Smile China Cleft Lip Palate Mission, Provincial Children's Hospital, Lanzhou, China, July 2004

2006 ◽  
Vol 160 (2) ◽  
pp. 119
Keyword(s):  
Cleft Lip ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Cleft Lip Palate

Time Trends and Determinants of Fistula in Cleft Patients at BC Children's Hospital, Canada

2018 ◽  
Vol 55 (7) ◽  
pp. 1013-1019
Author(s):  
Negar Salimi ◽  
Jolanta Aleksejüunienė ◽  
Edwin Yen ◽  
Angelina Loo
Keyword(s):  
Time Trends ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Palatal Fistula ◽  
Children's Hospital ◽  
Time Period ◽  
Treatment Type ◽  
Children’S Hospital ◽  
Total Observation ◽  
Type Of Surgery

Objective: To examine the time trends and determinants of palatal fistula in children with different types of cleft at British Columbia's Children's Hospital between 1995 and 2012. Methods: A total of 558 medical charts of nonsyndromic patients with cleft lip and palate were eligible for the chart review. The occurrence of primary palatal fistula was assessed at any time throughout the patient's total observation period. Three types of clefts were recorded: unilateral cleft lip and palate (ULCLP), bilateral cleft lip and palate (BLCLP), and isolated cleft palate (ICP). Cleft severity, time period of treatment, type of surgery and surgeon's experience were tested as determinants. Results: Of all 558 patients, 228 had ULCLP, 226 had ICP, and 104 had BLCLP. The combined postoperative palatal fistula rate was 28%. The significant differences in fistula rates related to type of cleft (patients with BLCLP had the highest fistula rates), time period (rates were higher in earlier years than in later years), type of surgery (highest rates were for two-flap palatoplasty), and surgeons with less experience. Conclusions: Almost one quarter of the patients, developed fistula, and fistula incidence declined after 2009. The higher fistula rates were determined by cleft severity, time period of treatment, type of surgery, and surgeon's experience.

Factors Associated With Delay in Cleft Surgery at a Tertiary Children’s Hospital in a Major US Metropolitan City

2021 ◽  
pp. 105566562198950
Author(s):  
Jacqueline Stoneburner ◽  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Madeleine S. Williams ◽  
Pedram Goel ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Hispanic Ethnicity ◽  
Delayed Surgery ◽  
Factors Associated ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Syndromic Diagnosis ◽  
Cleft Surgery

Objective: To identify factors associated with late cleft repair at a US tertiary children’s hospital. Design: Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records. Setting: US tertiary children’s hospital. Patients/Participants: Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018. Main Outcome Measures: Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery. Results: In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed. Conclusions: Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.

Unilateral Cleft Lip with or without Cleft Palate and Handedness: Is There an Association?

1998 ◽  
Vol 35 (1) ◽  
pp. 46-51 ◽  
Author(s):  
John Daskalogiannakis ◽  
Kari L. Kuntz ◽  
Albert E. Chudley ◽  
R. Bruce Ross
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Children's Hospital ◽  
Secondary Palate ◽  
Children’S Hospital ◽  
Primary Palate ◽  
The Difference ◽  
Sick Children ◽  
The Right

Objective The purpose of this study was to investigate the possibility of a relationship between the side of occurrence of unilateral clefting of the lip and/or palate and handedness, also taking into account the type of the initial cleft condition, a factor that has not been adequately assessed in previous studies. Design This was a retrospective study. Setting Division of Orthodontics, The Hospital for Sick Children, Toronto, Canada, and Cleft Lip and Palate Program, Children's Hospital, Winnipeg, Canada. Participants Subjects were 289 patients (176 males and 113 females) 9 years of age or older presenting with a history of unilateral clefts of the lip with or without the palate. Of these patients, 217 were recruited from the patient pool of the Orthodontic Clinic at the Hospital for Sick Children in Toronto. The remaining 72 were selected from the registry of the Cleft Lip and Palate Program of the Children's Hospital in Winnipeg. Any syndromic cases were excluded from the sample. Main outcome Measures Assessment of handedness was performed by asking the patients to fill out a multi-item questionnaire in which patients were asked to identify which hand they would use for different tasks. The side and type of the initial cleft condition were identified by reviewing each patient's hospital chart and by cross-referencing with clinical examination. Statistical evaluation of the results was performed by using the chi-square test. Results There was a significantly larger number of left-sided clefts (198) in the sample than right-sided clefts (91), (p < .001). The proportion of left-sided clefts among left-handers (84.6%) was higher than that among right-handers (66.8%). However, the relationship between side of cleft and handedness was not statistically significant (p = .185). Clefts of the primary palate only seemed to occur on the left side 3.5 times more often than on the right, whereas the corresponding ratio of left:right manifestation for clefts of the primary and secondary palate was 1.8:1. The difference was statistically significant (p < .05). Conclusion The findings of this study confirm the affinity of unilateral clefts for the left side but suggest that there are differences between clefts of the primary palate only and clefts of the primary and secondary palate. Also, non-right-handed patients show a greater predilection for having a cleft on the left side than do right-handed patients.

scholarly journals Knowledge and practice of feeding plate obturators among medical doctors in Kanti children’s hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 20-28
Author(s):  
B Pathak ◽  
KR Joshi ◽  
S Bhattarai ◽  
H Joshi
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Treatment Protocol ◽  
Medical Doctors ◽  
Feeding Difficulties ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Knowledge And Practice ◽  
Feeding Plate ◽  
Study Participants

Introduction: Cleft lip and cleft palate (CLCP) affects several systems and functions of the child and result in social and psychological problems.Therefore early repair of CLCP is imperative. Every cleft center follows its own surgical treatment protocol. Before closure of palatal defects, babies with cleft palate have great difficulty in feeding. To overcome this feeding difficulties, use of special bottles, nipples, initial palatal obturator therapy are used. The first exposure of those children are primarily the medical doctors including pediatricians from where they are generally referred to the concerned speciality for repair of CLCP. The aim of this study was to assess the knowledge and practice of orofacial clefts and feeding plate obturator among medical doctors working in Kanti Children’s Hospital (KCH). Method: This was a questionnaire based survey among medical doctors working in KCH. The pretested questionnaire with 7 questions each on the knowledge and practice of feeding plate obturator was distributed among the medical doctors and data was collected. The data collected were subjected to statistical analysis using frequency of responses and percentages. Results: Of the total 57 study participants, 32 (56.1%) were males and 25 (43.9%) were females. Majority i.e. 61.4% belonged to 31-40 years age group. 91.2% study participants faced the cleft lip/ palate related feeding difficulties 0-5 times/month while 5 (8.8%) faced this condition 6-10 times/ month. Majority of the infants who were less than 28 days (43.9%) attended the OPD due to difficultyin feeding/ swallowing (57.9%) followed by regurgitation/ aspiration (22.8%). 49.1% of the participants thought feeding plate oburator as the best way to feed a cleft patient on discharge from hospital. In their clinical practice, three fourth of paticipants (70.2%) had never seen a patient with feeding plate obturator, half of the participants (50.9%) didn’t advise for feeding plate obturator for patients withcleft palate and 89.5% were not aware of the replacement of feeding plate obturator. Conclusion: There is low exposure regarding the feeding plate obturator among medical doctors in KCH which needs to be reinforced through meaningful continuing education and training programs.

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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