovid, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and reference lists between 1948 and November 2013. Potentially relevant papers were selected according to the full text of the articles. Relevant data were extracted onto a data extraction sheet. Nine high- or moderate-quality cohort studies were included in this study. VTI was administered in 38% to 53% of the OME cases, and more severe cases appeared more likely to undergo VTI. Compared with conservative forms of management (eg, watchful waiting), VTI has been shown to be beneficial to the recovery of hearing in children with cleft palate and OME. A growing body of evidence demonstrates the benefits of VTI in the development of speech and language in children with cleft palate and OME. These children face a higher risk of complications than those undergoing conservative treatments, the most common of which are eardrum retraction and tympanosclerosis, with an incidence of ∼ 11% to 37%. This review provides evidence-based information related to the selection of treatment for OME in children with cleft palate. Additional randomized controlled trials are required to obtain bias-resistant evidence capable of reliably guiding treatment decisions. The conclusions in this review are based on underpowered cohort studies and very-low-strength evidence. Copyright © 2014 by the American Academy of Pediatrics.

  13. Speech summer camp for treating articulation disorders in cleft palate patients.

    Science.gov (United States)

    Pamplona, Carmen; Ysunza, Antonio; Patiño, Carmeluza; Ramírez, Elena; Drucker, Mónica; Mazón, Juán J

    2005-03-01

    Compensatory articulation disorder (CAD) severely affects speech intelligibility of cleft palate children. CAD must be treated with speech therapy. Children can manage articulation better when they use language in event contexts such as every day routines. The purpose of this paper is to study and compare two modalities of speech intervention in cleft palate children with associated CAD. The first modality is a conventional approach providing speech therapy in 1-h sessions, twice a week. The second modality is a speech summer camp in which children received therapy 4h per day, 5 days a week for a period of 3 weeks. We were aimed to determine if a speech summer camp could significantly enhance articulation in CP children with CAD. Forty-five children with repaired cleft palates who exhibited CAD were studied. A matched control group of 45 children with repaired cleft palate who also exhibited CAD were identified. The patients included in the first group attended a speech summer camp for 3 weeks. The matched control subjects included in the second group received speech therapy aimed to correct CAD twice per-week in 1-h sessions. At the onset of either the summer camp or the speech therapy period, the severity of CAD was evenly distributed with non-significant differences across both groups of patients (p > 0.05). After the summer camp (3 weeks) or 12 months of speech therapy sessions at a frequency of twice per-week, both groups of patients showed a significant decrease in the severity of their CAD (p speech therapy period, non-significant differences were found between both groups of patients (p > 0.05). A speech summer camp is a valid and efficient method for providing speech therapy in cleft palate children with compensatory articulation disorder.

  14. 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 hearing thresholds in the higher frequencies at >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.

  15. Use of autologous platelet-rich plasma in complete cleft palate repair.

    Science.gov (United States)

    El-Anwar, Mohammad Waheed; Nofal, Ahmed Abdel Fattah; Khalifa, Mohamed; Quriba, Amal Saeed

    2016-07-01

    Evaluate the effect of topical application of autologous platelet-rich plasma (PRP) in primary repair of complete cleft palate and then compare the result with another group of patients using the same surgical technique, without application of PRP with regard to the incidence of oronasal fistula, velopharyngeal closure, and grade of nasality. Case control study. This study was carried on 44 children with complete cleft palate with age range from 12 to 23 months. The children were divided into two age- and gender-matched groups: All children were subjected to the same technique of V-Y pushback repair of the complete cleft palate. In group A (22 children), the PRP prepared from the patient was topically applied between the nasal and oral mucosa layer during palatoplasty, whereas in group B (22 children) the PRP was not applied. All cases were recovered smoothly without problems. In group A, no oronasal fistula was reported, whereas in group B three patients (13.6%) had postoperative fistulae and two patients (9.1%) needed revision palatoplasty. At 6 months postoperative assessment, group A (with PRP application) showed significantly better grade of nasality (P = 0.024) and better endoscopic velopharyngeal closure (P = 0.016) than group B. Usage of autologous PRP in complete cleft palate repair is simple; effective; can decrease the incidence of oronasal fistula; and also significantly improves the grade of nasality and velopharyngeal closure, which decreases the need of further surgical intervention in cleft palate patients. 3b. Laryngoscope, 126:1524-1528, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Width and elevation of the palatal shelves in unoperated unilateral and bilateral cleft lip and palate patients in the permanent dentition.

    NARCIS (Netherlands)

    Latief, B.S.; Lekkas, K.C.; Schols, J.G.J.H.; Fudalej, P.S.; Kuijpers, M.A.R.

    2012-01-01

    Patients with cleft left lip and palate (CLP) normally require extensive surgery from an early age up to the end of adolescence. These surgeries affect the growth of the maxillofacial complex. The degree to which the cleft itself affects growth of the maxillofacial complex remains poorly understood.

  17. Addressing the challenges of cleft lip and palate research in India

    Directory of Open Access Journals (Sweden)

    Mossey Peter

    2009-10-01

    Full Text Available The Indian sub-continent remains one of the most populous areas of the world with an estimated population of 1.1 billion in India alone. This yields an estimated 24.5 million births per year and the birth prevalence of clefts is somewhere between 27,000 and 33,000 clefts per year. Inequalities exist, both in access to and quality of cleft care with distinct differences in urban versus rural access and over the years the accumulation of unrepaired clefts of the lip and palate make this a significant health care problem in India. In recent years the situation has been significantly improved through the intervention of Non Governmental Organisations such as SmileTrain and Transforming Faces Worldwide participating in primary surgical repair programmes. The cause of clefts is multi factorial with both genetic and environmental input and intensive research efforts have yielded significant advances in recent years facilitated by molecular technologies in the genetic field. India has tremendous potential to contribute by virtue of improving research expertise and a population that has genetic, cultural and socio-economic diversity. In 2008, the World Health Organisation (WHO has recognised that non-communicable diseases, including birth defects cause significant infant mortality and childhood morbidity and have included cleft lip and palate in their Global Burden of Disease (GBD initiative. This will fuel the interest of India in birth defects registration and international efforts aimed at improving quality of care and ultimately prevention of non-syndromic clefts of the lip and palate.

  18. Associated anomalies in cleft lip and palate: analysis of 811 ...

    African Journals Online (AJOL)

    facial congenital anomalies. It has not been established if specific types of anomalies are frequently related with clefts, or which organ is most commonly affected. This study aimed to assess the prevalence of associated anomalies in consecutive ...

  19. 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

    Cleft lip and palate (CLP) is comprised within the wide range of congenital deformities of the maxillofacial region with an overall incidence on the increase from 1:1000 to 1:700 live births thus being the most common congenital birth error. Failure of the lateral and medial nasal processes to fuse with the anterior extension of maxillary processes and of the palatal shelves between the 4th and 8th gestational week results in cleft lip and palate. Clefts include different types with variable severity, confirming the complexity and unpredictable expression of cleft modality and have a multifactorial aetiology. Functional impairment, aesthetic disturbances and psychosocial effects are common sequalae in patients with cleft lip and palate. The main long-term morbidity of this condition may include dysfunctional speech, impaired hearing and communication, as well as dental problems. These complications are followed by unfavourable surgical outcome and aesthetic appearance, which all seem to affect this group of patients significantly and have an impact significantly both quality of life and healthcare. Treatment requirements of cleft patients are multifactorial and a multi-disciplinary approach and intervention at multiple levels is necessary. Yet, in this country, resources available to parents and consistent publicity given to this issue and its treatment are still inadequate in spite of the introduction of "Centres of Excellence" and Unified Hospitalization Coding or DRG equivalents to optimize health management. The multi-disciplinary approach to cleft management has been a reality for over a century while cleft treatment protocols are still being evaluated in order to optimise standards of cleft care. According to relevant guidelines primary surgical management of lip and palate defects is performed during the first 3 to 9 months of life. Secondary operations in the form of revisional lip and nose procedures are performed at later stages aiming with an

  20. [Application of team approach and key techniques of cleft lip and palate].

    Science.gov (United States)

    Bing, Shi; Yuchuan, Fu; Ningbei, Yin; Hong-Zhang, Huang; Jianhua, Liu; Renji, Chen; Hongping, Zhu; Qiang, Liu; Yongqing, Huang; Zhanping, Ren; Yong, Lu; Wenlin, Xiao; Qinggao, Song; Wanshan, Li; Sheng, Li; Hongtao, Wang; Junrui, Zhang; Liping, Jiang; Li, Ma; Ling, Wang; Dengqi, He

    2017-02-01

    The development of an expert consensus based on specific domestic situations will provide practical guidance to the efforts aiming at improving cleft care in China. The team approach of twenty-one cleft centers were pooled together, covering pre-surgical orthopedics, primary surgical repair, orthodontic treatment, alveolar bone graft, secondary deformity correction, palatal fistulae repair, the diagnosis and treatment of velopharyngeal incompetence, speech therapy, otitis media management, and skeletal deformity correction. Agreement was achieved among the authors concerning the application of critical surgical and non-surgical techniques. The ambition of this consensus is to introduce more clinicians to the revolution of sequential treatment of clefts, and form the basis for a more comprehensive cleft care manual in the future.

  1. Presurgical nasoalveolar remodeling – an experience in the journey of cleft lip and palate

    Science.gov (United States)

    Mandwe, Ranjit Suresh; Puri, Swapna; Shingane, Shrikant; Pawar, Ganesh; Kolhe, Vivek Ramdas; Alsi, Atul

    2015-01-01

    Aims and objectives To assess the effect of presurgical nasoalveolar molding (PNAM) therapy in the management of patients with nonsyndromic unilateral cleft lip and palate (UCLP). Material and method Ten patients with UCLP treated from 2009 to 2012. The initiation for PNAM treatment was 7 days and the average time of the treatment was 175 days. Measurements on patients and of casts were made, and statistical analysis was used to evaluate the changes in pre- and posttreatment measurements. Results Subsequent to PNAM treatment, there was a statistically considerable rise in cleft nostril height and columellar width. There was reduction in both intraoral cleft width and columellar deviation, which was significant statistically. Conclusion PNAM treatment reduces alveolar cleft width. It enhances symmetry of the nose by changing columellar angulation, preserving alar width bilaterally, gaining height of the nostril on the affected side, and increasing columellar length. PMID:25565894

  2. 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

  3. The incidence of congenital anomalies associated with cleft palate/cleft lip and palate in neonates in the Konya region, Turkey.

    Science.gov (United States)

    Altunhan, Hüseyin; Annagür, Ali; Konak, Murat; Ertuğrul, Sabahattin; Ors, Rahmi; Koç, Hasan

    2012-09-01

    Additional congenital anomalies have often been found in patients with orofacial clefts. We wanted to find out the incidence and type of congenital malformations that may accompany cleft palate (CP) and cleft lip and palate (CLP) in babies born in the Konya region. A total of 121 newborn babies with CP or CLP were prospectively included in the study, and all were assessed in detail for congenital anomalies. Of 121 babies, 86 (71%) had CLP and 35 (29%) had CP. There was at least one congenital malformation in 80 (66%) of the cases. Additional congenital malformations were seen in 26 (74%) of the 35 with isolated CP, and 54 (63%) in the 86 patients with CLP (pbabies in whom congenital malformations were found, 31 (39%) had dysmorphic features. While 21 (68%) of dysmorphic cases had isolated CP, 10 (32%) had CLP (ppremature delivery, intrauterine growth retardation, and consanguinity between parents were higher in patients with CP or CLP. The neonatal mortality was 20% (n=24). Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with CP and CLP, and these anomalies significantly increase their morbidity and mortality. All newborn babies with CP and CLP should be screened for additional congenital anomalies, particularly of the cardiovascular system. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. 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

  5. Influence of palatoplasty on occlusion of patients with isolated cleft palate

    Directory of Open Access Journals (Sweden)

    Omar Gabriel da Silva Filho

    2012-04-01

    Full Text Available OBJECTIVE: This study compared the dental arch morphology of adult patients with isolated cleft palate in order to verify the influence of palatoplasty on occlusion. METHODS: Cast models of 77 patients, 30 males and 47 females, with an average age of 21 years and no syndromes were taken. They were in the permanent dentition and had not undergone orthodontic treatment. The sample was divided into non-operated and operated patients, the latter having been submitted to palatoplasty at a mean age of 2.2 years. RESULTS: Almost 80% of the sample exhibited sagittal discrepancies in the inter-arch relationship, with a Class II malocclusion prevailing (59.74% followed by Class III (20,78%, regardless of palatoplasty. Transverse analysis showed a 23% incidence of posterior crossbite also not influenced by palatoplasty. Intra-arch relationship indicated that constriction and crowding on the upper arch were more frequent in the operated group (p=0.0238 and p=0.0002, respectively, showing an influence of palatoplasty on its morphology. The predominant morphological characteristics in patients with isolated cleft palate were a Class II malocclusion, upper dental arch constriction and upper and lower anterior crowding. CONCLUSION: The influence of palatoplasty was restricted to constriction and crowding of the upper dental arch, with no interference from the extension of the cleft, except for the upper crowding, which occurred more in patients with complete cleft palates.

  6. A genome-wide association study of cleft lip with and without cleft palate identifies risk variants near MAFB and ABCA4

    DEFF Research Database (Denmark)

    Beaty, Terri H; Murray, Jeffrey C; Marazita, Mary L

    2010-01-01

    Case-parent trios were used in a genome-wide association study of cleft lip with and without cleft palate. SNPs near two genes not previously associated with cleft lip with and without cleft palate (MAFB, most significant SNP rs13041247, with odds ratio (OR) per minor allele = 0.704, 95% CI 0.......635-0.778, P = 1.44 x 10(-11); and ABCA4, most significant SNP rs560426, with OR = 1.432, 95% CI 1.292-1.587, P = 5.01 x 10(-12)) and two previously identified regions (at chromosome 8q24 and IRF6) attained genome-wide significance. Stratifying trios into European and Asian ancestry groups revealed differences...... and ABCA4. Expression studies support a role for MAFB in palatal development....

  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. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Rating Nasolabial Aesthetics in Unilateral Cleft Lip and Palate Patients: Cropped Versus Full-Face Images.

    Science.gov (United States)

    Schwirtz, Roderic M F; Mulder, Frans J; Mosmuller, David G M; Tan, Robin A; Maal, Thomas J; Prahl, Charlotte; de Vet, Henrica C W; Don Griot, J Peter W

    2018-01-01

    To determine if cropping facial images affects nasolabial aesthetics assessments in unilateral cleft lip patients and to evaluate the effect of facial attractiveness on nasolabial evaluation. Two cleft surgeons and one cleft orthodontist assessed standardized frontal photographs 4 times; nasolabial aesthetics were rated on cropped and full-face images using the Cleft Aesthetic Rating Scale, and total facial attractiveness was rated on full-face images with and without the nasolabial area blurred using a 5-point Likert scale. Cleft Palate Craniofacial Unit of a University Medical Center. Inclusion criteria: nonsyndromic unilateral cleft lip and an available frontal view photograph around 10 years of age. a history of facial trauma and an incomplete cleft. Eighty-one photographs were available for assessment. Differences in mean CARS scores between cropped versus full-face photographs and attractive versus unattractive rated patients were evaluated by paired t test. Nasolabial aesthetics are scored more negatively on full-face photographs compared to cropped photographs, regardless of facial attractiveness. (Mean CARS score, nose: cropped = 2.8, full-face = 3.0, P images compared to full-face images. For this reason, cropping images, revealing the nasolabial area only, is recommended for aesthetical assessments.

  9. Sustained Auditory Attention Ability Test (SAAAT) in seven-year-old children with cleft lip and palate

    National Research Council Canada - National Science Library

    Lemos, Isabel Cristina Cavalcanti; Feniman, Mariza Ribeiro

    2010-01-01

    Cleft lip and palate (CLP) is a risk indicator to middle ear alterations, which may damage the development of auditory abilities such as attention that is essential to learn new skills, oral and written communication...

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

    Directory of Open Access Journals (Sweden)

    Pandey S

    2005-01-01

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

  11. Blepharophimosis, ptosis, epicanthus inversus syndrome (BPES and cleft lip and palate. Report of two Brazilian families

    Directory of Open Access Journals (Sweden)

    N.M. Kokitsu-Nakata

    1998-06-01

    Full Text Available We have evaluated a girl and a boy with the blepharophimosis, ptosis and epicanthus inversus syndrome (BPES. The girl presented cleft palate and the boy showed cleft lip and palate as additional clinical signs. Both showed familial recurrence in fourth and third generations, respectively. The other family members also presented blepharophimosis, ptosis, and epicanthus inversus, but without lip and palatal involvement. There were no additional clinical signs nor infertility in these patients. To our knowledge this is the first instance of cleft lip and palate reported as additional signs of the BPES syndrome.Os autores descrevem uma menina e um menino com a síndrome de blefarofimose, ptose e epicanto inverso (BPES. A menina apresentou fissura de palato e o menino mostrou fissura de lábio e palato como sinais clínicos adicionais. Ambos mostraram recorrência familial em quatro e três gerações, respectivamente. Outros membros de ambas as famílias apresentaram também blefarofimose, ptose e epicanto inverso, mas sem envolvimento de lábio e palato. Não existem sinais clínicos adicionais nem infertilidade nestes pacientes. De acordo com o nosso conhecimento, este é o primeiro relato de fissura de lábio e palato registrada como sinal adicional na síndrome BPES.

  12. [Summer school speech therapy for children with cleft palate and language disorder].

    Science.gov (United States)

    Pamplona, María del Carmen; Ysunza, Antonio; Pérez, Gloria; Vergara, Sabrina

    2009-01-01

    Cleft palate patients with language impairment require specific therapy. Study two modalities of speech intervention in cleft palate children with associated linguistic impairment, a conventional approach providing speech therapy, twice a week, and a speech summer camp for a period of three weeks. Twenty-five cleft palate patients with language impairment were studied. A matched control group was gathered. Patients included in the first group attended a three week duration speech summer camp. Control patients included in the second group received speech therapy twice a week. At the onset of either the summer camp or the speech intervention period, the severity of language impairment was evenly distributed with non-significant differences across groups (p > 0.05). After the summer camp or 9 months of speech therapy sessions, both groups showed a significant decrease in the severity of language impairment (p therapy period, non-significant differences, were found between groups (p > 0.05). Speech summer camp is a reliable and efficient method to provide speech therapy for left palate patients with language impairment.

  13. Goldenhar syndrome associated with cleft lip and palate. A case report.

    Directory of Open Access Journals (Sweden)

    Nayaret Soto

    2012-12-01

    Full Text Available In the literature is possible to find an extense variety of syndromes associated with cleft palate, so in patients with this condition is essential to ask if the damage is or not associated with some syndrome. Necessary to provide adequate treatment. Case report: To the Service of Orthodontics, Las Higueras Hospital was derived a female patient, born on June 22th, 2012. Clinical diagnosis was cleft lip and full cracked palate with a GAP of 17mm, left and right macrostomia, malformed ears, epibulbar cyst in left eyeball, serie of oral papillomas and headphone level, apparently associating this condition to some kind of syndrome. It was made an acrylic plate for the patient can feed and initiates the treatment presurgical orthopedics. The mother recounts in the clinical History suffer diabetes, one of his sons has cognitive delay, not associated to syndrome. Imaging test shows mild hydrocephalus, jaw fully formation, normal audiometry. All changes are in facial area at the rest of the body is shown within normal parameters.Was performed a complete clinical and imaging examination and request help from geneticist, who collected all the facts confirm the presumptive diagnosis of Goldenhar syndrome.Many syndromes that manifest cleft palate are associated with genetic component, except that even Goldenhar syndrome of unknown cause.It is important to note that there are syndromes expressing varying degrees of severity of cracked palate to also give the patient a full treatment.

  14. A restricted test of single word intelligibility in 3-year-old children with and without cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Poulsen, Mads

    2012-01-01

    listeners to understand. The error of retraction/backing of alveolar target consonants to velar place of articulation occurred frequently and most often in the HPU group and was found to have a negative effect on intelligibility. Key words: intelligibility, cleft palate, naïve listeners, error types, single......Abstract Objective: In a previous study, children with cleft palate with hard palate closure at 12 months of age showed more typical phonological development than children with an unrepaired hard palate at 36 months of age. This finding was based on narrow transcription of word initial target...... hard palate closure at either12 months (HPR (hard palate repaired)) or 36 months (HPU (hard palate unrepaired)), were compared to data obtained from 14 age-matched, typically developing, control children. Methods: Video recordings of the children naming target words were shown to 84 naïve listeners...

  15. 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.

  16. Influence of timing of two-stage palate closure on early phonological and lexical development in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    of the studies conducted, including the lack of randomized clinical trials (RCT) (Peterson-Falzone 1996). A  prospective RCT was conducted to add to the knowledge of the influence of timing of hard palate closure on early phonological and lexical development from 1 to 3 years. METHODS Fourty-one children....... However, both groups of children with cleft palate had a smaller productive vocabulary than the control children, but the late group produced a smaller number of word tokens than the early group. This difference between the two cleft palate groups is hypothesized to be caused by reduced intelligibility...

  17. Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair.

    Science.gov (United States)

    Abdel-Aziz, Mosaad; Khalifa, Badawy; Shawky, Ahmed; Rashed, Mohammed; Naguib, Nader; Abdel-Hameed, Asmaa

    2016-01-01

    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. The aim of this study was to assess the effect of transoral endoscopic partial adenoidectomy on the speech of children with repaired cleft palate. 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° 4mm 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. 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). 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. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  18. Prenatal Counseling, Ultrasound Diagnosis, and the Role of Maternal-Fetal Medicine of the Cleft Lip and Palate Patient.

    Science.gov (United States)

    James, Jeffrey N; Schlieder, Daniel W

    2016-05-01

    A multidisciplinary team is the standard of care and the cornerstone of management of cleft patients. With readily improving advanced diagnostic modalities, early prenatal diagnosis of cleft lip and palate increasingly becomes a topic of importance for both the team caring for and families of cleft patients. Maternal-fetal medicine is a fellowship subspecialty of obstetrics that can offer high-quality care and coordination to the cleft team. Both 3-D and 4-D sonography lead to early prenatal diagnosis of cleft patients; however, differences in training result in variations in its diagnostic accuracy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. ROR2 gene is associated with risk of non-syndromic cleft palate in an Asian population.

    Science.gov (United States)

    Wang, Hong; Hetmanski, Jacqueline B; Ruczinski, Ingo; Liang, Kung Yee; Fallin, M Daniele; Redett, Richard J; Raymond, Gerald V; Chou, Yah-Huei Wu; Chen, Philip Kuo-Ting; Yeow, Vincent; Chong, Samuel S; Cheah, Felicia Sh; Jabs, Ethylin Wang; Scott, Alan F; Beaty, Terri H

    2012-02-01

    The receptor tyrosine kinase-like orphan receptor 2 (ROR2) gene has been recently shown to play important roles in palatal development in animal models and resides in the chromosomal region linked to non syndromic cleft lip with or without cleft palate in humans. The aim of this study was to investigate the possible association between ROR2 gene and non-syndromic oral clefts. Here we tested 38 eligible single-nucleotide polymorphisms (SNPs) in ROR2 gene in 297 non-syndromic cleft lip with or without cleft palate and in 82 non-syndromic cleft palate case parent trios recruited from Asia and Maryland. Family Based Association Test was used to test for deviation from Mendelian inheritance. Plink software was used to test potential parent of origin effect. Possible maternally mediated in utero effects were assessed using the TRIad Multi-Marker approach under an assumption of mating symmetry in the population. Significant evidence of linkage and association was shown for 3 SNPs (rs7858435, rs10820914 and rs3905385) among 57 Asian non-syndromic cleft palate trios in Family Based Association Tests. P values for these 3 SNPs equaled to 0.000068, 0.000115 and 0.000464 respectively which were all less than the significance level (0.05/38 = 0.0013) adjusted by strict Bonferroni correction. Relevant odds ratios for the risk allele were 3.42 (1.80 - 6.50), 3.45 (1.75 - 6.67) and 2.94 (1.56 - 5.56), respectively. Statistical evidence of linkage and association was not shown for study groups other than non-syndromic cleft palate. Neither evidence for parent-of-origin nor maternal genotypic effect was shown for any of the ROR2 markers in our analysis for all study groups. Our results provided evidence of linkage and association between the ROR2 gene and a gene controlling risk to non-syndromic cleft palate.

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    V Krishna Priya; J Sharada Reddy; Y Ramakrishna; C Pujita Reddy

    2011-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Mariana Maciel Tinano

    2015-02-01

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

  3. [Cleft lip, alveolar and palate sequelae. Proposal of new alveolar score by the Alveolar Cleft Score (ACS) classification].

    Science.gov (United States)

    Molé, C; Simon, E

    2015-06-01

    The management of cleft lip, alveolar and palate sequelae remains problematic today. To optimize it, we tried to establish a new clinical index for diagnostic and prognostic purposes. Seven tissue indicators, that we consider to be important in the management of alveolar sequelae, are listed by assigning them individual scores. The final score, obtained by adding together the individual scores, can take a low, high or maximum value. We propose a new classification (ACS: Alveolar Cleft Score) that guides the therapeutic team to a prognosis approach, in terms of the recommended surgical and prosthetic reconstruction, the type of medical care required, and the preventive and supportive therapy to establish. Current studies are often only based on a standard radiological evaluation of the alveolar bone height at the cleft site. However, the gingival, the osseous and the cellular areas bordering the alveolar cleft sequelae induce many clinical parameters, which should be reflected in the morphological diagnosis, to better direct the surgical indications and the future prosthetic requirements, and to best maintain successful long term aesthetic and functional results. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases.

    Science.gov (United States)

    Al-Rudainy, D; Ju, X; Mehendale, F; Ayoub, A

    2018-03-01

    This study was performed to assess facial asymmetry in patients with unilateral cleft lip and palate (UCLP) before and after primary lip repair. Three-dimensional facial images of 30 UCLP cases (mean age 3.7±0.8months) captured 1-2days before surgery and 4 months after surgery using stereophotogrammetry were analysed. A generic mesh - a mathematical facial mask consisting of thousands of points (vertices) - was conformed on the three-dimensional images. Average preoperative and postoperative conformed facial meshes were obtained and mirrored by reflecting on the lateral plane. Facial asymmetry was assessed by measuring the distances between the corresponding vertices of the superimposed facial meshes. Asymmetries were further examined in three directions: horizontal, vertical, and anteroposterior. Preoperatively, the philtrum and bridge of the nose were deviated towards the non-cleft side. The maximum vertical asymmetry was at the upper lip. The greatest anteroposterior asymmetry was at the alar base and in the paranasal area. The overall facial asymmetry improved markedly after surgery. Residual anteroposterior asymmetry was noted at the alar base, upper lip, and cheek on the cleft slide. In conclusion, dense correspondence analysis provided an insight into the anatomical reasons for the residual dysmorphology following the surgical repair of cleft lip for future surgical consideration. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Remote Digital Preoperative Assessments for Cleft Lip and Palate May Improve Clinical and Economic Impact in Global Plastic Surgery.

    Science.gov (United States)

    Hughes, Christopher; Campbell, Jacob; Mukhopadhyay, Swagoto; McCormack, Susan; Silverman, Richard; Lalikos, Janice; Babigian, Alan; Castiglione, Charles

    2017-09-01

    Reconstructive surgical care can play a vital role in the resource-poor settings of low- and middle-income countries. Telemedicine platforms can improve the efficiency and effectiveness of surgical care. The purpose of this study is to determine whether remote digital video evaluations are reliable in the context of a short-term plastic surgical intervention. The setting for this study was a district hospital located in Latacunga, Ecuador. Participants were 27 consecutive patients who presented for operative repair of cleft lip and palate. We calculated kappa coefficients for reliability between in-person and remote digital video assessments for the classification of cleft lip and palate between two separate craniofacial surgeons. We hypothesized that the technology would be a reliable method of preoperative assessment for cleft disease. Of the 27 (81.4%) participants, 22 received operative treatment for their cleft disorder. Mean age was 11.1 ± 8.3 years. Patients presented with a spectrum of disorders, including cleft lip (24 of 27, 88.9%), cleft palate (19 of 27, 70.4%), and alveolar cleft (19 of 27, 70.4%). We found a 95.7% agreement between observers for cleft lip with substantial reliability (κ = .78, P cleft palate, with a moderate interrater reliability (κ = .55, P = .01). We found only a 47.8% agreement between observers for alveolar cleft with a nonsignificant, weak kappa agreement (κ = .06, P = .74). Remote digital assessments are a reliable way to preoperatively diagnose cleft lip and palate in the context of short-term plastic surgical interventions in low- and middle-income countries. Future work will evaluate the potential for real-time, telemedicine assessments to reduce cost and improve clinical effectiveness in global plastic surgery.

  6. Cleft lip and palate: Parental experiences of stigma, discrimination, and social/structural inequalities.

    Science.gov (United States)

    Adeyemo, Wasiu Lanre; James, Olutayo; Butali, Azeez

    2016-01-01

    Cleft lip and palate (CLP) are the most common craniofacial birth impairment and one of the most common congenital impairments in humans. Anecdotal evidence suggests that stigmatization, discrimination, and sociocultural inequalities are common "phenomenon" experienced by families of children with CLP in Nigeria. This study aimed to explore the stigmatization, discrimination, and sociocultural inequalities experiences of families with children born with CLP. The study was carried out at the surgical outpatient cleft clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. This was a cross-sectional descriptive study among mothers of children born with CLP, using both interviewer-administered questionnaire and a semi-structured interview. A total of 51 mothers of children with cleft lip and/or palate participated in the study. 35.3% of respondents believed cleft was an "act of God," whereas others believed it was either due to "evil spirit" (5.9%), "wicked people" (9.8%). Seventy-three percent of the mothers were ashamed of having a child with orofacial cleft. Two of the respondents wanted to abandon the baby in the hospital. About a quarter of the respondent wished the child was never born and 59% of the fathers were ashamed of the facial cleft. Fifty-one percent admitted that their relatives were ashamed of the orofacial cleft, and 65% admitted that their friends were ashamed of the cleft. In addition, 22% of the respondents admitted that they have been treated like an outcast by neighbors, relatives, and friends because of the cleft of their children. When asked about refusal to carry the affected children by friends, relatives, and neighbors, 20% of respondents said "Yes." Myths surrounding the etiology of orofacial cleft are prevalent in Nigeria. Parents and individuals with CLP experience stigma as well as social and structural inequalities due to societal perceptions and misconception about CLP. Public and health-care professionals must be equipped

  7. Short-stay cleft palate surgery with intraoperative dexamethasone and marcaine.

    Science.gov (United States)

    Bateman, Michael C; Conejero, J Alejandro; Mooney, Eric K; Rothkopf, Douglas M

    2006-09-01

    The perioperative management of cleft palate surgery remains controversial. Early literature supported hospital stays of 2-5 days, but more recent reports have supported 24-hour admissions in carefully screened patients without congenital syndromes. We retrospectively reviewed 65 cleft palate repairs performed by the senior author from August 1992 through November 2003. Procedures included repairs of the soft palate (n = 25), hard palate (n = 4), or combined hard and soft palate (n = 36). All repairs were performed using a Furlow double, opposing Z-plasty technique. Nine patients (14%) had associated congenital syndromes. Prior to January 1995, patients (n = 15) received perioperative antibiotics and local injection of lidocaine with epinephrine prior to incision. The average operative time to first oral feeding was 13 hours, and the average length of stay in this group was 2.4 days. Previous oral surgery literature has demonstrated the reduction of pain, edema, and trismus with the use of dexamethasone. As part of our recent operative protocol, all patients (n = 50) after January 1995 received perioperative antibiotics, local injection of a 50/50 mixture of 1% lidocaine with epinephrine, and 0.5% Marcaine with epinephrine prior to incision and 4 mg of intravenous dexamethasone perioperatively. The average time to first feeding was 7 hours and the average length of stay was 1.1 days. Postoperatively, patients from both groups were maintained on a liquid or soft diet, depending on their age without the use of bottles. There were no differences in the use of antibiotics or pain management between the 2 groups. Patients were assessed by the surgical team for evaluation of the surgical site and oral intake prior to discharge. Patients in the steroid/Marcaine group had earlier oral intake (P cleft palate surgery is safe, given adequate oral intake, competent parents, and a safe home environment.

  8. Consanguinity and occurrence of cleft lip/palate: a hospital-based registry study in Riyadh.

    Science.gov (United States)

    Ravichandran, Kandasamy; Shoukri, Mohamed; Aljohar, Aziza; Shazia, Naz Subhani; Al-Twaijri, Yasmin; Al Jarba, Ibtisam

    2012-03-01

    This paper focuses on the influence of consanguinity on the occurrence of orofacial clefts. All patients with orofacial clefts registered at King Faisal Specialist Hospital and Research Center, Riyadh since June 1999 until December 2009 were included in this study. Patients were classified in two distinct groups: cleft lip with or without cleft palate (CL ± P) and isolated cleft palate (CP). Chi-squared test was used to test independence of variables. Intracluster correlation coefficient was estimated to assess the degree of concordance between siblings. Among 1,171 total patients, CL ± P was found to be more common (64.0%). Males were more likely to be affected with CL ± P (M:F = 1.5:1) and females were more likely to be affected with CP (M:F = 0.9:1; P Consanguineous relationships were seen in 56.8% of our patients' parents. Family history was more likely to be positive for patients whose parents were consanguineous than those who were non-consanguineous (34.2% vs. 25.8%; P = 0.003), both for the CL ± P and CP groups. Recurrence among siblings did not differ between those born to consanguineous versus non-consanguineous parents. Recurrence of clefts in offspring was higher among parents affected by cleft compared to those who were not affected (51.4% vs. 11.4%; P consanguinity is important for populations with a high degree of consanguinity. Copyright © 2012 Wiley Periodicals, Inc.

  9. Management of Cleft Lip and Palate in Nigeria: A Survey

    African Journals Online (AJOL)

    2018-01-24

    Jan 24, 2018 ... Aesthetic Surgeons. A questionnaire done on Google survey was mailed or handed over directly to those identified. The surgeons were asked among other questions to provide information about their specialty, the geopolitical location of their practice, cleft surgery training, the workload, scope.

  10. Unoperated Adult Cleft of the Primary Palate in Ilorin, Nigeria ...

    African Journals Online (AJOL)

    Three of our patients dropped out of secondary education because of social embarrassment and one has returned to school after repair. Although clefts were very wide on presentation, there was adequate well developed soft tissue in adults to achieve cosmetically and functionally acceptable repair. Public enlightenment ...

  11. Nasal Airway Dimensions of Children With Repaired Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Trindade, Inge Elly Kiemle; Gomes, Adriana de Oliveira Camargo; Fernandes, Marilyse de Bragança Lopes; Trindade, Sergio Henrique Kiemle; Silva Filho, Omar Gabriel da

    2015-09-01

    To measure cross-sectional areas of the main nasal constrictions as a function of the distance into the nose in children with repaired unilateral cleft lip and palate, as compared with children without cleft, by acoustic rhinometry. Prospective analysis. Craniofacial anomalies hospital. A total of 39 children with repaired unilateral cleft lip and palate and 34 healthy controls without cleft, of both genders, aged 6 to 9 years. Interventions/Variables : Nasal cross-sectional areas measured at the three main deflections of the rhinogram (CSA1, CSA2, CSA3) and distances from the nares (dCSA1, dCSA2, dCSA3) were assessed by means of an Eccovision Acoustic Rhinometer, before and after nasal decongestion. Differences were analyzed at a significance level of 5%. At the cleft side, mean CSA1, CSA2, and CSA3 values ± standard deviation obtained before nasal decongestion were 0.17 ± 0.12, 0.29 ± 0.20, and 0.40 ± 0.28 cm(2), respectively, and dCSA1, dCSA2, and dCSA3 values ± standard deviation were 2.02 ± 0.40, 3.74 ± 0.51, and 5.50 ± 0.44 cm, respectively. At the noncleft side, these were 0.33 ± 0.11, 0.65 ± 0.28, and 0.90 ± 0.43 cm(2), respectively, and 1.69 ± 0.48, 3.67 ± 0.53, and 5.60 ± 0.70 cm, respectively. Increased cross-sectional area means were seen after nasal decongestion in the control and cleft groups. Mean cross-sectional area values at the cleft side were significantly smaller than noncleft side and control values, and the mean dCSA1 value was smaller at the noncleft side before and after decongestion. Objective assessment of internal nasal dimensions has shown that children with unilateral cleft lip and palate have a significant impairment of nasal patency due to the reduced cross-sectional areas seen at the cleft side.

  12. 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…

  13. Outcomes of Cleft Palate Repair in Patients with Pierre Robin Sequence: A Matched Case-Control Study.

    Science.gov (United States)

    Hardwicke, Joseph T; Richards, Helen; Cafferky, Louise; Underwood, Imogen; ter Horst, Britt; Slator, Rona

    2016-03-01

    Pierre Robin sequence results from a cascade of events that occur during embryologic development and frequently presents with cleft palate. Some studies have shown speech outcomes to be worse in patients with Pierre Robin sequence after cleft palate repair. A cohort of Pierre Robin sequence patients who all required an airway intervention and nasogastric feeding in the neonatal period were identified and speech outcomes assessed at 5 years of age. A cleft- and sex-matched non-Pierre Robin sequence, cleft palate-only comparison group was also identified from the same institution and study period. A total of 24 patients with Pierre Robin sequence that required airway and nutritional support in the neonatal period were matched for age, sex, and cleft type to a group of 24 non-Pierre Robin sequence cleft patients. There was no significant difference in the incidence of oronasal fistula between the groups. Secondary surgery for velopharyngeal incompetence was significantly more (p = 0.017) in the Pierre Robin sequence group, who also had significantly greater nasality (p = 0.031) and cleft speech characteristic (p = 0.023) scores. The authors hypothesize that other factors may exist in Pierre Robin sequence that may lead to poor speech outcomes. The authors would suggest counseling parents of children with Pierre Robin sequence that have required a neonatal airway intervention, that speech development may be poorer than in other children with cleft palate, and that these children will have a significantly higher incidence of secondary speech surgery. Risk, II.

  14. Facial profile esthetics in operated children with bilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Moura Carvalho Lauris

    Full Text Available ABSTRACT Objective: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP, comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. Methods: Thirty children in the mixed dentition (24 male; 6 female with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3, esthetically acceptable (grade 4 to 6, and esthetically pleasant (grade 7 to 9. Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall’s test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. Results: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. Conclusions: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.

  15. Speech and phonology in Swedish-speaking 3-year-olds with unilateral complete cleft lip and palate following different methods for primary palatal surgery.

    Science.gov (United States)

    Klintö, Kristina; Svensson, Henry; Elander, Anna; Lohmander, Anette

    2014-05-01

    Objective : To describe and compare speech and phonology at age 3 years in children born with unilateral complete cleft lip and palate treated with three different methods for primary palatal surgery. Design : Prospective study. Setting : Primary care university hospitals. Participants : Twenty-eight Swedish-speaking children born with nonsyndromic unilateral complete cleft lip and palate. Interventions : Three methods for primary palatal surgery: two-stage closure with soft palate closure between 3.4 and 6.4 months and hard palate closure at mean age 12.3 months (n = 9) or 36.2 months (n = 9) or one-stage closure at mean age 13.6 months (n = 10). Main Outcome Measures : Based on independent judgments performed by two speech-language pathologists from standardized video recordings: percent correct consonants adjusted for age, percent active cleft speech characteristics, total number of phonological processes, number of different phonological processes, hypernasality, and audible nasal air leakage. The hard palate was unrepaired in nine of the children treated with two-stage closure. Results : The group treated with one-stage closure showed significantly better results than the group with an unoperated hard palate regarding percent active cleft speech characteristics and total number of phonological processes. Conclusions : Early primary palatal surgery in one or two stages did not result in any significant differences in speech production at age 3 years. However, children with an unoperated hard palate had significantly poorer speech and phonology than peers who had been treated with one-stage palatal closure at about 13 months of age.

  16. Unilateral Cleft Lip and Palate : Quality of Life and Nasal Form and Function among Adults

    OpenAIRE

    Mani, Maria

    2010-01-01

    Unilateral cleft lip and palate (UCLP) is a craniofacial malformation with functional and aesthetical impact on the face and the upper airways. The aims of the current thesis were to evaluate Quality of life (QoL) in adults treated for UCLP  (I), to objectively evaluate nasal form and function and to search for possible differences in residual nasal deformity and impairment of function between patients operated according to one-stage and two-stage palate closure (II) as well as to evaluate th...

  17. Orthosurgical management of a skeletal class III in an operated cleft lip and palate case

    Directory of Open Access Journals (Sweden)

    Arun Nayak

    2017-01-01

    Full Text Available A 16-year-old female with an operated unilateral cleft lip and palate reported with a chief complaint of severely crowded upper and lower teeth. Significant orthodontic clinical features were retropositioned maxilla, a reverse overjet and a unilateral posterior crossbite, retruded upper lips, and a deranged occlusion. Comprehensive orthodontic therapy including arch expansion with nickel titanium palatal expander followed by a LeFort I maxillary advancement was carried out. The treatment over a period of 3 years resulted in a 97% improvement of the peer assessment review index and long-term stability.

  18. Airway management: A comparative study in cleft lip and palate repair surgery in children

    Science.gov (United States)

    Sen, Jayashree; Sen, Bitan

    2014-01-01

    Background: Cleft lip with or without palate is one of the common congenital malformations. Aim: To evaluate the per-operative complications of anesthesia, a comparative study was conducted in children using the endotracheal tubes available in the Institute so that the complications can be averted in future procedures. Materials and Methods: The rural population of Tripura, India. Result: Awareness was generated and the incidence of repair surgeries of cleft lip and palate was thus increased considerably in Dr. B. R. Ambedkar Memorial Teaching Hospital, Agartala, Tripura. Conclusion: The RAE tube has been found to be the choicest one and at a minimal risk for maintaining patients’ patent airway and other related complications. PMID:25886101

  19. [The application of nasometer on the analysis of normal and cleft palate speech].

    Science.gov (United States)

    Luo, Y

    1992-09-01

    This paper reports the use of for assessment of speech by oronasal acoustic measures. Nasal energy during speech is reflected by nasolance value and graph pattern. The degree of velopharyngeal closure and the situation and movement of other speech organs can be demonstrated. The speech of 120 normal children and 60 preoperation cleft palate patients are studied. The scales of normal value and graph pattern are recorded. Comparing with normal speech, the scale of nasolance value and characteristics of graph pattern of cleft palate speech are obviously changed and may be assessed by this apparatus. The treatment and speech therapy plan can be made with the results obtained by this method as the basis.

  20. THE MAIN DIRECTIONS IN THE COMPLEX REHABILITATION OF CHILDREN WITH CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Юлия Владимировна Степанова

    2013-03-01

    Full Text Available Complex treatment of children with cleft lip and palate is complicated and multi-step. Treatment is conducted by high-skilled specialists. The organization and execution of this complex are possible only at the large specialized center. Coordinator of this work is the maxillofacial surgeon. The performance of rehabilitation circuits includes preoperative orthodontic and orthopedic treatment, operative intervention (reconstructive and plastic surgery, orthodontic and orthopedic treatment after operation. Post-operative conservative treatment prevents the development of secondary deformities of the nose and upper lip. Professional psychological help and long supervision promote the achievement of good social adaptation of patients with congenital cleft lip and palate, improvement of their health.

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

    Science.gov (United States)

    Kolbenstvedt, A; Aaløkken, T M; Arctander, K; Johannessen, S

    2002-11-01

    To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. 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. 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. 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.

  2. Vertical changes in patients with complete unilateral and bilateral cleft lip, alveolus and palate.

    Science.gov (United States)

    Lisson, Jörg A; Hanke, Ilka; Tränkmann, Joachim

    2004-05-01

    Twelve UCLP and eleven BCLP patients who had been treated according to the Hanover treatment protocol were evaluated by means of cephalometric analysis and cast measurements. The aim of this investigation was to demonstrate changes in the vertical plane and in incisor position in the course of craniofacial growth compared to age-matched non-cleft controls. Lateral cephalograms and casts were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a non-cleft control group (n = 20). A vertical growth impairment of the maxilla was registered in patients with cleft lip, alveolus and palate. The maxilla of the cleft patients showed a significant clockwise rotation while the inclination of the mandible remained virtually unchanged. Both upper and lower incisors, which were significantly retruded at the beginning of the late mixed dentition, could be protruded in the course of craniofacial growth, development of the dentition and treatment, but remained retruded in comparison with the non-cleft controls. The posterior midfacial height was highly significantly shorter in both UCLP and BCLP patients at both evaluation timepoints, whereas the anterior lower jaw height was greater than in the control group

  3. Comparison of risk indicators of dental caries in children with and without cleft lip and palate deformities

    Science.gov (United States)

    Shashni, Rubina; Goyal, Ashima; Gauba, Krishan; Utreja, Ashok Kumar; Ray, Pallab; Jena, Ashok Kumar

    2015-01-01

    Objective: To test the hypothesis that there are no differences in various risk factors of dental caries among children with cleft lip and palate when compared to non-cleft high caries risk and non-cleft caries free children. Design: Seventy-three children in the age range of 4–9 years comprised three groups; Group-I (n = 23, children with cleft lip and palate), Group-II (n = 25, non-cleft high caries risk children) and Group-III (n = 25, non-cleft caries free children). Various risk factors for dental caries like type of oral hygiene practice, sugar exposures/day, developmental defects of enamel, caries activity, salivary streptococci mutans levels and lactobacilli levels were evaluated and compared among the three groups of children. Results: The mean deft score among Group-II children was significantly more (P dental caries was significant (P streptococcus mutans levels in Group-I and Group-II children were higher when compared to lactobacillus counts. Conclusion: The risk factors of dental caries among children with cleft lip and palate were more as compared to non-cleft high caries risk and non-cleft caries free children. PMID:25684913

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

    OpenAIRE

    Abdolreza Jamilian; Alessandra Lucchese; Alireza Darnahal; Zinat Kamali; Letizia Perillo

    2016-01-01

    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 conclusi...

  5. Hypohidrotic ectodermal dysplasia with ankylosis of temporomandibular joint and cleft palate: A rare presentation

    Directory of Open Access Journals (Sweden)

    Manisha Goyal

    2015-01-01

    Full Text Available The ectodermal dysplasias are a heterogenous group of diseases, which have one or more anomalies of the hair, teeth, nails, and sweat glands. Hypohidrotic ectodermal dysplasia (HED is the most common type and is usually transmitted as an X-linked recessive trait. It is characterized by classical triad of hypotrichosis, anhidrosis/hypohidrosis, and hypodontia/anodontia. Here, we describe an Indian boy affected with HED and rare features including ankylosis of temporomandibular joint and cleft palate.

  6. Preliminary study of Korean orthodontic residents' current concepts and knowledge of cleft lip and palate management

    OpenAIRE

    Cho, Il-Sik; Shin, Hyo-Keun; Baek, Seung-Hak

    2012-01-01

    Objective A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. Methods A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. Results All of the respondents reported that they bel...

  7. The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate.

    Science.gov (United States)

    Shaffer, Amber D; Ford, Matthew D; Choi, Sukgi S; Jabbour, Noel

    2017-09-01

    Objective Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children's hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age. Data from 152 patients with isolated cleft palate and 166 patients with cleft lip and palate were analyzed using Wilcoxon rank-sum, χ2, and Fisher exact test and logistic regression. Results Most patients (242, 76.1%) received tubes before palatoplasty. Hearing loss after tubes, but not before, was associated with speech/language delays at 24 months ( P = .005) and language delays ( P = .048) and speech sound production disorders (SSPDs, P = .040) at 5 years. Receiving tubes before palatoplasty was associated with failed newborn hearing screen ( P = .001) and younger age at first posttubes type B tympanogram with normal canal volume ( P = .015). Hearing loss after tubes ( P = .021), language delays ( P = .025), SSPDs ( P = .003), and velopharyngeal insufficiency ( P = .032) at 5 years and speech surgery ( P = .022) were associated with more tubes. Conclusion Continued middle ear disease, reflected by hearing loss and multiple tubes, may impair speech and language development. Inserting tubes before palatoplasty did not mitigate these impairments better than later tube placement.

  8. Mandibular and maxillary asymmetry in individuals with unilateral cleft lip and palate.

    Science.gov (United States)

    Laspos, C P; Kyrkanides, S; Tallents, R H; Moss, M E; Subtelny, J D

    1997-05-01

    This study was conducted to evaluate the degree of maxillary and mandibular asymmetry in the verticle and transverse planes seen in posteroanterior cephalometric radiographs relative to chronologic age in postoperative complete UCLP patients compared to controls. Mandibular and nasomaxillary asymmetry was retrospectively studied in complete unilateral cleft lip and palate (UCLP) and noncleft individuals (controls) by means of posteroanterior cephalometric analysis. All the UCLP patients available (total 40) and randomly selected noncleft controls (total 142) were included in the study. The UCLP patients had undergone lip and palate reconstruction in Strong Memorial Hospital, University of Rochester, Rochester, New York, and orthodontic treatment in the Department of Orthodontics, Eastman Dental Center, Rochester, New York. The controls were selected based on the age that treatment was initiated and were treated in the department for various malocclusions; none had undergone maxillary expansion or surgical treatment. The asymmetry assessed on mixed longitudinal records of the patients with UCLP was analyzed relative to three chronologic age groups and compared to the controls. In addition, mandibular asymmetry was correlated to maxillary asymmetry in UCLP individuals to investigate possible growth patterns between the two jaws. Mandibular asymmetry in UCLP individuals was found to increase with growth and time and peaked at post-pubertal growth-spurt stages. The cleft subjects were more asymmetric than controls in all stages of growth. Mandibular asymmetry followed the affected maxilla closely, indicating a parallel growth pattern of the jaws. The unilateral cleft lip and palate patients manifested asymmetry of the mandible. This asymmetry develops in a parallel pattern with the affected maxilla, suggesting that early evaluation and treatment of the anomalies in the nasomaxillary skeleton as well as in the mandible is necessary when treating unilateral cleft lip and

  9. Achieving consensus in the measurement of psychological adjustment to cleft lip and/or palate

    OpenAIRE

    Stock, N. M.; Hammond, V; Owen, T.; Kiff, J.; Shanly, A.; Rumsey, N

    2015-01-01

    Background: Psychological adjustment to cleft lip/palate is multifaceted, and can fluctuate over time and across different situations. Consequently, a comprehensive understanding of adjustment is difficult to capture, and the challenge of achieving consensus among researchers and clinicians regarding key constructs and processes is considerable. Numerous measures have been used in research and clinical audit, resulting in conflicting findings and difficulties in evidencing the value of psycho...

  10. Fordyce Happiness Program and Happiness in Mothers of Children with a Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Zeinab Hemati

    2016-11-01

    Full Text Available Introduction: Facial deformities and aesthetic and functional anomalies in children may be a cause of real distress in families. Problems faced by parents in coping with a child’s anomaly can be upsetting and lead parents to exhibit over-severe behavior. The present study was conducted in order to study the effect of happiness program on the happiness of the mothers of children with a cleft lip and palate.   Materials and Methods: In this semi-experimental study, 64 mothers of children with a cleft lip and palate enrolled by convenience random sampling were assigned to an intervention or control group based on a simple random sampling. Then, a program of happiness training was implemented consisting of 10 sessions of 2 hours each. A demographic questionnaire and the Oxford Happiness Questionnaire were completed prior to and 2 months after the last session of intervention. The data were analyzed using descriptive and analytical statistics, consisting of a paired t-test, independent t-test and Chi-square test using SPSS version 20.   Results: The independent t-test indicated a significant difference in mean happiness score after training between the intervention and control groups (P0.05.   Conclusion: In light of the efficacy of happiness training on the promotion of happiness in the mothers of children with a cleft lip and palate, this model is recommended as a healthcare intervention to decrease stress in mothers following the birth of an infant with a cleft lip and palate.

  11. Normative Velopharyngeal Data in Infants: Implications for Treatment of Cleft Palate.

    Science.gov (United States)

    Schenck, Graham C; Perry, Jamie L; Fang, Xiangming

    2016-09-01

    Identifying normative data related to velopharyngeal muscles and structures may have clinical significance for infants born with cleft palate, especially as they relate to selection of surgical intervention and postsurgical outcomes. Previous studies suggest that patients whose anatomy postsurgically is dissimilar to that of their normative counterparts are at risk for hypernasal speech. However, studies have not documented what constitutes "normal" anatomy for the clinically relevant population-that is, the infant population. The purpose of this study is to examine a magnetic resonance imaging database (n = 29) related to normative velopharyngeal structures and provide a preliminary comparison to 2 selected patients with repaired cleft palate. Twenty-nine healthy infants between 9 and 23 months of age (mean = 15.2 months) with normal craniofacial and velopharyngeal anatomy were recruited to participate in this study. Normative data were compared to 2 infants with repaired cleft palate between 13 and 15 months of age (mean = 14 months). Quantitative craniometric and velopharyngeal measures from the sagittal and oblique coronal image planes were collected. Variables of interest included: levator muscle, velar, and craniometric measures. Females demonstrated significantly larger intravelar segments compared with males. White infants demonstrated significantly larger levator muscles compared to non-white infants. Infants with repaired cleft palate demonstrated increased overall levator muscle length and levator extravelar length compared with infants with normal velopharyngeal anatomy.Data from the present study provide a normative database for future investigators to utilize as a comparative tool when evaluating infants with normal and abnormal velopharyngeal anatomy.

  12. Cleft lip with or without cleft palate: Associations with transforming growth factor alpha and retinoic acid receptor loci

    Energy Technology Data Exchange (ETDEWEB)

    Chenevix-Trench, G.; Jones, K. (Queensland Inst. of Medical Research (Australia) Univ. of Queensland (Australia)); Green, A.C.; Duffy, D.L.; Martin, N.G. (Queensland Inst. of Medical Research (Australia))

    1992-12-01

    The first association study of cleft lip with or without cleft palate (CL/P), with candidate genes, found an association with the transforming growth-factor alpha (TGFA) locus. This finding has since been replicated, in whole or in part, in three independent studies. Here the authors extend their original analysis of the TGFA TaqI RFLP to two other TGFA RFLPs and seven other RFLPs at five candidate genes in 117 nonsyndromic cases of CL/P and 113 controls. The other candidate genes were the retinoic acid receptor (RARA), the bcl-2 oncogene, and the homeobox genes 2F, 2G, and EN2. Significant associations with the TGFA TaqI and BamHI RFLPs were confirmed, although associations of clefting with previously reported haplotypes did not reach significance. Of particular interest, in view of the known teratogenic role of retinoic acid, was a significant association with the RARA PstI RFLP (P = .016; not corrected for multiple testing). The effect on risk of the A2 allele appears to be additive, and although the A2A2 homozygote only has an odds ratio of about 2 and recurrence risk to first-degree relatives ([lambda][sub 1]) of 1.06, because it is so common it may account for as much as a third of the attributable risk of clefting. There is no evidence of interaction between the TGFA and RARA polymorphisms on risk, and jointly they appear to account for almost half the attributable risk of clefting. 43 refs., 1 fig., 4 tabs.

  13. Electrophysiological assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate.

    Science.gov (United States)

    Ma, Xiaoran; McPherson, Bradley; Ma, Lian

    2016-01-01

    Cleft lip and/or palate is a common congenital craniofacial malformation found worldwide. A frequently associated disorder is conductive hearing loss, and this disorder has been thoroughly investigated in children with non-syndromic cleft lip and/or palate (NSCL/P). However, analysis of auditory processing function is rarely reported for this population, although this issue should not be ignored since abnormal auditory cortical structures have been found in populations with cleft disorders. The present study utilized electrophysiological tests to assess the auditory status of a large group of children with NSCL/P, and investigated whether this group had less robust central auditory processing abilities compared to craniofacially normal children. 146 children with NSCL/P who had normal peripheral hearing thresholds, and 60 craniofacially normal children aged from 6 to 15 years, were recruited. Electrophysiological tests, including auditory brainstem response (ABR), P1-N1-P2 complex, and P300 component recording, were conducted. ABR and N1 wave latencies were significantly prolonged in children with NSCL/P. An atypical developmental trend was found for long latency potentials in children with cleft compared to control group children. Children with unilateral cleft lip and palate showed a greater level of abnormal results compared with other cleft subgroups, whereas the cleft lip subgroup had the most robust responses for all tests. Children with NSCL/P may have slower than normal neural transmission times between the peripheral auditory nerve and brainstem. Possible delayed development of myelination and synaptogenesis may also influence auditory processing function in this population. Present research outcomes were consistent with previous, smaller sample size, electrophysiological studies on infants and children with cleft lip/palate disorders. In view of the these findings, and reports of educational disadvantage associated with cleft disorders, further research

  14. Electrophysiological assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

    Directory of Open Access Journals (Sweden)

    Xiaoran Ma

    2016-08-01

    Full Text Available Objectives Cleft lip and/or palate is a common congenital craniofacial malformation found worldwide. A frequently associated disorder is conductive hearing loss, and this disorder has been thoroughly investigated in children with non-syndromic cleft lip and/or palate (NSCL/P. However, analysis of auditory processing function is rarely reported for this population, although this issue should not be ignored since abnormal auditory cortical structures have been found in populations with cleft disorders. The present study utilized electrophysiological tests to assess the auditory status of a large group of children with NSCL/P, and investigated whether this group had less robust central auditory processing abilities compared to craniofacially normal children. Methods 146 children with NSCL/P who had normal peripheral hearing thresholds, and 60 craniofacially normal children aged from 6 to 15 years, were recruited. Electrophysiological tests, including auditory brainstem response (ABR, P1-N1-P2 complex, and P300 component recording, were conducted. Results ABR and N1 wave latencies were significantly prolonged in children with NSCL/P. An atypical developmental trend was found for long latency potentials in children with cleft compared to control group children. Children with unilateral cleft lip and palate showed a greater level of abnormal results compared with other cleft subgroups, whereas the cleft lip subgroup had the most robust responses for all tests. Conclusion Children with NSCL/P may have slower than normal neural transmission times between the peripheral auditory nerve and brainstem. Possible delayed development of myelination and synaptogenesis may also influence auditory processing function in this population. Present research outcomes were consistent with previous, smaller sample size, electrophysiological studies on infants and children with cleft lip/palate disorders. In view of the these findings, and reports of educational

  15. Early post-natal development of the mandibular permanent first molar in infants with unilateral complete cleft lip and palate

    DEFF Research Database (Denmark)

    Hermann, N. V.; Darvann, Tron Andre; Kreiborg, S.

    2017-01-01

    and crown of M1(inf) in children with combined cleft lip and palate. Design: Retrospective, longitudinal study. Cephalometric X-rays of 47 consecutive Danish children with UCCLP (37 males; 10 females) and 44 with unilateral incomplete cleft lip (UICL) (29 males; 15 females) examined at 2 and 22 months......Objectives: Studies have shown that the mandibular permanent first molar (M1(inf)) in young children with isolated cleft palate is characterized by delay in maturation and has reduced crown width. Consequently, it is of interest to investigate the early maturation and width of the follicle...

  16. Identification of microdeletions in candidate genes for cleft lip and/or palate

    DEFF Research Database (Denmark)

    Shi, Min; Mostowska, Adrianna; Jugessur, Astanand

    2009-01-01

    BACKGROUND: Genome-wide association studies are now used routinely to identify genes implicated in complex traits. The panels used for such analyses can detect single nucleotide polymorphisms and copy number variants, both of which may help to identify small deleted regions of the genome that may...... contribute to a particular disease. METHODS: We performed a candidate gene analysis involving 1,221 SNPs in 333 candidate genes for orofacial clefting, using 2,823 samples from 725 two- and three-generation families with a proband having cleft lip with or without cleft palate. We used SNP genotyping, DNA...... for deletion detection. Apparent Mendelian inconsistencies between parents and children suggested deletion events in 15 individuals in 11 genomic regions. We confirmed deletions involving CYP1B1, FGF10, SP8, SUMO1, TBX1, TFAP2A, and UGT7A1, including both de novo and familial cases. Deletions of SUMO1, TBX1...

  17. The Effects of Essential Oil of Galbanum on Caffeine Induced-Cleft palate in Rat Embryos

    Directory of Open Access Journals (Sweden)

    Mahmood Khaksary-Mahabady

    2014-02-01

    Full Text Available Background: Caffeine at high doses is a known rodent teratogen and induces limb malformations along with cleft palate in various strains of rats and mice. The teratogenic effects of some drugs can be prevented by the application of antioxidant drugs and stimulation of the maternal immune system. Also, there is some evidence that galbanum is antioxidant. Therefore, in this study, the prophylactic effect of galbanum on teratogenic effects of caffeine was evaluated. Materials and Methods: This experimental study was performed on 28 pregnant rats that were divided into four groups. Control group received normal saline and test groups received caffeine (80 mg/kg, caffeine (80 mg/kg plus galbanum (200 mg/kg and galbanum (200 mg/kg, intraperitonealy at 9-11thP Pdays of gestation, respectively. Fetuses were collected at 20thP Pday of gestation and after determination of weight and length; they were stained by Alizarin red - Alcian blue method. Results: Cleft palate incidence was 33.3%, in caffeine group and decreased to 8.3% by galbanum. The mean of weight and length of fetuses from rat that received galbanum were significantly greater than those received only caffeine. Conclusion: It is concluded that galbanum decreased cleft palate induced by caffeine; but its mechanism needs more details evaluation.

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

    Science.gov (United States)

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

    2012-04-01

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

  19. Autologous fat injection combined with palatoplasty and pharyngoplasty for velopharyngeal insufficiency and cleft palate: preliminary experience.

    Science.gov (United States)

    Cao, Yimei; Ma, Tingting; Wu, Di; Yin, Ningbei; Zhao, Zhenmin

    2013-08-01

    The aim was to evaluate clinical application of autologous fat transplantation in the posterior pharynx to treat velopharyngeal incompetence and cleft palate. Case series with chart review. Cleft Lip and Palate Center of Plastic Surgery Hospital, an academic medical center. We studied 11 patients (age, 5-26 years) with a cleft palate and velopharyngeal insufficiency who underwent autologous fat injection. Patients were followed for 9 to 40 months. Pronunciation evaluation, visual appearance of the palatopharyngeal area, nasopharyngeal fibroscopy (NPF), palatopharyngeal lateral radiography, and magnetic resonance imaging (MRI) were undertaken before and after the operation. Speech intelligibility was markedly increased in all patients. Pronunciation was good to excellent compared with the preoperative level (P = .001). Mean velopharyngeal insufficiency rate was significantly reduced from 26.05% to 6.96% (P = .028) by NPF and from 26.42% to 7.11% (P = .017) by MRI (axial plane). Magnetic resonance imaging indicated significantly reduced mean minimum velopharyngeal distance, from 10.39 to 3.65 mm (P = .012) in the sagittal plane, and markedly increased thickness of transplanted fat in the posterior pharyngeal wall (sagittal, 5.43 mm; axial, 4.74 mm). There were few complications (sleep apnea, nasopharyngeal regurgitation). Autologous fat transplantation in the posterior pharyngeal wall was a good method for treating velopharyngeal incompetence. The safety profile was good in our sample, and we got a consistent result in the follow-up period. In addition, it also could be combined with routine surgery.

  20. A case report of acampomelic campomelic dysplasia and operative difficulties in cleft palate reconstruction

    Directory of Open Access Journals (Sweden)

    M Pasupathy

    2016-01-01

    Full Text Available Acampomelic campomelic dysplasia (CD is a type of CD (CD; OMIM #114290, a rare form of congenital short-limbed dwarfism and is due to mutations in SOX9 gene family. Characteristic phenotypes of CD include bowing of the lower limbs, a narrow thoracic cage, 11 pairs of ribs, hypoplastic scapulae, macrocephaly, flattened supraorbital ridges and nasal bridge, cleft palate and micrognathia. The bending of the long bones is not an obligatory feature and is absent in about 10% of cases, referred to as acampomelic CD. A child previously diagnosed with acampomelic CD was brought to our outpatient clinic for cleft palate reconstruction. Our neurosurgeon cautioned us against performing surgery with extension of the neck in view of the possibility of producing quadriparesis, due to narrowing of the spinal canal as part of the osseous anomaly noted in the magnetic resonance imaging study of the spine, thus making the anaesthesia, surgical and post-operative procedures difficult. The cleft palate reconstruction was performed with all precautions and was uneventful.

  1. Horizontal and vertical maxillary osteotomy stability, in cleft lip and palate patients, using allogeneic bone graft

    Directory of Open Access Journals (Sweden)

    Kelston Ulbricht Gomes

    2013-10-01

    Full Text Available OBJECTIVE: This study was carried out to evaluate maxillary stability after orthodontic-surgical treatment of patients with cleft lip and palate. Cephalometric analysis was applied to two different groups, with and without allogeneic bone graft. METHODS: The sample comprised 48 patients with cleft lip and palate. The test group comprised 25 patients who, after correction of maxillary position, received allogeneic bone graft at the gap created by Le Fort I osteotomy. The control group comprised 23 patients and its surgical procedures were similar to those applied to the test group, except for the use of bone graft. Manual cephalometric analysis and comparison between lateral teleradiographs, obtained at the preoperative phase, immediate postoperative phase and after a minimum period of six months, were carried out. RESULTS: An higher horizontal relapse was observed in the control group (p0.05. CONCLUSION: The use of allogeneic bone graft in cleft lip and palate patients submitted to Le Fort I osteotomy contributed to increase postoperative stability when compared to surgeries without bone graft.

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

    Directory of Open Access Journals (Sweden)

    Luciane Macedo de Menezes

    2012-04-01

    Full Text Available OBJECTIVE: The establishment of normal occlusal relationships in patients with cleft lip and palate using rapid maxillary expansion may promote good conditions for future rehabilitation. OBJECTIVE: This study describes the clinical case of monozygotic twins with unilateral cleft lip and palate at the age of mixed dentition, who were treated using the same rapid maxillary expansion protocol, but with two different screws (conventional and fan-type expansion screw. Results were evaluated using plaster models, intraoral and extraoral photographs, and Cone-Beam computed tomography (CBCT scans obtained before the beginning of the treatment, (T1. METHODS: The patients were followed up for 6 months after maxillary expansion, when the same tests requested at T1 were obtained again for review (T2. T1 and T2 results were compared using lateral cephalometric tracings and measurements of the intercanine and intermolar distances in the plaster models using a digital caliper. RESULTS: The two types of expansion screws corrected the transverse discrepancy in patients with cleft lip and palate. The shape of the upper arches improved at 10 days after activation. CONCLUSION: CBCT scans provide detailed information about craniofacial, maxillary and mandibular changes resulting from rapid maxillary expansion. The most adequate screw for each type of malocclusion should be chosen after detailed examination of the dental arches.

  3. Acoustic analysis of voice in children with cleft palate and velopharyngeal insufficiency.

    Science.gov (United States)

    Villafuerte-Gonzalez, Rocio; Valadez-Jimenez, Victor M; Hernandez-Lopez, Xochiquetzal; Ysunza, Pablo Antonio

    2015-07-01

    Acoustic analysis of voice can provide instrumental data concerning vocal abnormalities. These findings can be used for monitoring clinical course in cases of voice disorders. Cleft palate severely affects the structure of the vocal tract. Hence, voice quality can also be also affected. To study whether the main acoustic parameters of voice, including fundamental frequency, shimmer and jitter are significantly different in patients with a repaired cleft palate, as compared with normal children without speech, language and voice disorders. Fourteen patients with repaired unilateral cleft lip and palate and persistent or residual velopharyngeal insufficiency (VPI) were studied. A control group was assembled with healthy volunteer subjects matched by age and gender. Hypernasality and nasal emission were perceptually assessed in patients with VPI. Size of the gap as assessed by videonasopharyngoscopy was classified in patients with VPI. Acoustic analysis of voice including Fundamental frequency (F0), shimmer and jitter were compared between patients with VPI and control subjects. F0 was significantly higher in male patients as compared with male controls. Shimmer was significantly higher in patients with VPI regardless of gender. Moreover, patients with moderate VPI showed a significantly higher shimmer perturbation, regardless of gender. Although future research regarding voice disorders in patients with VPI is needed, at the present time it seems reasonable to include strategies for voice therapy in the speech and language pathology intervention plan for patients with VPI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. 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.

  5. Development of Information System for Patients with Cleft Lip and Palate undergoing Operation.

    Science.gov (United States)

    Augsornwan, Darawan; Pattangtanang, Pantamanas; Surakunprapha, Palakorn

    2015-08-01

    Srinagarind Hospital has 150-200 patients with cleft lip and palate each year. When patients are admitted to hospital for surgery patients and family feel they are in a crisis of life, they feel fear anxiety and need to know about how to take care of wound, they worry if patient will feel pain, how to feed patients and many things about patients. Information is very important for patients/family to prevent complications and help their decision process, decrease parents stress and encourage better co-operation. To develop information system for patients with cleft lip-palate undergoing operation. This is an action research divided into 3 phases. Phase 1 Situation review: in this phase we interview, nursing care observation, and review nursing documents about the information giving. Phase 2 Develop information system: focus groups, for discussion about what nurses can do to develop the system to give information to patients/parents. Phase 3 evaluation: by interviewing 61 parents using the structure questionnaire. 100 percent of patients/parents received information but some items were not received. Patients/parents satisfaction was 94.9 percent, no complications. The information system development provides optimal care for patients and family with cleft lip and palate, but needs to improve some techniques or tools to give more information and evaluate further the nursing outcome after.

  6. Quality of life of patients with cleft lip palate in east Indonesia

    Directory of Open Access Journals (Sweden)

    KJ Li

    2016-06-01

    Full Text Available In patients with a cleft, the lip as well as the palate can be involved. According to Rocher et al(2010 it presents the majority of congenital malformations in the craniofacial aria. It’s prevalence and appearance depends on the ethnicity, socio-economic state and the geographic location. In the Western world the prevalence is estimated on 1 in 650, and in Asia 1 in 440. As facial disfiguration can influence enormously the quality of life it is of utmost interest to investigate the influence of surgical treatment on quality of life in patient with a cleft lip and palate. The aim of this study is to do compare the quality of life before and after surgery of cleft lip and palate in East Indonesia.The patients are collected by local dentists, which mostly will be found in rural areas of the Island of Celebes and East-Borneo. Patients are asked to fill questionnaires themselves and by their parents. The questionnaires of patients from 11 years and less will be filled in by their parents. The questionnaire used is the COHIP: Child Oral Health Impact Profile.The questionnaires will be collected and converted by SPSS 20.0 for data processing. The data will all be taken on a nominal level, so the Mann Whitney U test will be used to compare the groups on 1 variable. The discrepancy between the scores pre- and post-surgery will be compared with a Wilcoxon signed rank test.

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

    Science.gov (United States)

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

    2000-01-01

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

  8. [The analysis of formant characteristics of vowels in the speech of patient with cleft palate].

    Science.gov (United States)

    Yang, Xuecai; Li, Ningyi; Bu, Lingxue

    2003-12-01

    To analyze the formant frequency of vowels in the sequence therapy of patient with cleft palate. The formant frequency of vowels [a], [e], [i], [u] of normal children and postoperative patients with and without speech therapy was measured and analyzed by VS-99. 1. The mean value of F1, F2, F3 of [a] did not show significant difference among the three groups (P > 0.05). 2. The difference of mean value of [e] was significant between control group and pre-speech-therapy group, and between pre-speech-therapy and post-speech-therapy group (P 0.05). The mean value of the formant in post-speech-therapy was higher than that of pre-speech-therapy. 3. The difference of mean value of [i] was significant between pre-speech-therapy and post-speech-therapy (P 0.05). Surgical repair of cleft palate cannot make all patients obtain perfect Velopharyngeal competence (VPC), while speech therapy can improve patient's pronunciation. Speech spectrum analysis can judge the effect of cleft palate therapy objectively.

  9. [Nursing intervention and evaluation of postoperative pain in preschool children with cleft lip and palate].

    Science.gov (United States)

    Gong, Caixia; Yan, Miao; Jiang, Fei; Chen, Zehua; Long, Yuan; Chen, Lixian; Zheng, Qian; Shi, Bing

    2014-06-01

    This study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief. A total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared. The postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

  10. Audiovisual materials are effective for enhancing the correction of articulation disorders in children with cleft palate.

    Science.gov (United States)

    Pamplona, María Del Carmen; Ysunza, Pablo Antonio; Morales, Santiago

    2017-02-01

    Children with cleft palate frequently show speech disorders known as compensatory articulation. Compensatory articulation requires a prolonged period of speech intervention that should include reinforcement at home. However, frequently relatives do not know how to work with their children at home. To study whether the use of audiovisual materials especially designed for complementing speech pathology treatment in children with compensatory articulation can be effective for stimulating articulation practice at home and consequently enhancing speech normalization in children with cleft palate. Eighty-two patients with compensatory articulation were studied. Patients were randomly divided into two groups. Both groups received speech pathology treatment aimed to correct articulation placement. In addition, patients from the active group received a set of audiovisual materials to be used at home. Parents were instructed about strategies and ideas about how to use the materials with their children. Severity of compensatory articulation was compared at the onset and at the end of the speech intervention. After the speech therapy period, the group of patients using audiovisual materials at home demonstrated significantly greater improvement in articulation, as compared with the patients receiving speech pathology treatment on - site without audiovisual supporting materials. The results of this study suggest that audiovisual materials especially designed for practicing adequate articulation placement at home can be effective for reinforcing and enhancing speech pathology treatment of patients with cleft palate and compensatory articulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. [The need for clinical guidelines for the comprehensive management of patients with cleft lip and palate].

    Science.gov (United States)

    Guerrero-Abello, Paola; Ariza-Araujo, Yoseth; Caycedo-García, Diego J; Pachajoa, Harry

    2016-02-01

    Objective To identify clinical guidelines for the treatment of cleft lip and / or palate in children under one year of age, published in Colombia and internationally. Method A search was conducted in three databases: PubMed, Lilacs and Scielo with the terms "guideline cleft lip and palate", "protocols cleft lip and palate", "guía clínica labio paladar fisurado", "guía de manejo labio paladar fisurado" and "guía labio paladar hendido". In addition to this, we consulted the websites of all pediatric hospitals in Colombia. Results 190 papers were found, of which 96 were not related to the population or focused on treatment, 84 were disciplinary, 8 interdisciplinary and only two were clinical guidelines. Conclusions There are few published guidelines and there is a lack of unified criteria. This gives rise to numerous forms of intervention and the creation of interdisciplinary teams. Therefore, there is a need to reach a consensus regarding the therapeutic approach in order to create treatment protocols based on evidence with quality standards.

  12. Differential effects of FGFR2 mutations on syndactyly and cleft palate in Apert syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Slaney, S.F.; Oldridge, M.; Wilkie, A.O.M. [Univ. of Oxford (United Kingdom)] [and others

    1996-05-01

    Apert syndrome is a distinctive human malformation characterized by craniosynostosis and severe syndactyly of the hands and feet. It is caused by specific missense substitutions involving adjacent amino acids (Ser252Trp or Pro253Arg) in the linker between the second and third extracellular immunoglobulin domains of fibroblast growth factor receptor 2 (FGFR2). We have developed a simple PCR assay for these mutations in genomic DNA, based on the creation of novel SfiI and BstUI restriction sites. Analysis of DNA from 70 unrelated patients with Apert syndrome showed that 45 had the Ser252Trp mutation and 25 had the Pro253Arg mutation. Phenotypic differences between these two groups of patients were investigated. Significant differences were found for severity of syndactyly and presence of cleft palate. The syndactyly was more severe with the Pro253Arg mutation, for both the hands and the feet. In contrast, cleft palate was significantly more common in the Ser252Trp patients. No convincing differences were found in the prevalence of other malformations associated with Apert syndrome. We conclude that, although the phenotype attributable to the two mutations is very similar, there are subtle differences. The opposite trends for severity of syndactyly and cleft palate in relation to the two mutations may relate to the varying patterns of temporal and tissue-specific expression of different fibroblast growth factors, the ligands for FGFR2. 54 refs., 5 figs., 3 tabs.

  13. The parameters of care for cleft lip and palate patients in Aarhus, Denmark.

    Science.gov (United States)

    Enemark, H; Bolund, S; Grymer, L; Jørgensen, I; Sindet-Pedersen, S; Willadsen, E

    1996-01-01

    Aarhus Cleft Palate Institute receives approximately 75 new cleft patients a year. Due to statuary notification of all newborn cleft patients to the Institute, the treatment protocol can be offered to the family from right after birth, and a coordinated team approach can be established. The individually planned primary surgery, speech and growth of the maxillo-facial skeleton is followed by regular team examinations. Speech development is followed from the child is one year old in order to be able to provide speech assessment as soon as problems of hypernasality and articulation disorders or language delay is evident. One of the goals of speech assessment is to achieve acceptable speech as early as possible and at best before school start. Orthodontic treatment is usually started at 8 years of age, in UCLP and BCLP patients in combination with bonegrafting at 9-11 years of age. In patients with impaired growth of the maxilla, attention is paid to identify candidates for orthognathic surgical treatment as early as possible. All secondary surgical treatment on jaws, lips and nose are coordinated and usually the treatment can be finished by the late teens. The described team approach towards the parameters of care for cleft lip and palate patients has basically been used for more than 50 years. A systematic follow-up and data collection on all patients provide a scientific base for evaluation of treatment results. Based on long-term investigations the protocol has gradually been modified during time to improve the quality of patient care.

  14. 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

  15. 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.

  16. Nonsyndromic cleft lip and palate: Evidence of linkage to a microsatellite marker on 6p23

    Energy Technology Data Exchange (ETDEWEB)

    Carinci, F.; Pezzetti, F.; Scapoli, L.; Padula, E.; Baciliero, U.; Curioni, C.; Tognon, M.

    1995-01-01

    Nonsydromic cleft lip with or without secondary clefting of the palate (CL+/{minus}P) is one of the most common birth defects. A previous linkage study concerning CL+/{minus}P and cleft palate (CP) families indicated chromosome 6p, near F13A locus, as a possible region for the presence of a clefting gene. More recently, another linkage study performed on a sample of 12 families with nonsyndromic CL+/{minus}P seemed to exclude this association. To test the hypothesis on the possible presence of a major gene on chromosome 6p, we carried out a study on a large sample (21) of CL+/{minus}P families from northeastern Italy. In conclusion, our investigation can be summarized as follows: (i) CL+/{minus}P disease appears to be heterogeneous; (ii) {approximately}66% of the pedigrees showed an autosomal dominant inheritance with incomplete penetrance; and (iii) CL+/{minus}P locus maps on 6p23 very close to or at the microsatellite marker D6S89. To verify whether the D6S89 is the closest marker to the CL+/{minus}P locus, additional examinations with new markers are underway. 19 refs., 1 fig., 1 tab.

  17. MOTHERS' EXPERIENCES WHEN THEIR INFANTS WERE DIAGNOSED WITH CLEFT LIPS ANDIOR PALATES

    Directory of Open Access Journals (Sweden)

    Brenda Louw

    2011-11-01

    Full Text Available Traditionally the diagnosis of cleft lip and palate was made at birth or soon thereafter, but modem technology has led to the identification of cleft lip prenatally The aim of this study was to describe 16 mothers' experiences of pre- and postnatal diagnosis of their infants' cleft lip and palate, and to develop clinical guidelines for craniofacial team members, to meet parental expectations and needs in both pre- and postnatal periods. In order to provide the best possible care to each affected child and the most effective support to each mother, it is of the utmost importance that craniofacial teams have guidelines to assist them in developing a more accountable, effective and sensitive service to these mothers. An exploratory, descriptive quantitative survey research design was selected to describe mothers' reactions to and perceptions of the pre- and postnatal diagnosis. Scheduled structured interviews were used as a data collecting technique. The results indicated that, irrespective of the time of diagnosis, the mothers required support that included emotional support, information, interaction with other parents of children with clefts, and a team approach. This study emphasised the importance of understanding parental preferences in order to enhance the team approach and also highlighted the need for further research.

  18. Language Development in Children With Cleft Palate With or Without Cleft Lip Adopted From Non-English-Speaking Countries.

    Science.gov (United States)

    Morgan, Amy R; Bellucci, Claudia Crilly; Coppersmith, Jody; Linde, Sebastian B; Curtis, Arthur; Albert, Meredith; O'Gara, Mary M; Kapp-Simon, Kathleen

    2017-05-17

    The purpose of this study was to determine whether language skills differed between children with cleft palate or cleft lip and palate (CP±CL) who were adopted into an English-speaking home from a non-English-speaking country (late English exposure [LE]) and children with CP±CL raised from birth in an English-speaking home (early English exposure [EE]). Children (51 LE, 67 EE), ages 3;0 (years;months) to 9;0, completed the Clinical Evaluation of Language Fundamentals (CELF), Preschool Second Edition or Fourth Edition. Linear regression analysis was used to assess the impact of age of adoption and time in an English-speaking home on language skills, as measured by the CELF-P2 and CELF-4. Children with CP±CL who were adopted scored less well on all language indices, with mean adjusted differences between LE and EE children ranging from 0.4 to 0.7 SD on the CELF index scales. Only 53% of the EE children and 57% of the LE children obtained scores above 90 on all indices. For LE children, younger age at adoption was associated with better language skills. CP±CL increases risk for language delay, with the highest risk for LE children. LE children with CP±CL should receive language services soon after adoption.

  19. High-Resolution Array Comparative Genomic Hybridization Utility in Polish Newborns with Isolated Cleft Lip and Palate.

    Science.gov (United States)

    Szczałuba, Krzysztof; Nowakowska, Beata A; Sobecka, Katarzyna; Smyk, Marta; Castaneda, Jennifer; Dudkiewicz, Zofia; Kutkowska-Kaźmierczak, Anna; Sąsiadek, Maria M; Śmigiel, Robert; Bocian, Ewa

    2015-01-01

    Cleft lip with or without cleft palate is one of the most common birth defects of unknown etiology. A fraction of its genetic causes is attributable to copy number variations detected by array comparative genomic hybridization. The value of array comparative genomic hybridization screening as a first-tier test in the newborn population with multiple congenital anomalies has now been accepted. Due to unspecific clinical picture at this age, it can also be applied to neonates with isolated anomalies. Our purpose was to assess utility of array comparative genomic hybridization in the population of newborns with isolated cleft lip and palate. We conducted the study in a group of 52 Polish newborns with apparently isolated cleft lip and palate. In the study group, we found 8 rearrangements. Of these, 2 de novo events have been noted that potentially explain the phenotype. In addition, 2 novel candidate genes for cleft lip and palate, CHN2 and CDH19, are suggested. Given the high number of inherited potentially benign changes, we question the clinical utility of array comparative genomic hybridization in the newborn population with isolated cleft lip and palate, at the same time pointing to the need of skilled professional's clinical assessment at a later age. However, the value of this technology in searching for the cause of isolated anomalies cannot be underestimated. © 2015 S. Karger AG, Basel.

  20. Early Orthopedic Retraction of the Premaxilla in Bilateral Complete Cleft Lip and Palate: An Innovative Approach to a Difficult Problem.

    Science.gov (United States)

    Mahmood, Rizwan; Flood, Tim; Robinson, Stephen; Al-Gholmy, Mohammed

    2016-05-01

    Bilateral cleft lip and palate occurs in 9.2% of cleft patients. Many approaches have been adopted to manage the protrusive premaxillary segment in patients with bilateral cleft lip and palate. Some advocate the use of intraoral appliances, occasionally combined with invasive surgery, which often requires revision at a later date. The authors describe the case of a 3-year-old child born with bilateral cleft lip and palate presenting with a protuberant premaxilla and an overjet greater than 25 mm. Prompt intervention was warranted in this case due to the potential for traumatic compromise to the dentition of the premaxillary segment and a distinct lack of social integration reported by the parents. The patient was managed with a novel, innovative approach using orthodontic traction and minimally invasive surgery. The literature has been reviewed and the patient's subsequent physiological and psychosocial development has been monitored. He has since undergone successful alveolar bone grafting.

  1. 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.

  2. Behavioral Signs of (Central) Auditory Processing Disorder in Children With Nonsyndromic Cleft Lip and/or Palate: A Parental Questionnaire Approach.

    Science.gov (United States)

    Ma, Xiaoran; McPherson, Bradley; Ma, Lian

    2016-03-01

    Objective Children with nonsyndromic cleft lip and/or palate often have a high prevalence of middle ear dysfunction. However, there are also indications that they may have a higher prevalence of (central) auditory processing disorder. This study used Fisher's Auditory Problems Checklist for caregivers to determine whether children with nonsyndromic cleft lip and/or palate have potentially more auditory processing difficulties compared with craniofacially normal children. Methods Caregivers of 147 school-aged children with nonsyndromic cleft lip and/or palate were recruited for the study. This group was divided into three subgroups: cleft lip, cleft palate, and cleft lip and palate. Caregivers of 60 craniofacially normal children were recruited as a control group. Hearing health tests were conducted to evaluate peripheral hearing. Caregivers of children who passed this assessment battery completed Fisher's Auditory Problems Checklist, which contains 25 questions related to behaviors linked to (central) auditory processing disorder. Results Children with cleft palate showed the lowest scores on the Fisher's Auditory Problems Checklist questionnaire, consistent with a higher index of suspicion for (central) auditory processing disorder. There was a significant difference in the manifestation of (central) auditory processing disorder-linked behaviors between the cleft palate and the control groups. The most common behaviors reported in the nonsyndromic cleft lip and/or palate group were short attention span and reduced learning motivation, along with hearing difficulties in noise. Conclusion A higher occurrence of (central) auditory processing disorder-linked behaviors were found in children with nonsyndromic cleft lip and/or palate, particularly cleft palate. Auditory processing abilities should not be ignored in children with nonsyndromic cleft lip and/or palate, and it is necessary to consider assessment tests for (central) auditory processing disorder when an

  3. Loss of lysyl oxidase-like 3 causes cleft palate and spinal deformity in mice

    Science.gov (United States)

    Zhang, Jian; Yang, Rui; Liu, Ziyi; Hou, Congzhe; Zong, Wen; Zhang, Aizhen; Sun, Xiaoyang; Gao, Jiangang

    2015-01-01

    In mammals, embryonic development are highly regulated morphogenetic processes that are tightly controlled by genetic elements. Failure of any one of these processes can result in embryonic malformation. The lysyl oxidase (LOX) family genes are closely related to human diseases. In this study, we investigated the essential role of lysyl oxidase-like 3 (LOXL3), a member of the LOX family, in embryonic development. Mice lacking LOXL3 exhibited perinatal lethality, and the deletion of the Loxl3 gene led to impaired development of the palate shelves, abnormalities in the cartilage primordia of the thoracic vertebrae and mild alveolar shrinkage. We found that the obvious decrease of collagen cross-links in palate and spine that was induced by the lack of LOXL3 resulted in cleft palate and spinal deformity. Thus, we provide critical in vivo evidence that LOXL3 is indispensable for mouse palatogenesis and vertebral column development. The Loxl3 gene may be a candidate disease gene resulting in cleft palate and spinal deformity. PMID:26307084

  4. Loss of lysyl oxidase-like 3 causes cleft palate and spinal deformity in mice.

    Science.gov (United States)

    Zhang, Jian; Yang, Rui; Liu, Ziyi; Hou, Congzhe; Zong, Wen; Zhang, Aizhen; Sun, Xiaoyang; Gao, Jiangang

    2015-11-01

    In mammals, embryonic development are highly regulated morphogenetic processes that are tightly controlled by genetic elements. Failure of any one of these processes can result in embryonic malformation. The lysyl oxidase (LOX) family genes are closely related to human diseases. In this study, we investigated the essential role of lysyl oxidase-like 3 (LOXL3), a member of the LOX family, in embryonic development. Mice lacking LOXL3 exhibited perinatal lethality, and the deletion of the Loxl3 gene led to impaired development of the palate shelves, abnormalities in the cartilage primordia of the thoracic vertebrae and mild alveolar shrinkage. We found that the obvious decrease of collagen cross-links in palate and spine that was induced by the lack of LOXL3 resulted in cleft palate and spinal deformity. Thus, we provide critical in vivo evidence that LOXL3 is indispensable for mouse palatogenesis and vertebral column development. The Loxl3 gene may be a candidate disease gene resulting in cleft palate and spinal deformity. © The Author 2015. Published by Oxford University Press.

  5. Linkage study of nonsyndromic cleft lip with or without cleft palate using candidate genes and mapped polymorphic markers

    Energy Technology Data Exchange (ETDEWEB)

    Stein, J.D.; Nelson, L.D.; Conner, B.J. [Univ. of Texas, Houston (United States)] [and others

    1994-09-01

    Nonsyndromic cleft lip with or without cleft palate (CL(P)) involves fusion or growth failure of facial primordia during development. Complex segregation analysis of clefting populations suggest that an autosomal dominant gene may play a role in this common craniofacial disorder. We have ascertained 16 multigenerational families with CL(P) and tested linkage to 29 candidate genes and 139 mapped short tandem repeat markers. The candidate genes were selected based on their expression in craniofacial development or were identified through murine models. These include: TGF{alpha}, TGF{beta}1, TGF{beta}2, TGF{beta}3, EGF, EGFR, GRAS, cMyc, FGFR, Jun, JunB, PDFG{alpha}, PDGF{beta}, IGF2R, GCR Hox7, Hox8, Hox2B, twirler, 5 collagen and 3 extracellular matrix genes. Linkage was tested assuming an autosomal dominant model with sex-specific decreased penetrance. Linkage to all of the candidate loci was excluded in 11 families. RARA was tested and was not informative. However, haplotype analysis of markers flanking RARA on 17q allowed exclusion of this candidate locus. We have previously excluded linkage to 61 STR markers in 11 families. Seventy-eight mapped short tandem repeat markers have recently been tested in 16 families and 30 have been excluded. The remaining are being analyzed and an exclusion map is being developed based on the entire study results.

  6. Complete trisomy 9 with unusual phenotypic associations: Dandy-Walker malformation, cleft lip and cleft palate, cardiovascular abnormalities.

    Science.gov (United States)

    Tonni, Gabriele; Lituania, Mario; Chitayat, David; Bonasoni, Maria Paola; Keating, Sarah; Thompson, Megan; Shannon, Patrick

    2014-12-01

    Trisomy 9 is a rare chromosomal abnormality usually associated with first-trimester miscarriage; few fetuses survive until the second trimester. We report two new cases of complete trisomy 9 that both present unusual phenotypic associations, and we analyze the genetic pathway involved in this chromosomal abnormality. The first fetus investigated showed Dandy-Walker malformation, cleft lip, and cleft palate) at the second trimester scan. Cardiovascular abnormalities were characterized by a right-sided, U-shaped aortic arch associated with a ventricular septal defect (VSD). Symmetrical intrauterine growth restriction and multicystic dysplastic kidney disease were associated findings. The second fetus showed a dysmorphic face, bilateral cleft lip, hypoplastic corpus callosum, and a Dandy-Walker malformation. Postmortem examination revealed cardiovascular abnormalities such as persistent left superior vena cava draining into the coronary sinus, membranous ventricular septal defect, overriding aorta, pulmonary valve with two cusps and three sinuses, and the origin of the left subclavian artery distal to the junction of ductus arteriosus and aortic arch. Complete trisomy 9 may result in a wide spectrum of congenital abnormalities, and the presented case series contributes further details on the phenotype of this rare aneuploidy. Copyright © 2014. Published by Elsevier B.V.

  7. Temporal osteocutaneous island flaps for complete reconstruction of cleft palate defects.

    Science.gov (United States)

    Furnas, D W

    1987-01-01

    In each of four patients, closure of a wide cleft palate was performed with a temporal osteocutaneous island flap (TOCI flap) based on the superficial temporal artery. These were fabricated island fasciocutaneous flaps composed of temporoparietalis fascia and galea with pericranium, surfaced with split skin grafts. Two flaps carried with them a segment of vascularized parietal bone (TOCI-I). In the other two flaps, the osseus component was supplied by placing an osteogenic powder in a pericranial pocket: a temporal artery "osteogenic" cutaneous flap (TOCI-II). In each case the flap closed the defect and lengthened the palate without the need for elevation of palatal mucoperiosteum. Growth of the parietal bone segment has been observed in the first patient (the only one to have a follow-up CT scan). This patient, the eldest, is developing normal speech so far. The others are still too young for evaluation.

  8. Magnetic resonance imaging of cleft palate patients after a palatoplasty to evaluate the nasopharyngeal results

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Hiroto [Teikyo Univ., Tokyo (Japan). Faculty of Medicine; Kadomatsu, Koichi; Hori, Shigeru; Miyata, Masayuki; Kozono, Kikuo; Onizuka, Takuya

    1995-10-01

    Magnetic resonance imaging (MRI) of 16 cleft palate patients was undertaken after a palatoplasty to evaluate the postoperative status of the nasopharyngeal soft tissue, the soft palate, and a pharyngeal flap. As MRI revealed no abnormal findings in the nasopharyngeal muscle of all 16 patients, we concluded that the palatoplasty had normalized the positioning and volume of the levator veli muscle and the muscle sling of the palate. Further, although most of the pharyngeal flaps had an adequate inner muscle volume, some flaps had shrunk and 1 flap was found to have more mucous tissue than muscle. These pharyngeal flap deficits may have been due to rough flap handling during the surgical intervention. Therefore, gentle manipulation of such flaps during the course of surgery is emphasized. (author).

  9. Two- and three-dimensional sonographic assessment of the fetal face. 2. Analysis of cleft lip, alveolus and palate.

    Science.gov (United States)

    Rotten, D; Levaillant, J M

    2004-09-01

    To describe the sonographic appearance of cleft lip with or without cleft palate (CL +/- P) using two-dimensional and three-dimensional (3D) ultrasound imaging. Also, to evaluate the accuracy of ultrasound to delineate with precision the bony extent of facial clefts, i.e. to differentiate clefts limited to the lips, or extending to the alveolus/premaxilla or the secondary palate. This was a retrospective study based on the examination of fetuses diagnosed with an isolated CL +/- P. Cases included were either discovered at systematic screening or referred for further investigation. Clefts were characterized by their precise anatomical location and extent. The defect could include a cleft lip (CL), a cleft alveolus (CA), or a cleft of the secondary palate (CSP). We analyzed 96 cases of CL +/- P. The mean gestational age at examination was 28.2 +/- 4.1 weeks. The sonographic appearance of CL, CA, and CSP was depicted. Strict concordance of the sonographic report with the anatomical defect was present in 84 cases (87.5%). In eight cases, the severity of the cleft was underestimated: three cases of CA, four of CA + CSP and one of CSP were missed. In four cases, the cleft was overestimated as CA was incorrectly suspected. Systematic screening with sonography to detect prenatally CL +/- P requires the imaging of at least the mid-sagittal and the anterior coronal 'nose-mouth' views. Once the presence of a facial cleft is suspected, the three reference orthogonal planes are imaged in order to characterize the anatomical defect, and for each plane, the serial scans are thoroughly examined. This protocol allows precise delineation of the defect. Inclusion of 3D and 4D ultrasound imaging in the examination protocol allows easier and more rapid screening and more precise evaluation of the different cleft constituents. Copyright 2004 ISUOG

  10. Initial Nutritional Assessment of Infants With Cleft Lip and/or Palate: Interventions and Return to Birth Weight.

    Science.gov (United States)

    Kaye, Alison; Thaete, Kristi; Snell, Audrey; Chesser, Connie; Goldak, Claudia; Huff, Helen

    2017-03-01

      To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design :  Retrospective review.   Tertiary pediatric hospital.   One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012.   Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments.   All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP.   Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

  11. STRESS – THE RISK FACTOR IN THE LIP AND PALATE CLEFT DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Zorica Blazej

    2007-12-01

    Full Text Available Lip and palate cleft (cheilognathopalatoschisis is most often congenital defect that affects craniofacial region. It is characterized by a difficult clinical presentation.The etiology is multicausal and not yet fully understood. The examination of numerous etiological factors imposed the need to study the role of stress in the development of lip and palate cleft. This is all the more important for the socioeconomic factors that characterized our society in the last years, after bombardment, poverty, higher divorce rate, and more family violence. The aim of this paper was to establish the importance of stressful events and their role in the development of lip and palate cleft. The examination included children born from March 1999 (time of war in this area, till December 2003, as well as their mothers.The study group comprised 96 children with the lip and palate cleft anomaly, and the control one included 142 healthy children. The chosen examinees were not under the influence of other etiological factors, such as heritage. The examination was conducted using a questionnaire containing questions related to stressful situations in the first trimester of pregnancy. The questions were thus formed so as to be clear to mothers of different levels of education, without expert phrases,except in the cases where it was necessary. The statistical differences between the study and control group were determined using Pearson's χ2 test. In the first trimester, the mothers of the study group, in regard to the control group,statistically more often had fears or anxiety (p<0.01, disorganized emotional life(p<0.001, more often phychological harassment (p<0.001, and the presence of any kind of harassment (p<0.001. The presence of stress was also greater in the study group, on the significance borderline in relation to the control group.The stressful situations to which mothers of the study group were exposed are in correlation with the increase of the children

  12. Cleft lip and/or palate genetic conditioning – is MMP2 gene polymorphism important for thisdefect development?

    Directory of Open Access Journals (Sweden)

    Marzena Zalewska-Ziob

    2014-09-01

    Full Text Available Introduction: Cleft lip/palate is one of the most common congenital malformations. In Poland, approximately 500 children with an orofacial cleft are born every year. Matrix metalloproteinases are involved in periodontal tissue remodelling and degradation. Polymorphisms in the promoter region of the MMP2 gene may affect transcription and activity of the protein produced by this gene. The aim of the study was to examine 1306 C/T MMP2 gene promoter polymorphisms in the group of children with cleft lip/palate and in the control group as well as to determine the frequency of individual genotypes in different types of orofacial clefts. Material and methods: The study was conducted in the group of 150 children with cleft lip/palate and 102 children without an orofacial cleft. Genomic DNA was obtained from oral mucosa epithelium. The MMP2 gene promoter polymorphism was genotyped by tetra-primer ARMS-PCR. Results: There are no significant differences in the frequency of individual alleles in different types of orofacial clefts. The occurrence of the CC genotype was significantly higher in the group with cleft lip and palate than in the healthy group (p = 0.005. Conclusion: Determining the polymorphism of matrix metalloproteinase gene promoter sequence can contribute to the elucidation of cleft lip/palate aetiopathogenesis.

  13. [Orofacial closure defects: cleft lip and palate. A literature review].

    Science.gov (United States)

    Díaz Casado, G H; Díaz Grávalos, G J

    2013-01-01

    Orofacial clefts are a common problem that can lead to significant healthcare use and costs, as well as suffering on the part of the affected individuals and families. There are several theories explaining their origin, but some of the findings are inconsistent. The most accepted theories involve a major genetic basis that could be modified by the presence of external agents. Understanding the underlying causes could help to prevent its occurrence, an area in which the family physician can play an important role. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  14. Clinical and Radiographic Assessment of Secondary Bone Graft Outcomes in Cleft Lip and Palate Patients

    Science.gov (United States)

    Khalil, W.; de Musis, C. R.; Volpato, L. E. R.; Veiga, K. A.; Vieira, E. M. M.; Aranha, A. M.

    2014-01-01

    Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts. PMID:27351004

  15. Association between gingival recession and proclination of maxillary central incisors near the cleft in patients with unilateral cleft lip and palate: A retrospective case-control study.

    Science.gov (United States)

    Zhu, Shiwen; Chen, Zhenqi

    2013-03-01

    The aim of this study was to investigate whether proclination of the maxillary central incisor near a cleft leads to gingival recession in patients born with unilateral cleft lip and palate. Forty patients with unilateral cleft lip and palate were retrospectively enrolled. By using intraoral slides, casts, and cephalograms, changes in gingival recession and proclination were measured. The 2-sample t test, correlation, and stepwise logistic regression analyses were applied. There were statistically significant differences in proclination variations between subjects with and without increased gingival recession (P gingival recession. Bone grafting during treatment resulted in a significant difference in gingival recession (P gingival recession (odds ratio, 3.06; 95% confidence interval, 1.329-7.046; P = 0.0086). Proclination of the maxillary central incisor adjacent to the cleft is positively correlated with gingival recession in patients with unilateral cleft lip and palate