The History of Treatment of Cleft Lip and Palate

Author(s):  
M. Perko
2021 ◽  
pp. 105566562110106
Author(s):  
Matthew Fell ◽  
Jibby Medina ◽  
Kate Fitzsimons ◽  
Miriam Seifert ◽  
Anne Roberts ◽  
...  

Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age. Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Northern Ireland were included in this study. Outcome Measures: Maxillary growth was analyzed using dental models scored by the 5-Year-Olds’ index, and perceptual speech analyses were scored by the Cleft Audit Protocol for Speech – Augmented rating. Results: Forty-one percent of the children achieved good maxillary growth (scores 1 and 2 on 5-Year-Old’ index). Fifty percent of the children achieved normal speech (achieving UK speech standard 1). Maxillary growth was not found to have an impact on speech outcome when described by the 3 UK National Cleft Lip and Palate Speech Audit Outcome Standards. Analysis according to individual speech parameters showed dentalizations to be less prevalent in children with good maxillary growth compared to fair and poor growth ( P = .001). The remaining speech parameters within resonance, nasal airflow, and articulation categories were not significantly associated with maxillary growth. Conclusion: The findings from this study suggest that children with a history of complete UCLP, who have poor maxillary growth, are not at a higher risk of having major speech errors compared to children with good or fair maxillary growth at 5 years of age.


1992 ◽  
Vol 29 (5) ◽  
pp. 470-474 ◽  
Author(s):  
Bente Felix-Schollaart ◽  
Jan B. Hoeksma ◽  
Jean Paul Van De Velde ◽  
Jerôme I. Puyenbroek ◽  
Birte Prahl-Andersen

The reproductive history was studied to evaluate if the three types of solitary, nonsyndromic clefts: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP) are homogeneous entities. Occurrence of fetal loss, maternal health, and drug consumption of the mother during the pregnancy were compared in cases involving three types of clefts. Data was gathered from 87 children with clefts, 55 males and 32 females. Spontaneous abortions and vaginal bleeding were found to occur significantly more often in the (older) mother of a CLP child. This suggests that the factors involved in the etiology of CLP differ from the factors involved in CL and CP. Therefore, grouping of data of the three types of clefts in studies on the etiology should be avoided.


2018 ◽  
Vol 55 (5) ◽  
pp. 682-687 ◽  
Author(s):  
Anas Imran Arshad ◽  
Mohammad Khursheed Alam ◽  
Mohammad Fadhli Khamis

Objectives: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome. Design: Retrospective observational study. Setting: Two regional cleft-referral centers. Main Outcome Measures: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score. Results: According to MHB, a mean (standard deviation) total occlusion score of –8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables—gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty—were analyzed with a logistic regression model. Conclusions: Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.


Author(s):  
Alta Kritzinger ◽  
Brenda Louw ◽  
René Hugo

This study investigated the early communication functioning and hearing abilities of 44 infants with cleft lip and palate, ages 3 to 31 months old. The results revealed that 64% of the subjects had a history of recurrent otitis media with effusion and 33% displayed associated anomalies. 26% of the subjects had mild hearing losses and middle ear pathology at the time of data collection. The subjects as a group displayed average developmental levels for perceptual-cognitive, socio-personal and receptive language skills, but a limited phonetic repertoire and a statistically significant expressive language delay. The results indicated that the subjects experienced a motor developmental delay, but this was not statistically significant. The implications for early communication intervention are to conduct regular hearing measurements and to conduct regular parent-centered therapy with individualized home programmes. Efforts should be directed towards expanding early communication intervention services to include all infants with cleft lip and palate in South Africa.


2016 ◽  
Vol 83 (3) ◽  
pp. 265-268 ◽  
Author(s):  
Adrianna Mostowska ◽  
Kamil K. Hozyasz ◽  
Piotr Wójcicki ◽  
Barbara Biedziak ◽  
Joanna Wesoły ◽  
...  

The project “Searching for new genes and loci involved in cleft lip and palate in the Polish population – genome-wide association study” is a case-control study in a group of unrelated subjects with non-syndromic cleft lip with or without cleft palate (NSCL/P) and healthy individuals with no family history of clefting or other congenital disorders. The overall goal of this grant proposal is to identify novel genetic factors, which can play a significant role in the pathogenesis of orofacial clefts in the Polish population. To accomplish the proposed aim, a two stage genome-wide association study will be performed. In the first stage, Illumina's HumanOmni Express BeadChips arrays will be used to genotype over 700,000 polymorphisms in NSCL/P patients and controls. In the second stage, SNPs showing the most compelling association with the risk of orofacial clefts will be tested in an independent sample set using standard genotyping methods. This research project is expected to be completed in July 2015.


2017 ◽  
Vol 54 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Elizabeth J. Leslie ◽  
Jenna C. Carlson ◽  
Margaret E. Cooper ◽  
Kaare Christensen ◽  
Seth M. Weinberg ◽  
...  

Objective Monozygotic twins of an individual with an orofacial cleft have a significantly elevated risk for orofacial cleft compared with the general population, but still the concordance rate for orofacial cleft in monozygotic twins is about 40% to 50%. The goal of this study was to determine whether unaffected cotwins have an increased frequency of orbicularis oris muscle defects, a subclinical form of orofacial cleft. The presence of such defects may reduce the overall rate of discordance. Method A total of 63 discordant monozygotic and dizygotic twin pairs, 262 unaffected nontwin siblings, and 543 controls with no history of orofacial clefts were assessed for orbicularis oris defects by high-resolution ultrasound. Frequencies were compared by the Fisher exact test. Results Unaffected cotwins from discordant monozygotic pairs had a higher frequency of defects (12.5%) than the other test groups (6.38% to 6.99%), but the difference was not statistically significant ( P = .74). Conclusions In this study, orbicularis oris defects were not statistically significantly more common among the unaffected twins from orofacial cleft discordant twin pairs. The trends in the results warrant future studies with larger sample sizes and additional subclinical phenotypes.


2012 ◽  
Vol 45 (01) ◽  
pp. 115-120 ◽  
Author(s):  
Jyoti Dvivedi ◽  
Sanjay Dvivedi

ABSTRACT Objectives: To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region. Design: A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years. Outcome measures: The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment. Results: Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results. Conclusion: This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.


2006 ◽  
Vol 43 (4) ◽  
pp. 471-476 ◽  
Author(s):  
John Daskalogiannakis ◽  
Gabriëlle E. H. M. Dijkman ◽  
Anne Marie Kuijpers-Jagtman ◽  
R. Bruce Ross

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, and the Cleft Lip and Palate Program, The Hospital for Sick Children, Toronto, Canada. Subjects Nineteen patients (16 male, 3 female) from Nijmegen and 19 patients (16 male, 3 female) from Toronto. Each patient was matched for sex and age with a patient from the other group. The mean ages at which lateral cephalometric radiographs were available for the Nijmegen group were 5.5, 9.9, and 18.3 years, while for the Toronto group these were available at mean ages of 5.3, 10.1, and 18.3 years, respectively. Eighteen patients from the Nijmegen group received an alveolar bone graft at a mean age of 9.5 years (range 8.2 to 13.5 years). None of the patients from Toronto received bone grafts. Main Outcome Measures Eighteen cephalometric variables per radiograph were calculated at each time registration, using Dentofacial Planner cephalometric software. Statistical evaluation was performed with repeated-measures analysis of variance. Results No differences were seen in the maxillary measurements. The patients in the Toronto group had significantly larger mandibles at all three time registrations. Conclusions The Nijmegen and Toronto protocols resulted in similar maxillary projections in patients with UCLP. Comparison of data from other studies supports the contention that the larger profile convexity of the Nijmegen group is a reflection of a genetically determined smaller mandibular size in the Dutch population.


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